hepatitis C virus (HCV) infection is high in sub-Saharan Africa, according to a
report in The Lancet Infectious Diseases.
UK investigators conducted a meta-analysis of 213 studies involving
approximately 1.2 million people in 33 countries. Overall HCV prevalence was
3%, but this differed between regions and risk groups. Approximately 6% of
people with HIV had HCV co-infection.
“We recorded a
high seroprevalence of HCV across populations in sub-Saharan Africa, including
in HIV-positive adults,” comment the authors. “We identified regional
Globally up to 150
million individuals have HCV. The infection therefore represents
an important global health challenge, especially for poorer countries. Data on
the epidemiology of HCV in sub-Saharan Africa is badly out of date. A review
published in 2002 found a prevalence of 3% but with significant regional
variations. Few studies have looked at rates of HIV/HCV co-infection, but
there is some evidence that HIV is associated with a higher risk of infection
wanted to update understanding of the HCV epidemic in the region. They
therefore conducted a systematic review and meta-analysis of studies published
between 2002 and 2014 that reported on HCV prevalence in sub-Saharan Africa and
rates of HIV/HCV co-infection.
divided according to whether the population was considered low risk for HCV
(antenatal clinic attendees; blood donors; people recruited in the general
population), or high risk (people with liver disease; people who had received
blood products or had surgery; people who inject drugs). People living with HIV were considered separately.
A total of 287
cohorts were included in the analysis and the overall HCV prevalence rate was
approximately 3%. However, this varied between region, ranging from 7% in
central Africa to 4% in west Africa and 1% in southeast Africa.
among low-risk groups was 2.65%. But, once again, there were some regional
variations with infection rates highest in central Africa and lowest in
Just over 3% of
antenatal clinic attendees were HCV-positive, an infection rate similar to that
seen in the overall low-risk population. The investigators therefore suggest
that antenatal patients would be a good population in which to monitor HCV trends
in the overall population.
of high-risk individuals were infected with HCV. Prevalence ranged between 46%
in a cohort of people who inject drugs in Kenya to 10% among people with liver
of people with HIV had HCV co-infection, with rates varying from nearly
7% in west Africa to 4.5% in southeast Africa.
“There is a clear
unmet need for prevention and treatment, access to which needs to be improved
for both monoinfected and co-infected individuals,” conclude the authors.