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Epidemiology of HBV-HCV Coinfection Among Iranian Patients: a Systematic Review and Meta-Analysis by Hamed Z. Anvari, Maryam M. Binabaj, Arezoo Asadi, Milad Abdi, Abolfazl Shakiba, Mohsen Heidary, Mohammad Sholeh

Introduction: Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are major causes of hepatitis, an important disease affecting millions of people worldwide. The present study aimed to estimate the prevalence of HBV-HCV coinfection in Iran and evaluate the demographic and behavioral factors associated with a heterogeneity of results.
Methods: We used MEDLINE/PubMed, Web of Science, SCOPUS, Google Scholar, and 1 Persian database (Scientific Information Database) for a systematic search from January 1, 2005 to February 26, 2022. Data were analyzed based on the city, publication time, enrollment time, number of patients, gender, mean age, and HBV/HCV diagnosis method. The analysis was carried out using R (version 4.2.1) and the metafor package (version 3.8.1).
Results: In total, 2,072 studies were found through databases: PubMed/Medline (n = 224), Scopus (n = 1,092), Web of Science (n = 394), Google Scholar (n = 272), and Scientific Information Database (n = 90). Overall, nine studies with 1,964 male and 1,909 female patients (age average = 38.1) were included in the analysis. The observed proportion ranged from 0.004 to 0.273. The estimated average proportion was μ = 0.040 (95% CI: 0.016 to 0.101). Therefore, the average outcome differed significantly from zero (z = -6.330, p < 0.001).
Conclusions: HBV/HCV coinfection is a challenging and crucial medical condition because of its variable clinical manifestations, increased risk of cirrhosis and HCC, and unpredictable treatment response. There is a heterogeneous distribution pattern of HBV/HCV infection between Iran’s provinces, indicating the necessity of continuous prevention and control measurements and the implementation of further epidemiologic studies for collecting reliable data on HBV/HCV prevalence in different parts of Iran.

DOI: 10.7754/Clin.Lab.2023.230503