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

Abstract

Background: Hepatitis C virus (HCV) coinfection is associated with higher mortality and morbidity in people with human immunodeficiency virus (PWH). Methods: We aimed to characterize the epidemiology and factors associated with HCV coinfection among PWH in Iran. In this systematic review, we searched 3 English databases (MEDLINE, SCOPUS, Embase) and 2 Farsi databases (Scientific Information Database and Magiran) for studies that measured the prevalence of HCV coinfection 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. Results: We summarized the HCV coinfection 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 12 996 PWH were included. Overall, HCV coinfection prevalence was 64% (95% confidence interval [CI], 58-69). The prevalence was higher among older (mean age ≥35 years) PWH (69%; 95% CI, 64-74) and PWH who inject drugs (77%; 95% CI, 71-82). Furthermore, we found that coinfection was higher among studies conducted between 2000 and 2014 (67%; 95% CI, 59-75) versus 2015-2020 (57%; 95% CI, 50-64). Conclusions: The prevalence of HCV coinfection is high in Iranian PWH, with significant geographical variations. Hepatitis C virus screening and treatment among PWH are warranted to avoid the future burden of HCV-related liver damage, cancer, and mortality.