Persistently high hepatitis C rates in haemodialysis patients in Brazil [a systematic review and meta-analysis]

• Published in: Scientific reports 2022-01, Vol.12 (1), p.330-330, Article 330
• Main Authors: Niquini, Roberta Pereira, Corrêa da Mota, Jurema, Bastos, Leonardo Soares, da Costa Moreira Barbosa, Diego, Falcão, Juliane da Silva, Palmieri, Paloma, Martins, Patrícia, Melo Villar, Livia, Bastos, Francisco I.
• Format: Article
• Language: English
• Subjects: 692/4020; 692/4022; 692/499; 692/53; 692/700; Brazil - epidemiology; COVID-19; COVID-19 - diagnosis; COVID-19 - epidemiology; COVID-19 - virology; Hemodialysis; Hepacivirus - genetics; Hepacivirus - physiology; Hepatitis C; Hepatitis C - diagnosis; Hepatitis C - epidemiology; Hepatitis C - virology; Heterogeneity; Humanities and Social Sciences; Humans; Infections; Meta-analysis; multidisciplinary; Nucleic Acid Amplification Techniques - methods; Pandemics; Patients; Prevalence; Quality control; Renal Dialysis - methods; Renal Dialysis - statistics & numerical data; Risk groups; RNA, Viral - genetics; SARS-CoV-2 - genetics; SARS-CoV-2 - physiology; Science; Science (multidisciplinary); Statistical analysis; Systematic review
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-021-03961-x

We conducted a systematic review and meta-analysis of studies assessing HCV infection rates in haemodialysis patients in Brazil (Prospero CRD #42021275068). We included studies on patients under haemodialysis, comprising both convenience samples and exhaustive information from selected services. Patients underwent HCV serological testing with or without confirmation by HCV RNA PCR. Exclusion criteria were the following: absence of primary empirical information and studies without information on their respective settings, study year, accurate infection rates, or full specification of diagnostic tests. Studies with samples ≤ 30 and serial assessments with repeated information were also excluded. Reference databases included PubMed, LILACS, Scopus, and Web of Science for the period 1989–2019. A systematic review was carried out, followed by two independent meta-analyses: (i) studies with data on HCV prevalence and (ii) studies with a confirmatory PCR (i.e., active infection), respectively. A comprehensive set of different methods and procedures were used: forest plots and respective statistics, polynomial regression, meta-regression, subgroup influence, quality assessment, and trim-and-fill analysis. 29 studies and 11,290 individuals were assessed. The average time patients were in haemodialysis varied from 23.5 to 56.3 months. Prevalence of HCV infection was highly heterogeneous, with a pronounced decrease from 1992 to 2001, followed by a plateau and a slight decrease in recent years. The summary measure for HCV prevalence was 34% (95% CI 26–43%) for studies implemented before 2001. For studies implemented after 2001, the corresponding summary measure was 11% (95% CI 8–15%). Estimates for prevalence of active HCV infection were also highly heterogeneous. There was a marked decline from 1996 to 2001, followed by a plateau and a slight increase after 2010. The summary measure for active HCV infection was 19% (95% CI 15–25%) in studies carried out before 2001. For studies implemented after 2001, the corresponding summary measure was 9% (95% CI 6–13%). Heterogeneity was pervasive, but different analyses helped to identify its underlying sources. Besides the year each study was conducted, the findings differed markedly between geographic regions and were heavily influenced by the size of the studies and publication biases. Our systematic review and meta-analysis documented a substantial decline in HCV prevalence among Brazilian haemodialysis patients from 1992 to