Hepatitis B, Hepatitis C Are Significant Burdens in Men With HIV

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Men who have sex with men who are living with HIV were found to have a significant burden of both hepatitis B and C infections.

Hepatitis B virus (HBV) and hepatitis C virus (HCV) are both significant burdens among men who have sex with men (MSM) living with HIV across the world, according to a review published in Health Sciences Reports.¹ Studies evaluating the factors that influence the disease burden would be useful in the future.

Patients who have HIV and HCV or HBV have shown a reduction in life expectancy in prior research,² and global health can be significantly more challenging. Approximately 242,000 people died from HCV in 2022, and new HBV and HCV infections numbered 13,800 and 67,400, respectively.¹ Approximately 37.7 million people were predicted to be HIV positive in 2020, with approximately 2.3 million of those individuals having a previous or current infection of HCV and 2.7 million having HBV infection.

The new review aimed to investigate the prevalence of HBV and HCV in MSM living with HIV.

Men with HIV have a higher burden of HBV and HCV | Image credit: kleberpicui - stock.adobe.com

The researchers used PubMed, Cochrance, Web of Science, Scopus, and ProQuest to search for applicable studies. The search was conducted on April 22, 2023. No publication was excluded based on publication year, and all studies were published in English.

All original studies that reported on prevalence of HBV or HCV in MSM living with HIV were included, with HBV and HCV having to be confirmed by either serum HCV-RNA positivity or anti-HCV immunoglobulin G positivity. Studies were excluded if they were narrative reviews, protocols, unpublished reports, editorials, clinical case reports, abstracts, or commentaries. Studies with a sample size of less than 100 were also excluded. Data extracted included country of study, type of population, total population of MSM living with HIV, and number of HCV or HBV infections.

A total of 53 studies were included in the final review and meta-analysis. The studies primarily came from Switzerland (5 studies), the United States (11 studies), Spain (4 studies), Netherlands (4 studies), France (3 studies), Taiwan (6 studies), United Kingdom (8 studies), Japan (2 studies), and Australia (2 studies). Other studies came from Belgium, Denmark, Canada, Italy, Sri Lanka, Germany, South Korea, China, Thailand and the greater European area.

Prevalence was calculated by pooling HCV cases from the included studies. The prevalence of HCV was found to be 7% (95% CI, 5%-10%) after pooling all participants. The prevalence of HBV was found to be 9% (95% CI, 4%-18%) after pooling the prevalence in all MSM living with HIV in the included studies. Both pooled estimates of prevalence had high heterogeneity, with prediction interval values of 100% and 98% for the analyses of MSM with HBV and HCV, respectively.

Asia had the lowest pooled prevalence of HCV at 5.84% (95% CI, 2.98%-11.13%); Europe had the highest pooled prevalence at 7.76% (95% CI, 4.35%-13.45%). North America and Australia had similar pooled prevalences of HCV at 6.09% (95% CI, 3.75%-9.73%) and 6.28% (95% CI, 3.74%-10.37%).

There were some limitations to this study. All studies needed to be published in English. Heterogeneity was also significant in both analyses and could not be resolved. There was also publication bias detected. The generalizability of the study is also limited due to the lack of representation from Africa, South America, the Middle East, and the Indian subcontinent, as well as the uneven distribution of the included studies.

The researchers concluded that HCV and HBV are prevalent in MSM who are living with HIV across the globe and pose a significant burden on the population. Variations in prevalence, developing interventions, and long-term outcomes should be the focus of future studies in this area.

References

Shabil M, Yadav A, Shamim MA, et al. Prevalence of hepatitis B and C infections among HIV positive men who have sex with men: a systematic review and meta-analysis. Health Sci Rep. 2024;7:e2206. doi:10.1002/hsr2.2206
Jia J, Zhu Q, Deng L, et al. Treatment outcomes of HIV patients with hepatitis B and C virus co-infections in Southwest China: an observational cohort study. Infect Dis Poverty. 2022;11:7. Doi:10.1186/s40249-021-00921-5