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Hepatitis C infection seroprevalence in pregnant women worldwide: a systematic review and meta-analysis

BACKGROUND: Monitoring progress towards the WHO global target to eliminate hepatitis C virus (HCV) infection by 2030, entails reliable prevalence estimates for HCV infection in different populations. Little is known about the global burden of HCV infection in pregnant women. Here, for the first time...

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Autores principales: Abbasi, Farzaneh, Almukhtar, Mustafa, Fazlollahpour-Naghibi, Andarz, Alizadeh, Faezeh, Behzad Moghadam, Kimia, Jafari Tadi, Mehrdad, Ghadimi, Saleh, Bagheri, Kimia, Babaei, Hedye, Bijani, Mohammad Hossein, Rouholamin, Safoura, Razavi, Maryam, Rezaeinejad, Mahroo, Chemaitelly, Hiam, Sepidarkish, Mahdi, Farid-Mojtahedi, Maryam, Rostami, Ali
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10692665/
https://www.ncbi.nlm.nih.gov/pubmed/38045801
http://dx.doi.org/10.1016/j.eclinm.2023.102327
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author Abbasi, Farzaneh
Almukhtar, Mustafa
Fazlollahpour-Naghibi, Andarz
Alizadeh, Faezeh
Behzad Moghadam, Kimia
Jafari Tadi, Mehrdad
Ghadimi, Saleh
Bagheri, Kimia
Babaei, Hedye
Bijani, Mohammad Hossein
Rouholamin, Safoura
Razavi, Maryam
Rezaeinejad, Mahroo
Chemaitelly, Hiam
Sepidarkish, Mahdi
Farid-Mojtahedi, Maryam
Rostami, Ali
author_facet Abbasi, Farzaneh
Almukhtar, Mustafa
Fazlollahpour-Naghibi, Andarz
Alizadeh, Faezeh
Behzad Moghadam, Kimia
Jafari Tadi, Mehrdad
Ghadimi, Saleh
Bagheri, Kimia
Babaei, Hedye
Bijani, Mohammad Hossein
Rouholamin, Safoura
Razavi, Maryam
Rezaeinejad, Mahroo
Chemaitelly, Hiam
Sepidarkish, Mahdi
Farid-Mojtahedi, Maryam
Rostami, Ali
author_sort Abbasi, Farzaneh
collection PubMed
description BACKGROUND: Monitoring progress towards the WHO global target to eliminate hepatitis C virus (HCV) infection by 2030, entails reliable prevalence estimates for HCV infection in different populations. Little is known about the global burden of HCV infection in pregnant women. Here, for the first time to our knowledge, we estimated the global and regional seroprevalence of HCV antibody (Ab) and determinants in pregnant women. METHODS: In this systematic review and meta-analysis study, we searched PubMed/MEDLINE, Web of Science, Embase, Scopus, and SciELO databases for peer-reviewed observational studies between January 1, 2000 and April 1, 2023, without language or geographical restrictions. Pooled global seroprevalence (and 95% confidence interval, CI) were estimated using random-effects meta-analysis and seroprevalences were categorised according to World Health Organization regions and subregions, publishing year, countries’ income and human development index (HDI) levels. We used sensitivity analysis to assess the effect of four large sample size studies on pooled global prevalence through the “leave-one-out” method. We also investigated the association of potential risk factors with HCV seropositivity in pregnant women by subgroup and meta-regression analyses. The Protocol was registered in PROSPERO CRD42023423259. FINDINGS: We included 192 eligible studies (208 datasets), with data for 148,509,760 pregnant women from 53 countries. The global seroprevalence of HCV Ab in pregnant women was 1.80% (95% CI, 1.72–1.89%) and 3.29% (3.01–3.57%) in overall and sensitivity analyses, respectively. The seroprevalence was highest in the Eastern Mediterranean region (6.21%, 4.39–8.29%) and lowest in the Western Pacific region (0.75%, 0.38–1.22%). Subgroup analysis indicated that the seroprevalence of HCV Ab among pregnant women was significantly higher for those with opioid use disorder (51.94%, 95% CI: 37.32–66.39) and HIV infection (4.34%, 95% CI: 2.21–7.06%) than for the general population of pregnant women (1.08%, 95% CI: 1.02–1.15%), as confirmed by multivariable meta-regression (p < 0.001). A significant decreasing trend was observed with increasing human development index levels. Other important risk factors for HCV seropositivity included older age, lower educational levels, poly sexual activity, history of blood transfusion, hospitalization, surgery, abortion and sexual transmitted diseases, having scarification/tattoo or piercing, and testing hepatitis B positive. INTERPRETATION: This meta-analysis showed relatively high burden of exposure to HCV infection (2.2–5.3 million) in pregnant women globally. However, due to substantial heterogeneity between studies, our estimates might be different than the true seroprevalence. Our findings highlighted the need to expand HCV screening for women of reproductive age or during pregnancy, particularly in countries with high prevalence; as well as for more studies that assess safety of existing therapeutic drugs during pregnancy or potentially support development of drugs for pregnant women. FUNDING: There was no funding source for this study.
