The prevalence of hepatitis C virus (HCV) infection in β-thalassemia patients in Pakistan: a systematic review and meta-analysis

Abstract

ABSTRACTObjectiveHepatitis C virus (HCV) infection is the most commonly reported bloodborne infection in Pakistan. Frequent blood transfusions in β-thalassemia patients expose them to a high risk of HCV infection. The purpose of this paper is to summarize the current data on the prevalence of HCV infection among β-thalassemia patients in Pakistan by using a systematic review and meta–analysis.DesignSystematic review and meta-analysis.Participantsβ-thalassemia patients in Pakistan.Data sourcesFollowing PRISMA guidelines, a comprehensive literature search in PubMed/MEDLINE and EMBASE was performed to identify published articles reporting on the prevalence of HCV among β-thalassemia patients in Pakistan. Only English language articles were considered. Two independent authors selected studies. The methodological quality of the included studies was assessed using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies.ResultsThe search conceded a total of 138 studies, of which 27 studies were finally considered for meta-analysis. The pooled prevalence of HCV in β-thalassemia patients in Pakistan was 36.21% (95% CI: 28.98– 43.75%) based on 5,789 β-thalassemia patients, but there was considerable heterogeneity. Meta-analysis estimated the HCV prevalence among the β-thalassemia patients at 45.98 % (95% CI: 38.15–53.90%) in Punjab, 31.81% (95% CI: 20.27–44.59%) in Sindh, and 28.04% (95% CI: 13.58–45.26%) in Khyber Pakhtunkhwa. Meta–regression analysis showed that geographical location was a key source of heterogeneity.ConclusionsThe pooled prevalence of hepatitis C virus among β-thalassemia patients in Pakistan was 36.21%, but varies regionally within the country. The prevalence is higher than in neighboring countries. With the use of standard prevention procedures during blood transfusion, the risk of HCV transmission among β-thalassemia patients could be controlled hence prevalence of HCV in β-thalassemia patients could be reduced.Strengths and limitations of this study➢This is the first systematic review and meta-analysis to estimate the pooled prevalence of HCV infection among the β-thalassemia patients in Pakistan➢We used of an extensive search strategy and adherence to predetermined inclusion and exclusion criteria.➢Strong and reliable methodological and statistical methods were used.➢Our analyses possessed a considerable amount of quantifiable heterogeneity.➢Not all regions in Pakistan were represented and most of the included studies were hospital-based, making it difficult to generalize the findings of this review.