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332518
Epidemiology of Hepatitis-C and HIV Co-infection in Asia: A Systematic Review and Meta-analysis


Wednesday, November 4, 2015 : 10:50 a.m. - 11:10 a.m.

Samuel A. Abariga, MD, MS, DTM&H, Division of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, Amherst, Amherst, MA
Roseric Azondekon, MS, MPH, Division of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA
Krishna C. Poudel, PhD, Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA
Audio (mp3) recording Recorded Presentation (mp4)
Background: Infection with hepatitis C virus (HCV) and human immunodeficiency virus (HIV) are estimated to affect 185 and 35 million of the world’s population, respectively. Due to share transmission routes, co-infection is common and can negatively affect the natural course of chronic hepatitis C infection as well as accelerate liver toxicity in HIV patients on antiretroviral therapy. Although public health policy decisions on prevention and treatment of HCV-HIV co-infection depend on reliable epidemiological data, its prevalence in Asia lacks definition.

Methods: We searched: MEDLINE, CINAHL, Global Health, Scopus, PsychINFO, Google Scholar and WHO InfoBase through 2014 for studies on HCV and HIV, conducted in Asia, published in English, confirmed HCV co-infection by Polymerase Chain Reaction (PCR) and data reported on co-infection. We used Freeman–Tukey-type double arcsine square-root transformation to stabilized variance in the raw proportions. We performed meta-analyses and computed prevalence at the 95% confidence interval (CI), by pooling the stabilized proportions using random-effects model.

Results: Twenty-one studies published in five Asian countries between 2004-2014, with 11,249 participants confirmed HIV-HCV co-infection with PCR and thus met inclusion criteria. Pooled prevalence of HCV-HIV co-infection was 32% (95% CI: 21%, 44%). Country level prevalence (95% CI) was: China (8 studies): 54.0% (32.0%, 85.0%); Japan (5 studies): 25% (-13.0%, 64.0%); India (2 studies): 5% (3.0%, 8.0%); Taiwan (2 studies): 37% (6.0%, 68.0%); Indonesia (1 study): 34% (21.0%, 44.0%).

Conclusion: High prevalence of HCV-HIV co-infection exists in Asia. Only 24% of identified studies with data on co-infection used PCR for confirmation of HCV co-infection.

Learning Areas:

Chronic disease management and prevention
Clinical medicine applied in public health
Epidemiology
Public health or related public policy

Learning Objectives:
Describe the epidemiology of HIV and Hepatitis C virus (HCV) Co-infection in Asia Assess the use of polymerase Chain Reaction (PCR) to confirm HCV infection in HIV patients

Keyword(s): HIV/AIDS, Hepatitis C

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a methodology expert, involved in critical appraisal and comparative effectiveness research, including the conduct of systematic reviews and meta-analysis. I am PI and co-PI in several chronic disease epidemiology studies including hypertension, kidney disease and chronic infectious disease such as HIV/AIDS and Hepatitis, as well as and quality of life studies. I have also contributed to the development of Evidence based Clinical Practice Guideline (CPG).
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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