Evidence map›Paper›PMID 28911765›Full record

SynthesisThe Lancet. Global health2017

Prevalence of hepatitis D virus infection in sub-Saharan Africa: a systematic review and meta-analysis.

Alexander J Stockdale, Mas Chaponda, Apostolos Beloukas, Richard Odame Phillips, Philippa C Matthews, Athanasios Papadimitropoulos, Simon King, Laura Bonnett, Anna Maria Geretti

Erratum issued Registry-linked trialOpen access · goldAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in The Lancet. Global health, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT06539052 (A Model to Improve the Screening and Linkage to Care of HDV Infection in Migrant Living in Southern Italy Taking Advantage of HDV Reflex Testing), which is not on this map. Cited by 60 papers, 11 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
60citing papers in PubMed, 11 pooled it
7.7field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06539052 not yet recruitingnot on this mapstarted 2024, after this paper: background citation

A Model to Improve the Screening and Linkage to Care of HDV Infection in Migrant Living in Southern Italy Taking Advantage of HDV Reflex Testing: MIGrant Reflex Test HDV (MIGRED) Project

Typeobservational_patient_registrySponsorUniversity of Campania Luigi VanvitelliRan2024 to 2026Enrolled7,500ConditionsHepatitis D Virus InfectionArmsanti-HDV positive with the reflex testing methodology
3 · Its place in the literature

Who cites it

60 citing papers in PubMed, 11 syntheses or guidelines pooled it, 137 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 3 countries.

Alexander J StockdaleMalawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi; Institute of Infection and Global Health, University of Liverpool, Liverpool, UK.
Mas ChapondaInstitute of Translational Medicine, University of Liverpool, Liverpool, UK.
Apostolos BeloukasInstitute of Infection and Global Health, University of Liverpool, Liverpool, UK.
Richard Odame PhillipsDepartment of Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana; Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
Philippa C MatthewsUniversity of Oxford and Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
Athanasios PapadimitropoulosInstitute of Infection and Global Health, University of Liverpool, Liverpool, UK.
Simon KingInstitute of Infection and Global Health, University of Liverpool, Liverpool, UK.
Laura BonnettDepartment of Biostatistics, University of Liverpool, Liverpool, UK.
Anna Maria GerettiInstitute of Infection and Global Health, University of Liverpool, Liverpool, UK. Electronic address: geretti@liverpool.ac.uk.
University of Liverpool · GBKomfo Anokye Teaching Hospital · GHMalawi-Liverpool-Wellcome Trust Clinical Research Programme · MWOxford University Hospitals NHS Trust · GB

Funding

Medical Research Council MR/J01477X/1Wellcome Trust
6 · The paper itself

Abstract

backgroundHepatitis D virus (also known as hepatitis delta virus) can establish a persistent infection in people with chronic hepatitis B, leading to accelerated progression of liver disease. In sub-Saharan Africa, where HBsAg prevalence is higher than 8%, hepatitis D virus might represent an important additive cause of chronic liver disease. We aimed to establish the prevalence of hepatitis D virus among HBsAg-positive populations in sub-Saharan Africa.

methodsWe systematically reviewed studies of hepatitis D virus prevalence among HBsAg-positive populations in sub-Saharan Africa. We searched PubMed, Embase, and Scopus for papers published between Jan 1, 1995, and Aug 30, 2016, in which patient selection criteria and geographical setting were described. Search strings included sub-Saharan Africa, the countries therein, and permutations of hepatitis D virus. Cohort data were also added from HIV-positive populations in Malawi and Ghana. Populations undergoing assessment in liver disease clinics and those sampled from other populations (defined as general populations) were analysed. We did a meta-analysis with a DerSimonian-Laird random-effects model to calculate a pooled estimate of hepatitis D virus seroprevalence.

findingsOf 374 studies identified by our search, 30 were included in our study, only eight of which included detection of hepatitis D virus RNA among anti-hepatitis D virus seropositive participants. In west Africa, the pooled seroprevalence of hepatitis D virus was 7·33% (95% CI 3·55-12·20) in general populations and 9·57% (2·31-20·43) in liver-disease populations. In central Africa, seroprevalence was 25·64% (12·09-42·00) in general populations and 37·77% (12·13-67·54) in liver-disease populations. In east and southern Africa, seroprevalence was 0·05% (0·00-1·78) in general populations. The odds ratio for anti-hepatitis D virus detection among HBsAg-positive patients with liver fibrosis or hepatocellular carcinoma was 5·24 (95% CI 2·74-10·01; p<0·0001) relative to asymptomatic controls.

interpretationFindings suggest localised clusters of hepatitis D virus endemicity across sub-Saharan Africa. Epidemiological data are needed from southern and east Africa, and from patients with established liver disease. Further studies should aim to define the reliability of hepatitis D virus testing methods, identify risk factors for transmission, and characterise the natural history of the infection in the region.

fundingWellcome Trust, Royal Society.

Indexed as

Africa South of the SaharaHepatitis DHepatitis Delta VirusHumansPrevalence

Identifiers

PMID28911765
PMCPMC5599428
OpenAlexW2755997084

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.