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spelling pubmed-106926652023-12-03 Hepatitis C infection seroprevalence in pregnant women worldwide: a systematic review and meta-analysis Abbasi, Farzaneh Almukhtar, Mustafa Fazlollahpour-Naghibi, Andarz Alizadeh, Faezeh Behzad Moghadam, Kimia Jafari Tadi, Mehrdad Ghadimi, Saleh Bagheri, Kimia Babaei, Hedye Bijani, Mohammad Hossein Rouholamin, Safoura Razavi, Maryam Rezaeinejad, Mahroo Chemaitelly, Hiam Sepidarkish, Mahdi Farid-Mojtahedi, Maryam Rostami, Ali eClinicalMedicine Articles BACKGROUND: Monitoring progress towards the WHO global target to eliminate hepatitis C virus (HCV) infection by 2030, entails reliable prevalence estimates for HCV infection in different populations. Little is known about the global burden of HCV infection in pregnant women. Here, for the first time to our knowledge, we estimated the global and regional seroprevalence of HCV antibody (Ab) and determinants in pregnant women. METHODS: In this systematic review and meta-analysis study, we searched PubMed/MEDLINE, Web of Science, Embase, Scopus, and SciELO databases for peer-reviewed observational studies between January 1, 2000 and April 1, 2023, without language or geographical restrictions. Pooled global seroprevalence (and 95% confidence interval, CI) were estimated using random-effects meta-analysis and seroprevalences were categorised according to World Health Organization regions and subregions, publishing year, countries’ income and human development index (HDI) levels. We used sensitivity analysis to assess the effect of four large sample size studies on pooled global prevalence through the “leave-one-out” method. We also investigated the association of potential risk factors with HCV seropositivity in pregnant women by subgroup and meta-regression analyses. The Protocol was registered in PROSPERO CRD42023423259. FINDINGS: We included 192 eligible studies (208 datasets), with data for 148,509,760 pregnant women from 53 countries. The global seroprevalence of HCV Ab in pregnant women was 1.80% (95% CI, 1.72–1.89%) and 3.29% (3.01–3.57%) in overall and sensitivity analyses, respectively. The seroprevalence was highest in the Eastern Mediterranean region (6.21%, 4.39–8.29%) and lowest in the Western Pacific region (0.75%, 0.38–1.22%). Subgroup analysis indicated that the seroprevalence of HCV Ab among pregnant women was significantly higher for those with opioid use disorder (51.94%, 95% CI: 37.32–66.39) and HIV infection (4.34%, 95% CI: 2.21–7.06%) than for the general population of pregnant women (1.08%, 95% CI: 1.02–1.15%), as confirmed by multivariable meta-regression (p < 0.001). A significant decreasing trend was observed with increasing human development index levels. Other important risk factors for HCV seropositivity included older age, lower educational levels, poly sexual activity, history of blood transfusion, hospitalization, surgery, abortion and sexual transmitted diseases, having scarification/tattoo or piercing, and testing hepatitis B positive. INTERPRETATION: This meta-analysis showed relatively high burden of exposure to HCV infection (2.2–5.3 million) in pregnant women globally. However, due to substantial heterogeneity between studies, our estimates might be different than the true seroprevalence. Our findings highlighted the need to expand HCV screening for women of reproductive age or during pregnancy, particularly in countries with high prevalence; as well as for more studies that assess safety of existing therapeutic drugs during pregnancy or potentially support development of drugs for pregnant women. FUNDING: There was no funding source for this study. Elsevier 2023-11-17 /pmc/articles/PMC10692665/ /pubmed/38045801 http://dx.doi.org/10.1016/j.eclinm.2023.102327 Text en © 2023 The Author(s) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Articles
Abbasi, Farzaneh
Almukhtar, Mustafa
Fazlollahpour-Naghibi, Andarz
Alizadeh, Faezeh
Behzad Moghadam, Kimia
Jafari Tadi, Mehrdad
Ghadimi, Saleh
Bagheri, Kimia
Babaei, Hedye
Bijani, Mohammad Hossein
Rouholamin, Safoura
Razavi, Maryam
Rezaeinejad, Mahroo
Chemaitelly, Hiam
Sepidarkish, Mahdi
Farid-Mojtahedi, Maryam
Rostami, Ali
Hepatitis C infection seroprevalence in pregnant women worldwide: a systematic review and meta-analysis
title Hepatitis C infection seroprevalence in pregnant women worldwide: a systematic review and meta-analysis
title_full Hepatitis C infection seroprevalence in pregnant women worldwide: a systematic review and meta-analysis
title_fullStr Hepatitis C infection seroprevalence in pregnant women worldwide: a systematic review and meta-analysis
title_full_unstemmed Hepatitis C infection seroprevalence in pregnant women worldwide: a systematic review and meta-analysis
title_short Hepatitis C infection seroprevalence in pregnant women worldwide: a systematic review and meta-analysis
title_sort hepatitis c infection seroprevalence in pregnant women worldwide: a systematic review and meta-analysis
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10692665/
https://www.ncbi.nlm.nih.gov/pubmed/38045801
http://dx.doi.org/10.1016/j.eclinm.2023.102327
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