Prevalence of hepatitis B and C infections among HIV‐positive men who have sex with men: A systematic review and meta‐analysis

Abstract

AbstractBackgroundHuman immunodeficiency virus (HIV) infection is highly prevalent and often coexists with other infectious diseases, especially Hepatitis B virus (HBV) and Hepatitis C virus (HCV). Men who have sex with men (MSM) represent a vulnerable population in terms of HIV infection. We aimed to determine the prevalence of HCV, HBV among HIV‐infected MSM.MethodsThis systematic review and meta‐analysis searched PubMed, Cochrane, Scopus, Web of Science, and ProQuest up‐to 2023/04/22. All studies reporting the prevalence of HBV or HCV infection in MSM PLHIV were included. Meta‐analysis used random effect model for synthesis and I2 along with prediction interval for heterogeneity. Subgroup analysis based on continent and meta‐regression for study size, average age and year of publication were used to explore heterogeneity. Modified Newcastle‐Ottawa Scale was used to evaluate the quality of studies according to the protocol (PROSPERO: CRD42023428764).ResultsFifty‐six of 5948 studies are included. In 53 studies with 3,07,589 participants, a pooled prevalence of 7% (95% confidence interval [CI]: 5–10) was found for HCV among MSM PLHIV, while a 9% (95% CI: 4–18) prevalence was found for HBV infection from five studies which included 5641 MSM PLHIV. Asia reported the lowest pooled prevalence at 5.84% (95% CI: 2.98–11.13) for HCV while Europe reported the highest pooled prevalence at 7.76% (95% CI: 4.35–13.45). Baujat plot and influence diagnostic identified contributors to influence and between‐study heterogeneity. Sensitivity analyses omitting these studies result in considerably more precise estimates. Another sensitivity analysis as leave‐one‐out meta‐analysis did not change any pooled estimate significantly.ConclusionThere is a significant burden of HCV and HBV among MSM PLHIV worldwide, with varying prevalence rates. Future studies should focus on these multimorbidity clusters and investigate factors influencing disease burden, long‐term outcomes, optimal testing strategies, and tailored interventions.