title: Prevalence and Disease Burden of HCV Coinfection in HIV Cohorts in the Asia Pacific Region: A Systematic Review and Meta-Analysis.
abstract: BACKGROUND
  Estimates of the prevalence and disease burden of HIV/HCV coinfection in the Asia Pacific Region are uncertain.
  
  
  METHODS
  A systematic review of indexed (PubMed, Embase and Web of Science) and non-indexed cross-sectional and cohort studies (2009-2015) reporting HCV seroprevalence in HIV-positive adults living in the Asia Pacific region was performed. Pooled prevalence estimates were calculated with a DerSimonian-Laird random-effects model.
  
  
  RESULTS
  39 studies from 10 countries in the Asia Pacific region comprising 89,452 HIV-positive individuals were included. In the high-income Asia Pacific region, HCV coinfection prevalence was 3.8% (95% confidence interval (CI): 3.1-4.5) in Singapore. In East Asia, HCV coinfection prevalence was 8.0% (95% CI: 6.4-9.8) in Hong Kong and 25.5% (95% CI: 17.5-34.4) in general HIV cohorts in China. In South Asia, HCV coinfection prevalence was 4.1% (95% CI: 1.7-7.3) in India and 42.6% (95% CI: 38.7-46.5) in Nepal. In Southeast Asia, HCV coinfection prevalence was 5.5% (95% CI: 4.9-6.1) in Cambodia, 5.3% (95% CI: 4.9-5.7) in Myanmar, and 5.1% (95% CI: 2.7-8.2) in Thailand, but higher in Vietnam (42.5%; 95% CI: 40.8-44.2) and Indonesia (17.9%; 95% CI: 15.0-20.9). The prevalence of HCV coinfection was higher in subpopulations of people who inject drugs (China 81.6%; 95% CI: 74.1-88.0; Nepal 80.8%; 95% CI: 76.4-84.9; Indonesia 81.6%; 95% CI: 71.1-90.3), former blood donors (China 82.9%; 95% CI: 73.9-90.3), and blood transfusion recipients (China 51.0%; 95% CI: 41.7-60.2).
  
  
  CONCLUSIONS
  HCV coinfection prevalence within HIV populations is highly variable in the Asia Pacific region, between countries and at-risk populations. Enhanced epidemiological data is required to support scale-up of interferon-free HCV therapy.
authors.affiliation: Kirby Institute, UNSW Australia, Sydney, Australia.
authors.forename: Marianne
authors.initials: M
authors.lastname: Martinello
authors.affiliation: Kirby Institute, UNSW Australia, Sydney, Australia.
authors.forename: Janaki
authors.initials: J
authors.lastname: Amin
authors.affiliation: Kirby Institute, UNSW Australia, Sydney, Australia.
authors.forename: Gail V
authors.initials: GV
authors.lastname: Matthews
authors.affiliation: Kirby Institute, UNSW Australia, Sydney, Australia.
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: Dore
mesh_terms: D060085:Coinfection / Q000453:epidemiology* / Q000821:virology*; D005202:Asia, Eastern / Q000453:epidemiology; D015658:HIV Infections / Q000150:complications* / Q000821:virology; D016174:Hepacivirus; D006526:Hepatitis C / Q000150:complications* / Q000821:virology; D006801:Humans; D015995:Prevalence