Meta-Analysis
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World J Meta-Anal. Feb 28, 2022; 10(1): 12-24
Published online Feb 28, 2022. doi: 10.13105/wjma.v10.i1.12
Hepatitis C virus among blood donors and general population in Middle East and North Africa: Meta-analyses and meta-regressions
Sarwat Mahmud, Hiam Chemaitelly, Ahmed S Alaama, Joumana G Hermez, Laith Abu-Raddad
Sarwat Mahmud, Hiam Chemaitelly, Laith Abu-Raddad, Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Doha 24144, Qatar
Ahmed S Alaama, Joumana G Hermez, Department of Communicable Diseases, HIV/Hepatitis/ STIs Unit, World Health Organization Regional Office for the Eastern Mediterranean, Cairo 11371, Egypt
Author contributions: Mahmud S conducted data extraction and analysis, and wrote the first draft of the paper; Abu-Raddad L conceived and led the design of the study, analyses, and drafting of the article; All authors contributed to data collection and acquisition, and/or database development, and/or discussion and interpretation of the results, and to the writing of the manuscript.
Supported by National Priorities Research Program (NPRP) grant from the Qatar National Research Fund (a member of Qatar Foundation), No. 12S-0216-190094; and the Biostatistics, Epidemiology, and Biomathematics Research Core at Weill Cornell Medicine-Qatar.
Conflict-of-interest statement: The authors have no conflicts of interest to disclose.
PRISMA 2009 Checklist statement: The methodology used for these reviews was informed by the Cochrane Collaboration Handbook, and all findings were reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Laith Abu-Raddad, PhD, Professor, Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Education City, PO Box, Doha 24144, Qatar. lja2002@qatar-med.cornell.edu
Received: August 5, 2021
Peer-review started: August 5, 2021
First decision: September 4, 2021
Revised: September 16, 2021
Accepted: December 31, 2021
Article in press: December 31, 2021
Published online: February 28, 2022
Processing time: 206 Days and 20.8 Hours
Abstract
BACKGROUND

Despite the Middle East and North Africa (MENA) Region reported to have the highest prevalence of hepatitis C virus (HCV) globally, HCV infection levels in the majority of MENA countries remain inadequately characterized. Blood donor data have been previously used as a proxy to assess levels and trends of HCV in the general population, however, it is unclear how comparable these populations are in MENA and whether blood donors provide an appropriate proxy.

AIM

To delineate HCV epidemiology among blood donors and the general population in the MENA.

METHODS

The data source was the systematically gathered MENA HCV Epidemiology Synthesis Project Database. Random-effects meta-analyses and meta-regressions were conducted. For comparison, analyses were conducted for Europe, utilizing the Hepatitis C Prevalence Database of the European Centre for Disease Prevention and Control.

RESULTS

One thousand two hundred and thirteen HCV antibody prevalence measures and 84 viremic rate measures were analyzed for MENA. Three hundred and seventy-seven antibody prevalence measures were analyzed for Europe. In MENA, pooled mean prevalence was 1.58% [95% confidence interval (CI): 1.48%–1.69%] among blood donors and 4.49% (95%CI: 4.10%–4.90%) in the general population. In Europe, pooled prevalence was 0.11% (95%CI: 0.10%–0.13%) among blood donors and 1.59% (95%CI: 1.25%–1.97%) in the general population. Prevalence in the general population was 1.72-fold (95%CI: 1.50–1.97) higher than that in blood donors in MENA, but it was 15.10-fold (95%CI: 11.48–19.86) higher in Europe. Prevalence was declining at a rate of 4% per year in both MENA and Europe [adjusted risk ratio: 0.96 (95%CI: 0.95–0.97) in MENA and 0.96 (95%CI: 0.92–0.99) in Europe]. Pooled mean viremic rate in MENA was 76.29% (95%CI: 67.64%–84.02%) among blood donors and 65.73% (95%CI: 61.03%–70.29%) in the general population.

CONCLUSION

Blood donor data provide a useful proxy for HCV infection in the wider population in MENA, but not Europe, and could improve HCV burden estimations and assess progress toward HCV elimination by 2030.

Keywords: Hepatitis C virus; Viral hepatitis; Blood donors; General population; Middle East and North Africa; Meta-analysis; Meta-regression

Core tip: We investigated hepatitis C virus (HCV) epidemiology among blood donors and the wider general population in Middle East and North Africa (MENA). For comparison, similar analyses were performed for Europe. Our results indicated that HCV antibody prevalence in the population of MENA and Europe appears to be declining by 4% per year. Blood donor data in MENA (but not in Europe) were found to provide a useful proxy for HCV infection levels and trends in the general population. Thus, the data can be utilized in HCV estimates and to assess, track and validate progress towards World Health Organization elimination goals for HCV.