Hepatitis C Virus Coinfection in People With Human Immunodeficiency Virus in Iran: A Systematic Review and Meta-Analysis

Abstract

HCV co-infection is associated with higher mortality and morbidity in people with HIV (PWH). We aimed to characterize the epidemiology and factors associated with HCV co-infection among PWH in Iran. In this systematic review, we searched three English databases (MEDLINE, SCOPUS, Embase) and two Farsi databases (Scientific Information Database, and Magiran) for studies that measured the prevalence of HCV co-infection among PWH, published between 2000 and January 1, 2021. We included studies with a minimum sample size of 5 PWH. Reviews, editorials, conference abstracts, theses, studies with no relevant data, and unclear serological assays were excluded. We summarized the HCV co-infection prevalence by random-effect meta-analysis and assessed the sources of heterogeneity by a meta-regression model. Of the 858 records identified, 69 eligible studies with 12996 PWH were included. Overall, HCV co-infection prevalence was 64% (95%CI 58–69). The prevalence was higher among older (mean age >= 35y) PWH (69%, 95%CI 64-74), and PWH who inject drugs (77%, 95%CI 71-82). Furthermore, we found that co-infection was higher among studies conducted between 2000-2014 (67%, 95%CI 59-75) versus 2015-2020 (57%, 95%CI 50-64). The prevalence of HCV co-infection is high in Iranian PWH, with significant geographical variations. HCV screening and treatment among PWH are warranted to avoid the future burden of HCV-related liver damage, cancer, and mortality.