Burden of tuberculosis and hepatitis co-infection among people living with HIV in Nepal: a systematic review and meta-analysis
Sulochan GC A B # , Ashok Khanal A C # , Vijay S. GC
D * , Suman Bhattarai A C , Suresh Panthee E F , Aashis Khanal C G , Amrit Gaire A , Sagar Poudel A , Rakesh Ghimire A and Sharada P. Wasti H
+ Author Affiliations
- Author Affiliations
A Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.
B Nepal Pharmacy Students’ Association (NPSA), Kathmandu, Nepal.
C Active Pharmacy Pvt. Ltd., Kathmandu, Nepal.
D Centre for Health Economics, University of York, York, UK.
E Teikyo University Institute of Medical Mycology, Otsuka 359, Hachioji, Tokyo, Japan.
F Sustainable Study and Research Institute, Balaju, Kathmandu-16, Nepal.
G Department of Computer Science, Georgia State University, Atlanta, GA, USA.
H School of Health and Human Sciences, University of Huddersfield, Huddersfield, UK.
* Correspondence to: vijay.gc@york.ac.uk
# These authors contributed equally to this paper
Handling Editor: Huachun Zou
Sexual Health 19(5) 406-416 https://doi.org/10.1071/SH21216
Submitted: 28 October 2021 Accepted: 14 May 2022 Published: 23 June 2022
© 2022 The Author(s) (or their employer(s)). Published by CSIRO Publishing. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)
Abstract
People living with HIV (PLHIV) are prone to tuberculosis (TB) and hepatitis co-infections, which cause substantial burden on morbidity and mortality. However, data on the burden of HIV co-infection from a specific low- and middle-income country are limited. To address this gap in evidence, a meta-analysis of published literature and country surveillance report was conducted to estimate the burden of TB, hepatitis B (HBV) and hepatitis C (HCV) co-infection among PLHIV in Nepal. Twenty-three studies, including 5900 PLHIV, were included in the meta-analysis. The pooled prevalence of HIV–TB, HIV–HBV and HIV–HCV co-infection was 19% (95% CI, 10–28%), 3% (2–5%) and 19% (4–33%), respectively. Low CD4 cell count (pooled odds ratio [OR] 4.38, 95% CI 1.11–17.25), smoking (3.07, 1.48–6.37) and alcohol drinking (3.12, 1.52–6.43) were significantly correlated with HIV–TB co-infection. The odds of HCV co-infection was greater in PLHIV, who were male (5.39, 1.54–18.89) and drug users (166.26, 15.94–1734.44). PLHIV who were on antiretroviral therapy had a reduced risk of HCV co-infection (0.49, 0.36–0.66) than the general PLHIV population. The burden of TB and hepatitis co-infection among PLHIV in Nepal was high. Regular screening of PLHIV for co-infections and prompt initiation of treatment are essential to reduce the transmission of infection and improve quality of life.
Keywords: co-infection, hepatitis, HIV, meta-analysis, Nepal, prevalence, systematic review, tuberculosis.
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