The Dual Burden of Hepatitis B and C Among Drug Users in Asia: The First Systematic Review and Meta-Analysis.

Jawaher Alotaibi, Ali A Zaidan, Nabiha A Bouafia, Tasneem I Zaidan, Mohammed A Garout, Huseyin Tombuloglu, Hayam A Alrasheed, Sana A Alshaikh, Ali A Rabaan, Kizito E Bello, Zaheda Radwan, Amal K Hassouneh, Bashayer Basrana, Kawthar Amur Al Amri, Kawthar Haider Al Alawi, Razi A Alalqam

Journal: Pathogens (Basel, Switzerland) 2025;14(4):

PMID: 40333162

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Abstract

Hepatitis B virus (HBV) and Hepatitis C virus (HCV) contribute significantly to morbidity and mortality among drug users in Asia. This study systematically reviews and analyzes the pooled prevalence of HBV and HCV, considering geographic and methodological variations. A meta-analysis following PRISMA guidelines included data from PubMed, Scopus, and Google Scholar on studies on HBV or HCV or a combination of both within Asia. A random-effects model estimated pooled prevalence, with subgroup analyses by region, study design, diagnostic method, and publication year. A total of 112 studies were analyzed. The pooled HBV prevalence among drug users was 14.3% (95% CI: 11.5-17.6), highest in Malaysia (28.7%) and Vietnam (26.6%). HCV prevalence was 58.6% (95% CI: 54.0-63.0), with the highest rates in Vietnam (63.5%) and China (62.9%). Retrospective studies reported a higher prevalence than cross-sectional ones. The use of ELISA for initial screening followed up by PCR reduced heterogeneity, improving diagnostic accuracy. HBV prevalence declined after 2010, while HCV rates remained persistently high. The high burden of HBV and HCV among drug users in Asia underscores an urgent public health concern. Targeted interventions, including vaccination, harm reduction strategies, and improved access to antiviral treatments, are essential to curbing transmission and enhancing health outcomes.

Address: Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran 31311, Saudi Arabia.; College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia.; Department of Public Health and Nutrition, The University of Haripur, Haripur 22610, Pakistan.; Department of Microbiology, Kogi State (Prince Abubakar Audu) University, Anyigba 10008, Nigeria.; Medical Laboratory Department, Mohammed Al-Mana College for Medical Sciences, Dammam 34222, Saudi Arabia.; Clinical Pharmacy Department, King Saud Medical City, Riyadh 11362, Saudi Arabia.; Department of Pharmacy Practice, College of Pharmacy, Princess Nourah bint Abdulrahman University, Riyadh 11671, Saudi Arabia.; Infectious Diseases Unit, Department of Medicine, King Faisal Specialist Hospital and Research Center, Riyadh 11564, Saudi Arabia.; Department of Infectious Disease, King Abdullah Medical Complex, Jeddah 6725, Saudi Arabia.; Gastroenterology Department, King Fahad Armed Forces Hospital, Jeddah 23831, Saudi Arabia.; Department of Community Medicine and Health Care for Pilgrims, Faculty of Medicine, Umm Al-Qura University, Makkah 21955, Saudi Arabia.; Pediatric Infectious Diseases Unit, Pediatric Department, King Abdulaziz Hospital, Jeddah 23831, Saudi Arabia.; Infection and Control Department, Armed Forces Hospital, Azaibah 130, Oman.; Diagnostic Virology Laboratory, Maternity and Children Hospital, Eastern Health Cluster, Dammam 32253, Saudi Arabia.; Nursing Department of Vaccine Clinic, Hospital: Al Jamaeen Primary Health Care, Dammam 32467, Saudi Arabia.; Department of Medicine, Royal College of Surgeons, D02 YN77 Dublin, Ireland.; Department of Genetics Research, Institute for Research and Medical Consultations (IRMC), Imam Abdulrahman Bin Faisal University, Dammam 34221, Saudi Arabia.; Infection Prevention and Control Centre of Excellence, Prince Sultan Medical Military City, Riyadh 12233, Saudi Arabia.; Preventive and Community Medicine Department, Faculty of Medicine, University of Sousse, Sousse 4002, Tunisia.

DOI: 10.3390/pathogens14040360

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MeSH Terms: Humans, Hepatitis B, Prevalence, Hepatitis C, Drug Users, Asia, Hepatitis B virus, Coinfection, Hepacivirus