Meta-analysis of 55 studies assesses HCV prevalence trends across Eastern Mediterranean Region populations
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Key Takeaway
Note variation in HCV prevalence across EMR populations necessitates population-specific strategies for WHO elimination targets.
This umbrella review synthesizes evidence from 55 meta-analyses regarding hepatitis C virus (HCV) prevalence within the Eastern Mediterranean Region (EMR). The scope encompasses diverse population groups, including key populations, patients co-infected with other hepatitis viruses or liver-related diseases, individuals with clinical or healthcare-associated exposure risks, and apparently healthy individuals. The analysis utilizes time-period comparisons between the era before 2015 and the period after 2015 to assess trends.
The primary outcome measured was pooled HCV prevalence. Results indicate that HCV prevalence among key populations was 31.0% (95% CI: 27.0-38.0). Similarly, prevalence among patients co-infected with other hepatitis viruses or liver-related diseases was 31.0% (95% CI: 12.0-49.0). Among those with clinical or healthcare-associated exposure risk, prevalence was 28.0% (95% CI: 23.0-32.0). In contrast, HCV prevalence among the apparently healthy population was 2.0% (95% CI: 1.0-2.0).
Regarding temporal trends, HCV prevalence among clinically exposed populations showed a decline from 29% to 10% after 2015. The authors note that variation in HCV prevalence across these diverse populations in the EMR highlights the need for population-specific strategies to support progress toward World Health Organization elimination targets. Safety data, including adverse events and tolerability, were not reported in the source material. Funding or conflicts of interest were not reported.
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View Original Abstract ↓
BACKGROUND: Hepatitis C virus (HCV) remains a major public health challenge in the Eastern Mediterranean Region (EMR), with prevalence varying across population groups. This umbrella review summarizes the distribution of HCV infection across diverse populations in the region.
METHODS: We conducted an umbrella review of systematic reviews with meta-analyses reporting HCV prevalence in the EMR. PubMed, Web of Science, Scopus, Iranian databases, including Magiran and the Scientific Information Database (SID), were searched. Google Scholar was additionally screened to ensure comprehensive coverage. Pooled estimates were extracted across four population groups: apparently healthy individuals; those with clinical or healthcare-associated exposure risk; patients co-infected with hepatitis viruses or other liver-related diseases; and key populations at increased risk (groups disproportionately affected due to their behaviors and higher vulnerability). For time-period analyses, meta-analyses were grouped into two intervals (before 2015 vs. 2015 and after) based on the median year of data collection of primary studies. Pooled prevalence was calculated using a random-effects model in STATA version 17.
RESULTS: A total of 55 meta-analyses were included. The pooled HCV prevalence was 31.0% (95% CI: 27.0-38.0) among key populations, and also 31.0% (95% CI: 12.0-49.0) among patients co-infected with other hepatitis viruses or liver-related diseases. Those with clinical or healthcare-associated exposure risk showed a prevalence of 28.0% (95% CI: 23.0-32.0), whereas the apparently healthy population had the lowest prevalence at 2.0% (95% CI: 1.0-2.0). Subgroup analysis indicated a decline in prevalence among clinically exposed populations after 2015, from 29% to 10%, coinciding with the direct-acting antivirals (DAAs) and strengthened infection-control practices. The highest prevalence was observed among key populations in Libya, healthcare-exposed populations in Morocco, and apparently healthy individuals in Egypt.
CONCLUSION: Variation in HCV prevalence across populations in the EMR highlights the need for population-specific strategies to support progress toward World Health Organization elimination targets.
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