Prevalence of hepatitis D virus infection in sub-Saharan Africa: a systematic review and meta-analysis Alexander J Stockdale, MRes, Mas Chaponda, PhD,

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Presentation transcript:

Prevalence of hepatitis D virus infection in sub-Saharan Africa: a systematic review and meta-analysis Alexander J Stockdale, MRes, Mas Chaponda, PhD, Apostolos Beloukas, PhD, Richard Odame Phillips, PhD, Philippa C Matthews, PhD, Athanasios Papadimitropoulos, MSc, Simon King, PhD, Laura Bonnett, PhD, Prof Anna Maria Geretti, PhD The Lancet Global Health Volume 5, Issue 10, Pages e992-e1003 (October 2017) DOI: 10.1016/S2214-109X(17)30298-X Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Terms and Conditions

Figure 1 Selection of studies of hepatitis D virus epidemiology in sub-Saharan Africa, 1995–2016, for inclusion in meta-analysis The Lancet Global Health 2017 5, e992-e1003DOI: (10.1016/S2214-109X(17)30298-X) Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Terms and Conditions

Figure 2 Seroprevalence of hepatitis D virus among HBsAg carriers in sub-Saharan Africa in published studies, 1995–2016 Data in parentheses are 95% CIs. Colour and size of bubble plots show prevalence and cohort size, respectively. *Data obtained in rural settings. The Lancet Global Health 2017 5, e992-e1003DOI: (10.1016/S2214-109X(17)30298-X) Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Terms and Conditions

Figure 3 Forest plots of hepatitis D virus seroprevalence among HBsAg-positive patients in sub-Saharan Africa 1995–2016 in general populations (A) and liver-disease populations (B) Data are from a random-effects model. HCC=hepatocellular carcinoma. The Lancet Global Health 2017 5, e992-e1003DOI: (10.1016/S2214-109X(17)30298-X) Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Terms and Conditions

Figure 4 Forest plot of hepatitis D virus seroprevalence among patients with liver disease compared with asymptomatic controls in sub-Saharan Africa Data are from a random-effects model. METAVIR is a histological scoring system based on liver biopsy. OR=odds ratio. HCC=hepatocellular carcinoma. The Lancet Global Health 2017 5, e992-e1003DOI: (10.1016/S2214-109X(17)30298-X) Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Terms and Conditions

Figure 5 Distribution of hepatitis D virus genotypes in sub-Saharan Africa Genotype data were derived from included studies and publicly available sequences deposited in Genbank and the European Nucleotide Archive database. Each bubble represents an individual study. The Lancet Global Health 2017 5, e992-e1003DOI: (10.1016/S2214-109X(17)30298-X) Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Terms and Conditions

Figure 6 Quality assessment of included studies HCC=hepatocellular carcinoma. *Data are from the present study. The Lancet Global Health 2017 5, e992-e1003DOI: (10.1016/S2214-109X(17)30298-X) Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Terms and Conditions