Seroprevalence of hepatitis C virus among people living with HIV/AIDS in Latin America and the Caribbean: a systematic review.
BACKGROUND
Studies have shown that the immunosuppression induced by the human immunodeficiency virus (HIV) accelerates the natural history of liver disease associated with hepatitis C virus (HCV), with 3- to 5-fold higher odds of coinfected individuals developing cirrhosis. However, estimates of the seroprevalence of hepatitis C among people living with HIV/acquired immune deficiency syndrome (AIDS) (PLHA) in Latin America and the Caribbean (LAC) are widely variable.


METHODS
We performed a systematic review to estimate the seroprevalence of HCV among PLHA. We searched studies on HIV and HCV infections in LAC included in the PubMed, LILACS and Embase databases in December of 2014 with no time or language restrictions. The following combinations of search terms were used in the PubMed and Embase databases: (HIV OR Acquired Immunodeficiency Syndrome Virus OR AIDS OR HTLV OR Human Immunodeficiency Virus OR Human T Cell) AND (HCV OR HEPATITIS C OR HEPATITIS C VIRUS OR HEPACIVIRUS) AND (name of an individual country or territory in LAC). The following search terms were used in the LILACS database: (HIV OR AIDS OR Virus da Imunodeficiencia Humana) AND (HCV OR Hepatite C OR Hepacivirus). An additional 11 studies were identified through manual searches. A total of 2,380 publications were located, including 617 duplicates; the remaining articles were reviewed to select studies for inclusion in this study.


RESULTS
A total of 37 studies were selected for systematic review, including 23 from Brazil, 5 from Argentina, 3 from Cuba, 1 from Puerto Rico, 1 from Chile, 1 from Colombia, 1 from Mexico, 1 from Peru and 1 from Venezuela. The estimated seroprevalence of HCV infection varied from 0.8 to 58.5 % (mean 17.37; median 10.91), with the highest in Argentina and Brazil and the lowest in Venezuela and Colombia.


CONCLUSIONS
Investigation of HCV infection among PLHA and of HIV infection among people living with HCV is highly recommended because it allows for better follow up, counseling and treatment of HIV/HCV-coinfected patients. Future studies with larger sample sizes are needed in both South and Central America to understand and address the risk factors associated with the acquisition of infection.
Department of Infectious and Parasitic Diseases, School of Medicine, University of São Paulo (Universidade de São Paulo - USP), São Paulo, Brazil. fatima.tengan@uol.com.br.|Laboratory of Viral Medical Research in Hepatology (Laboratório de Investigação Médica em Hepatologia por vírus - LIM-47), Clinical Hospital, School of Medicine, USP, São Paulo, Brazil. fatima.tengan@uol.com.br.
Fatima Mitiko
FM
Tengan
Department of Infectious and Parasitic Diseases, School of Medicine, University of São Paulo (Universidade de São Paulo - USP), São Paulo, Brazil.|Laboratory of Viral Medical Research in Hepatology (Laboratório de Investigação Médica em Hepatologia por vírus - LIM-47), Clinical Hospital, School of Medicine, USP, São Paulo, Brazil.
Karim Yakub
KY
Ibrahim
Laboratory of Viral Medical Research in Hepatology (Laboratório de Investigação Médica em Hepatologia por vírus - LIM-47), Clinical Hospital, School of Medicine, USP, São Paulo, Brazil.
Bianca Peixoto
BP
Dantas
Laboratory of Viral Medical Research in Hepatology (Laboratório de Investigação Médica em Hepatologia por vírus - LIM-47), Clinical Hospital, School of Medicine, USP, São Paulo, Brazil.
Caroline
C
Manchiero
Laboratory of Viral Medical Research in Hepatology (Laboratório de Investigação Médica em Hepatologia por vírus - LIM-47), Clinical Hospital, School of Medicine, USP, São Paulo, Brazil.
Mariana Cavalheiro
MC
Magri
School of Medicine, USP, São Paulo, Brazil.|Brazilian Medical Association, São Paulo, Brazil.
Wanderley Marques
WM
Bernardo
D000163:Acquired Immunodeficiency Syndrome / Q000453:epidemiology; D001118:Argentina / Q000453:epidemiology; D001938:Brazil / Q000453:epidemiology; D017691:Caribbean Region / Q000453:epidemiology; D002677:Chile / Q000453:epidemiology; D060085:Coinfection / Q000453:epidemiology*; D003462:Cuba / Q000453:epidemiology; D015658:HIV Infections / Q000453:epidemiology*; D016174:Hepacivirus; D006526:Hepatitis C / Q000453:epidemiology* / Q000276:immunology; D006801:Humans; D007843:Latin America / Q000453:epidemiology; D008103:Liver Cirrhosis / Q000453:epidemiology / Q000821:virology; D008800:Mexico / Q000453:epidemiology; D010568:Peru / Q000453:epidemiology; D011647:Puerto Rico / Q000453:epidemiology; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D014687:Venezuela / Q000453:epidemiology
Caribbean; Coinfection; HCV; HIV; Hepatitis C; Latin America; Seroprevalence