title: The epidemiology of hepatitis C virus in Afghanistan: systematic review and meta-analysis.
abstract: OBJECTIVE
  To characterize hepatitis C virus (HCV) epidemiology and inform public health research, policy, and programming priorities in Afghanistan.
  
  
  METHODS
  Records of HCV incidence and prevalence were reviewed systematically and synthesized following PRISMA guidelines. Meta-analyses were implemented using a DerSimonian-Laird random effects model with inverse variance weighting to estimate HCV prevalence among various at risk populations. A risk of bias assessment was incorporated.
  
  
  RESULTS
  The search identified one HCV incidence and 76 HCV prevalence measures. HCV incidence was only assessed among people who inject drugs (PWID), and was reported at 66.7 per 100 person-years. Meta-analyses estimated HCV prevalence at 0.7% among the general population (range 0-9.1%, 95% confidence interval (CI) 0.5-0.9%), 32.6% among PWID (range 9.5-70.0%, 95% CI 24.5-41.3%), and 2.3% among populations at intermediate risk (range 0.0-8.3%, 95% CI 1.3-3.7%). No data were available for other high risk populations such as hemodialysis, thalassemia, and hemophilia patients.
  
  
  CONCLUSIONS
  HCV prevalence among the general population in Afghanistan is comparable to global levels. Data are needed for the level of infection among key clinical populations at high risk of infection. There is also an immediate need for expansion of harm reduction programs among PWID and prisoners.
authors.affiliation: Infectious Disease Epidemiology Group, Weill Cornell Medical College in Qatar, Cornell University, Qatar Foundation - Education City, PO Box 24144, Doha, Qatar. Electronic address: hsc2001@qatar-med.cornell.edu.
authors.forename: Hiam
authors.initials: H
authors.lastname: Chemaitelly
authors.affiliation: Infectious Disease Epidemiology Group, Weill Cornell Medical College in Qatar, Cornell University, Qatar Foundation - Education City, PO Box 24144, Doha, Qatar.
authors.forename: Sarwat
authors.initials: S
authors.lastname: Mahmud
authors.affiliation: Afghanistan National Blood Safety and Transfusion Services, Kabul, Afghanistan.
authors.forename: Ahmad Masoud
authors.initials: AM
authors.lastname: Rahmani
authors.affiliation: Infectious Disease Epidemiology Group, Weill Cornell Medical College in Qatar, Cornell University, Qatar Foundation - Education City, PO Box 24144, Doha, Qatar; Department of Healthcare Policy and Research, Weill Cornell Medical College, Cornell University, New York, USA.
authors.forename: Laith J
authors.initials: LJ
authors.lastname: Abu-Raddad
mesh_terms: D000346:Afghanistan / Q000453:epidemiology; D016174:Hepacivirus; D006526:Hepatitis C / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D015995:Prevalence
keywords: Afghanistan; Epidemiology; Hepatitis C virus; Middle East; Prevalence; Systematic review