Prevalence of occult hepatitis B virus infection in Egypt: a systematic review with meta-analysis
Abstract Background Occult hepatitis B virus (HBV) infection (OBI) is a major public health problem. The clinical importance of OBI stems from the fact that it can be transmitted to healthy individuals at extremely low viral load levels. Additionally, immunosuppression has the potential to trigger v...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2023-07-01
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| Series: | Journal of the Egyptian Public Health Association |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s42506-023-00138-4 |
| _version_ | 1797769595011989504 |
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| author | Ahmed Azzam Heba Khaled Esraa S. El-kayal Fathy A. Gad Sarah Omar |
| author_facet | Ahmed Azzam Heba Khaled Esraa S. El-kayal Fathy A. Gad Sarah Omar |
| author_sort | Ahmed Azzam |
| collection | DOAJ |
| description | Abstract Background Occult hepatitis B virus (HBV) infection (OBI) is a major public health problem. The clinical importance of OBI stems from the fact that it can be transmitted to healthy individuals at extremely low viral load levels. Additionally, immunosuppression has the potential to trigger viral replication, which can result in life-threatening liver decompensation. Despite several studies examining the prevalence of OBI, the pooled prevalence of OBI in Egypt remains unknown, particularly among blood donors and high-risk individuals, to whom intervention should be targeted. Methods A comprehensive literature search of the following databases was conducted from inception to October 2022 using the following keywords: occult hepatitis B virus infection or occult HBV infection or OBI and Egypt in MEDLINE [PubMed], Scopus, Google Scholar, and Web of Science. The review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement. I-squared and Cochran’s Q were used to measure the heterogeneity between the studies, and based on the random effects model, results were reported as proportions (%) with a 95% confidence interval (CI). Analyses of subgroup analyses were conducted based on the target population. Sensitivity analyses were conducted using the leave-one-out approach to test the robustness of the results. Results A total of 50 studies with 62 estimations of OBI were included, 19 in patients who were HBsAg-negative and anti-HBc-positive and 43 in patients who were HBsAg-negative. The highest prevalence (41%) was among multi-transfused patients according to studies that report occult hepatitis B virus prevalence in an HBsAg-negative population, while the pooled prevalence of OBI among patients on hemodialysis, patients with chronic hepatitis C infection, patients with hepatocellular carcinoma (HCC), and patients with liver cirrhosis was 17%, 10%, 24%, and 13%, respectively. On the other hand, among studies that report OBI prevalence in HBsAg-negative and anti-HBc-positive individuals, the pooled prevalence of OBI among blood donors, patients with chronic hepatitis C infection, and patients with HCC was 12%, 15%, and 31%, respectively. Also, the majority of studies examining the genetic background of OBI have found that genotype D is the most prevalent. Conclusion This study highlights the high prevalence in OBI among blood donors and high-risk populations in Egypt. The implementation of HBV nucleic acid amplification testing (NAT) may increase the safety of blood transfusions by excluding all HBV DNA-positive donations. However, the cost-effectiveness of these tests should be investigated. |
| first_indexed | 2024-03-12T21:11:17Z |
| format | Article |
| id | doaj.art-b9242341903d4428b950e95f5c051be9 |
| institution | Directory Open Access Journal |
| issn | 2090-262X |
| language | English |
| last_indexed | 2024-03-12T21:11:17Z |
| publishDate | 2023-07-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Journal of the Egyptian Public Health Association |
| spelling | doaj.art-b9242341903d4428b950e95f5c051be92023-07-30T11:11:05ZengSpringerOpenJournal of the Egyptian Public Health Association2090-262X2023-07-0198111610.1186/s42506-023-00138-4Prevalence of occult hepatitis B virus infection in Egypt: a systematic review with meta-analysisAhmed Azzam0Heba Khaled1Esraa S. El-kayal2Fathy A. Gad3Sarah Omar4Department of Microbiology and Immunology, Faculty of Pharmacy, Helwan UniversityDepartment of Biochemistry, Faculty of Pharmacy, Cairo UniversityBiotechnology Program, Faculty of Science, Tanta UniversityFaculty of Medicine, Cairo UniversityFaculty of Medicine and Health Sciences, Aden UniversityAbstract Background Occult hepatitis B virus (HBV) infection (OBI) is a major public health problem. The clinical importance of OBI stems from the fact that it can be transmitted to healthy individuals at extremely low viral load levels. Additionally, immunosuppression has the potential to trigger viral replication, which can result in life-threatening liver decompensation. Despite several studies examining the prevalence of OBI, the pooled prevalence of OBI in Egypt remains unknown, particularly among blood donors and high-risk individuals, to whom intervention should be targeted. Methods A comprehensive literature search of the following databases was conducted from inception to October 2022 using the following keywords: occult hepatitis B virus infection or occult HBV infection or OBI and Egypt in MEDLINE [PubMed], Scopus, Google Scholar, and Web of Science. The review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement. I-squared and Cochran’s Q were used to measure the heterogeneity between the studies, and based on the random effects model, results were reported as proportions (%) with a 95% confidence interval (CI). Analyses of subgroup analyses were conducted based on the target population. Sensitivity analyses were conducted using the leave-one-out approach to test the robustness of the results. Results A total of 50 studies with 62 estimations of OBI were included, 19 in patients who were HBsAg-negative and anti-HBc-positive and 43 in patients who were HBsAg-negative. The highest prevalence (41%) was among multi-transfused patients according to studies that report occult hepatitis B virus prevalence in an HBsAg-negative population, while the pooled prevalence of OBI among patients on hemodialysis, patients with chronic hepatitis C infection, patients with hepatocellular carcinoma (HCC), and patients with liver cirrhosis was 17%, 10%, 24%, and 13%, respectively. On the other hand, among studies that report OBI prevalence in HBsAg-negative and anti-HBc-positive individuals, the pooled prevalence of OBI among blood donors, patients with chronic hepatitis C infection, and patients with HCC was 12%, 15%, and 31%, respectively. Also, the majority of studies examining the genetic background of OBI have found that genotype D is the most prevalent. Conclusion This study highlights the high prevalence in OBI among blood donors and high-risk populations in Egypt. The implementation of HBV nucleic acid amplification testing (NAT) may increase the safety of blood transfusions by excluding all HBV DNA-positive donations. However, the cost-effectiveness of these tests should be investigated.https://doi.org/10.1186/s42506-023-00138-4PrevalenceEpidemiologyOccult hepatitis BOBIHepatitis B virusHBV |
| spellingShingle | Ahmed Azzam Heba Khaled Esraa S. El-kayal Fathy A. Gad Sarah Omar Prevalence of occult hepatitis B virus infection in Egypt: a systematic review with meta-analysis Journal of the Egyptian Public Health Association Prevalence Epidemiology Occult hepatitis B OBI Hepatitis B virus HBV |
| title | Prevalence of occult hepatitis B virus infection in Egypt: a systematic review with meta-analysis |
| title_full | Prevalence of occult hepatitis B virus infection in Egypt: a systematic review with meta-analysis |
| title_fullStr | Prevalence of occult hepatitis B virus infection in Egypt: a systematic review with meta-analysis |
| title_full_unstemmed | Prevalence of occult hepatitis B virus infection in Egypt: a systematic review with meta-analysis |
| title_short | Prevalence of occult hepatitis B virus infection in Egypt: a systematic review with meta-analysis |
| title_sort | prevalence of occult hepatitis b virus infection in egypt a systematic review with meta analysis |
| topic | Prevalence Epidemiology Occult hepatitis B OBI Hepatitis B virus HBV |
| url | https://doi.org/10.1186/s42506-023-00138-4 |
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