EC Pulmonology and Respiratory Medicine

Background: Hepatitis B virus (HBV) and Hepatitis C virus (HCV) co-infections with tuberculosis (TB) are one of the main challenges for global TB prevention and control efforts, particularly drug-induced hepatotoxicity that potentially affects anti-TB treatment adherence and anti-TB treatment outcomes. However, there is limited data on the prevalence and risk factors of HBV and HCV among TB-HIV co-infected patients. Therefore, the main objective of this systematic and meta-analysis review was to estimate the pooled prevalence and risk factors of HBV and HCV virus among TB-HIV co-infected patients.

Method: We explicitly conducted comprehensive search on PubMed, Google scholar, African Journal online, biomedical data base, and Web of Science data bases for published articles on the prevalence and associated factors of HBV and HCV co-infections among TB-HIV patients. We enrolled those articles only presented with English language with full version from October 1997 to August 2024. To determine the pooled effect size across studies, a random-effects model was used. The I² statistic was used to examine for heterogeneity among the studies that were included. R software was used for all statistical analyses. This study was registered on PROSPERO (CRD42023468720). Moreover, PRISMA 2020 carefully considered.

Result: A total of 12 studies were included in this review. The prevalence of hepatitis virus infection was 7.38 (95%CI: 2.54-19.60). Also, the overall pooled prevalence of hepatitis B virus and hepatitis C virus was 3.20 (95%CI: 0.75-12.65) and 2.43 (95%CI: 0.70-8.08), respectively. Moreover, the pooled prevalence of HBV using Hepatitis B surface antigen was 1.89 (95%CI: 0.75-4.64). In the present study, we observed substantial difference on the prevalence of hepatitis B and C virus across the WHO regions with substantial heterogeneity and publication bias (I² > 50, p-value < 0.01). Our Meta analysis study using random effect model did not show any statistical difference for alcohol use, race, sex, and blood transfusion for the occurrence of hepatitis B and C virus infection among TB-HIV co-infected patients.

Conclusion: High level of hepatitis co-infection was found among TB-HIV co-infected patients. The interpretation and generalization of HBV, HCV co-infection HIV needs caution. Also, strategies to expand the routine screening and management of those viruses potentially improve the global TB prevention and control program.

 Keywords: HBV; HCV; TB-HIV Co-Infection; Hepatoxicity

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