Hepatitis C infection seroprevalence in pregnant women worldwide: a systematic review and meta-analysis

• Published in: EClinicalMedicine 2023-12, Vol.66, p.102327-102327, Article 102327
• Main Authors: Abbasi, Farzaneh, Almukhtar, Mustafa, Fazlollahpour-Naghibi, Andarz, Alizadeh, Faezeh, Behzad Moghadam, Kimia, Jafari Tadi, Mehrdad, Ghadimi, Saleh, Bagheri, Kimia, Babaei, Hedye, Bijani, Mohammad Hossein, Rouholamin, Safoura, Razavi, Maryam, Rezaeinejad, Mahroo, Chemaitelly, Hiam, Sepidarkish, Mahdi, Farid-Mojtahedi, Maryam, Rostami, Ali
• Format: Article
• Language: English
• Subjects: Global seroprevalence; Hepatitis C infection; Pregnant women; Systematic review and meta-analysis
• ISSN: 2589-5370; 2589-5370
• DOI: 10.1016/j.eclinm.2023.102327

Monitoring progress towards the WHO global target to eliminate hepatitis C virus (HCV) infection by 2030, entails reliable prevalence estimates for HCV infection in different populations. Little is known about the global burden of HCV infection in pregnant women. Here, for the first time to our knowledge, we estimated the global and regional seroprevalence of HCV antibody (Ab) and determinants in pregnant women. In this systematic review and meta-analysis study, we searched PubMed/MEDLINE, Web of Science, Embase, Scopus, and SciELO databases for peer-reviewed observational studies between January 1, 2000 and April 1, 2023, without language or geographical restrictions. Pooled global seroprevalence (and 95% confidence interval, CI) were estimated using random-effects meta-analysis and seroprevalences were categorised according to World Health Organization regions and subregions, publishing year, countries’ income and human development index (HDI) levels. We used sensitivity analysis to assess the effect of four large sample size studies on pooled global prevalence through the “leave-one-out” method. We also investigated the association of potential risk factors with HCV seropositivity in pregnant women by subgroup and meta-regression analyses. The Protocol was registered in PROSPERO CRD42023423259. We included 192 eligible studies (208 datasets), with data for 148,509,760 pregnant women from 53 countries. The global seroprevalence of HCV Ab in pregnant women was 1.80% (95% CI, 1.72–1.89%) and 3.29% (3.01–3.57%) in overall and sensitivity analyses, respectively. The seroprevalence was highest in the Eastern Mediterranean region (6.21%, 4.39–8.29%) and lowest in the Western Pacific region (0.75%, 0.38–1.22%). Subgroup analysis indicated that the seroprevalence of HCV Ab among pregnant women was significantly higher for those with opioid use disorder (51.94%, 95% CI: 37.32–66.39) and HIV infection (4.34%, 95% CI: 2.21–7.06%) than for the general population of pregnant women (1.08%, 95% CI: 1.02–1.15%), as confirmed by multivariable meta-regression (p