Hepatitis C virus prevalence among patients with thalassemia and inherited bleeding disorders in Iran: a systematic review and meta-analysis

Abstract

Background: Hepatitis C Virus (HCV), a most common causes of post transfusion infections, is a major global health problem that results liver cirrhosis and hepato-carcinoma. Its prevalence is vary in different part of the world. Also, it has been shown that HCV is more prevalent in patients who received multiple transfusions. Hence, Patients with thalassemia and inherited bleeding disorders are at high risk of HCV infection. Some reports showed that HCV prevalence is high among Iranian patients underwent multiple transfusions. Aims: This systematic review and meta-analysis study aimed to determine hepatitis C virus prevalence among patients with thalassemia and inherited bleeding disorders in Iran. Methods: Comprehensive searches have carried out in different databases such as PubMed, Embases, the Scientific Information Database (SID) of Iran and the World Health Organization Index Medicus for the Eastern Mediterranean Region (IMEMR WHO) up to January 2017. The findings were reported following PRISMA guidelines. The pooled proportion rates was calculated using Metaprop program on Stata version 14.1 for Mac. Also, the confidence intervals of each study was calculated using the exact method. Results: Forty-seven studies, composed of 12449 patients; 8673 thalassemia and 3776 patients with inherited bleeding disorders (mainly hemophilia), fulfilled our criteria and included in this meta-analysis. The year of data collection in the evaluated studies were between 1998 and 2015. The pooled HCV prevalence was estimated 28% (95% confidence intervals [CI] = 22%>33%). The prevalence in patients with thalassemia and inherited bleeding disorders were 19% ([CI] 95%= 16%>23%) and 42% ([CI] 95%= 33% >52%), respectively. There was a considerable heterogeneity between studies. Summary/Conclusions: Our findings indicated the high prevalence of HCV among patients with thalassemia and inherited bleeding disorders in Iran. Moreover, it is significantly higher in patients with inherited bleeding disorders than those with thalassemia. The results also showed that transfusion related transmission of HCV in Iran is higher than other developing countries.