Prevalence and Disease Burden of HCV Coinfection in HIV Cohorts in the Asia Pacific Region: A Systematic Review and Meta-Analysis

AIDS Rev. 2016 Apr-Jun;18(2):68-80.

Abstract

Background: Estimates of the prevalence and disease burden of HIV/HCV coinfection in the Asia Pacific Region are uncertain.

Methods: A systematic review of indexed (PubMed, Embase and Web of Science) and non-indexed cross-sectional and cohort studies (2009-2015) reporting HCV seroprevalence in HIV-positive adults living in the Asia Pacific region was performed. Pooled prevalence estimates were calculated with a DerSimonian-Laird random-effects model.

Results: 39 studies from 10 countries in the Asia Pacific region comprising 89,452 HIV-positive individuals were included. In the high-income Asia Pacific region, HCV coinfection prevalence was 3.8% (95% confidence interval (CI): 3.1-4.5) in Singapore. In East Asia, HCV coinfection prevalence was 8.0% (95% CI: 6.4-9.8) in Hong Kong and 25.5% (95% CI: 17.5-34.4) in general HIV cohorts in China. In South Asia, HCV coinfection prevalence was 4.1% (95% CI: 1.7-7.3) in India and 42.6% (95% CI: 38.7-46.5) in Nepal. In Southeast Asia, HCV coinfection prevalence was 5.5% (95% CI: 4.9-6.1) in Cambodia, 5.3% (95% CI: 4.9-5.7) in Myanmar, and 5.1% (95% CI: 2.7-8.2) in Thailand, but higher in Vietnam (42.5%; 95% CI: 40.8-44.2) and Indonesia (17.9%; 95% CI: 15.0-20.9). The prevalence of HCV coinfection was higher in subpopulations of people who inject drugs (China 81.6%; 95% CI: 74.1-88.0; Nepal 80.8%; 95% CI: 76.4-84.9; Indonesia 81.6%; 95% CI: 71.1-90.3), former blood donors (China 82.9%; 95% CI: 73.9-90.3), and blood transfusion recipients (China 51.0%; 95% CI: 41.7-60.2).

Conclusion: HCV coinfection prevalence within HIV populations is highly variable in the Asia Pacific region, between countries and at-risk populations. Enhanced epidemiological data is required to support scale-up of interferon-free HCV therapy.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Asia, Eastern / epidemiology
  • Coinfection / epidemiology*
  • Coinfection / virology*
  • HIV Infections / complications*
  • HIV Infections / virology
  • Hepacivirus*
  • Hepatitis C / complications*
  • Hepatitis C / virology
  • Humans
  • Prevalence