Estimates of the prevalence of occult HBV infection in Asia: a systematic review and meta-analysis

Abstract

Purpose

Occult Hepatitis B virus infection (OBI) is of great significance to the transmission of Hepatitis B virus (HBV) and the evolution of the patient’s clinical outcome. We conducted a systematic review and meta-analysis to estimate the prevalence of OBI in Asia.

Methods

Literature search was conducted in PubMed, Cochrane Library database, Web of Science and Embase with the keywords of ‘Hepatitis B virus’, ‘occult infection’, ‘prevalence’. 70 studies were included in the meta-analysis. Meta-analysis was performed using random-effects models to calculate the pooled prevalence of OBI and 95% confidence interval (CI). The data were analyzed in R 4.1.2.

Results

The overall prevalence of OBI was 4% (95%CI: 0.03–0.06) in Asia. Subgroup analysis based on geographic region showed a prevalence of 3% (95%CI 0.02–0.06) in East Asia, 9% (95%CI 0.05–0.15) in West Asia, 3% (95%CI 0.01–0.11) in Southern Asia and 9% (95%CI 0.05–0.15) in Southeast Asia. Subgroup analysis demonstrated a prevalence of 1% (95%CI 0.00–0.02) in general population, 5% (95%CI: 0.03–0.08) in high-risk population, 9% (95%CI: 0.03–0.22) in the human immunodeficiency virus (HIV)-infected patient, 18% (95%CI: 0.09–0.32) in the hepatopathy patients.

Conclusion

Based on the meta-analysis of the prevalence of OBI in different populations, we concluded that the prevalence of OBI in the high-risk population, hepatopathy patients, and HIV-infected patients was higher than that in the general population. A systematic review showed that OBI was associated with disease progression and prognosis. Therefore, these populations should be routinely screened for OBI and promptly intervened to avoid promoting disease progression.

Keywords:

• Occult HBV infection
• prevalence
• epidemiology
• Asia
• meta-analysis

Author contributions

YJS conceived and designed this meta-analysis; WYYX designed the search strategy and performed the literature search; WYYX, HYH and YJS conducted literature screening; WYYX and HYH assessed the quality of the studies, WYYX and CFS performed the data extraction and meta-analysis; WYYX and CFS drafted the manuscript; CFS, YJS and CLD reviewed the manuscript critically. All authors read and approved the final manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

We browse the reference list of included articles and raw data from publicly available databases and websites. The statistical analysis software material (the ‘meta’ or ‘meta for’ package in R 4.1.2.) is obtained for free from the official website.