A Synthesis of Hepatitis C prevalence estimates in Sub-Saharan Africa: 2000-2013.
A Synthesis of Hepatitis C prevalence estimates in Sub-Saharan Africa: 2000-2013.
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DOI：
10.1186/s12879-016-1584-1
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发表时间：
2016-06-13
影响因子：
3.7
通讯作者：
Layden JE
中科院分区：
文献类型：
--
作者：
Mora N;Adams WH;Kliethermes S;Dugas L;Balasubramanian N;Sandhu J;Nde H;Small C;Jose J;Scaglione S;Layden JE
丙型肝炎（HCV）是一种有害的病毒，可以用新的、高效的抗病毒治疗方法治愈，但全球仍有超过1.85亿人保持HCV阳性（绝大多数未被诊断或未经治疗）。重要的是，HCV是慢性肝病和肝癌的主要原因，特别是在撒哈拉以南非洲（SSA），那里的患病率仍然很高，但由于很少有基于人口的流行病证据而不确定。我们的目的是综合现有的数据来计算和强调SSA的HCV疾病负担。采用加权随机效应广义线性混合模型按风险队列、非洲地区（南部、东部、西部和中部非洲）、所用检测类型、出版年份以及估计值是否包括儿童估计患病率。还计算了合并患病率估计值。由于包括儿童在内的研究有限，多变量分析仅限于成人人群中的队列和地区特异性患病率估计。流行率估计值还使用每个区域内已知的成年人口规模进行加权。我们收集了10多年的数据。几乎一半关于SSA中HCV流行率的研究来自西部地区（49%），超过一半的研究来自献血者（25%）或一般人群队列（31%）。在单变量分析中，南部非洲的患病率最低（0.72%），其次是东非（3.00%）、西非（4.14%）和中非（7.82%）。献血者的感染率始终最低（1.78%），其次是孕妇（2.51%）、艾滋病毒共病患者（3.57%）、普通人群（5.41%）、慢性病患者（7.99%）和感染高危人群（10.18%）。在调整了每个地区的人口规模后，SSA中HCV的总体成人患病率从3.82%上升到3.94%。这项荟萃分析及时更新了SSA的HCV疾病负担，并提供了新的流行证据。该研究强调了在描述SSA中的HCV流行时需要考虑队列类型和区域差异，需要进行更多包括儿童的研究，以及在规划公共卫生干预措施时需要考虑这些变化。本文的在线版本（doi：10.1186/s12879-016-1584-1）包含补充材料，可供授权用户使用。
Hepatitis C (HCV) is a deleterious virus that can be cured with new, highly effective anti-viral treatments, yet more than 185 million individuals worldwide remain HCV positive (with the vast majority un-diagnosed or untreated). Of importance, HCV is a leading cause of chronic liver disease and liver cancer, especially in Sub-Saharan Africa (SSA) where the prevalence remains high but uncertain due to little population-based evidence of the epidemic. We aimed to synthesize available data to calculate and highlight the HCV disease burden in SSA. Weighted random-effects generalized linear mixed models were used to estimate prevalence by risk cohort, African region (Southern, Eastern, Western, and Central Africa), type of assay used, publication year, and whether the estimate included children. A pooled prevalence estimate was also calculated. Multi-variable analyses were limited to cohort and region specific prevalence estimates in the adult population due to limited studies including children. Prevalence estimates were additionally weighted using the known adult population size within each region. We included more than 10 years of data. Almost half of the studies on HCV prevalence in SSA were from the Western region (49 %), and over half of all studies were from either blood donor (25 %) or general population cohorts (31 %). In uni-variable analyses, prevalence was lowest in Southern Africa (0.72 %), followed by Eastern Africa at 3.00 %, Western Africa at 4.14 %, and Central Africa at 7.82 %. Blood donors consistently had the lowest prevalence (1.78 %), followed by pregnant women (2.51 %), individuals with comorbid HIV (3.57 %), individuals from the general population (5.41 %), those with a chronic illness (7.99 %), and those at high risk for infection (10.18 %). After adjusting for the population size in each region, the overall adult prevalence of HCV in SSA rose from 3.82 to 3.94 %. This meta-analysis offers a timely update to the HCV disease burden in SSA and offers additional evidence of the burgeoning epidemic. The study highlights the need to account for type of cohort and region variation when describing the HCV epidemic in SSA, the need for more studies that include children, as well as the need to factor in such variations when planning public health interventions. The online version of this article (doi:10.1186/s12879-016-1584-1) contains supplementary material, which is available to authorized users.