There is plenitude of information on HIV infection among pregnant mothers attending antenatal care (ANC) in sub-Saharan Africa. However, the epidemiology of HBV–HIV co-infections in the same cohort is not clear despite the common route of transmission of both viruses. The aim of our study was to synthesize data on the prevalence of HBV–HIV co-infection among pregnant women attending ANC in Sub-Saharan Africa to assist in the design of public health interventions to mitigate the challenge. The study was done in tandem with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) standards and the Cochran’s Q test, I2 statistics for heterogeneity and the prevalence were calculated using commercially available software called MedCalcs ( https://www.medcalc.org ). A random effect model was used to pool the prevalence since all the heterogeneities were high (≥ 78%) and Phet < 0.05 indicated significant heterogeneities. The risk factors and risk differences for HBV–HIV co-infection were analyzed. Any likely sources of heterogeneity were analyzed through sensitivity analysis, meta-regression and sub-group analysis. All analyses were done at 95% level of significance and a P < 0.05 was considered significant. The overall pooled prevalence of HBV–HIV co-infection among pregnant mothers in sub-Saharan Africa was low 3.302% (95%CI = 2.285 to 4.4498%) with heterogeneities (I2) of 97.59% (P > 0.0001). Within regional sub group meta-analyses, West Africa had significantly higher prevalence of 5.155% (95% = 2.671 to 8.392%) with heterogeneity (I2) of 92.25% (P < 0.0001) than any other region (P < 0.001). Articles published from 2004–2010 had significantly higher prevalence of 6.356% (95% = 3.611 to 9.811%) with heterogeneity (I2) 91.15% (P < 0.0001) compared to those published from 2011 to 2019 (P < 0.001). The HIV positive cohort had significantly higher prevalence of HBV–HIV co-infection of 8.312% (95% CI = 5.806 to 11.22%) with heterogeneity (I2)94.90% (P < 0.0001) than the mothers sampled from the general population with a prevalence of 2.152% (95% CI = 1.358 to 3.125%) (P < 0.001). The overall and sub group analyses had high heterogeneities (I2 > 89%, P < 0.0001) but was reduced for South Africa (I2) = 78.4% (P = 0.0314). Age, marital status and employment were independent factors significantly associated with risk of HBV–HIV co-infection (P < 0.001) but not extent of gravidity and education level (P > 0.05). After meta-regression for year of publication and sample size for HBsAg positivity, the results were not significantly associated with HBV pooled prevalence for sample size (P = 0.146) and year of publication (P = 0.560). Following sensitivity analysis, the HBsAg pooled prevalence slightly increased to 3.429% (95% CI = 2.459 to 4.554%) with heterogeneity I2 = 96.59% (95% CI = 95.93 to 97.14%), P < 0.0001 There is an urgent need for routine HBV screening among HIV positive pregnant mothers attending antenatal care in sub-Saharan Africa to establish the extent of HBV–HIV co-infection in this cohort. Future studies need to investigate the putative risk factors for HBV–HIV co-infection and prioritize plausible control strategies.

中文翻译：

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在撒哈拉以南非洲 (SSA) 参加产前保健 (ANC) 的孕妇中人类免疫缺陷病毒-乙型肝炎病毒 (HIV-HBV) 合并感染的血清流行率及相关风险因素：系统评价和荟萃分析

有大量关于在撒哈拉以南非洲参加产前保健 (ANC) 的孕妇感染艾滋病毒的信息。然而，尽管两种病毒的传播途径相同，但同一队列中 HBV-HIV 合并感染的流行病学尚不清楚。我们研究的目的是综合有关在撒哈拉以南非洲参加 ANC 的孕妇中 HBV-HIV 合并感染流行率的数据，以协助设计公共卫生干预措施以减轻挑战。该研究与系统评价和 Meta 分析的首选报告项目 (PRISMA) 标准和 Cochran 的 Q 检验同时进行，异质性的 I2 统计数据和流行率是使用称为 MedCalcs 的市售软件计算的 (https://www. medcalc.org）。由于所有异质性都很高（≥ 78%）并且 Phet < 0.05 表明存在显着的异质性，因此使用随机效应模型来汇总流行率。分析了HBV-HIV合并感染的风险因素和风险差异。通过敏感性分析、元回归和亚组分析分析任何可能的异质性来源。所有分析均在 95% 的显着性水平下进行，P < 0.05 被认为是显着的。撒哈拉以南非洲地区孕妇 HBV-HIV 合并感染的总体合并患病率低 3.302%（95%CI = 2.285 至 4.4498%），异质性（I2）为 97.59%（P > 0.0001）。在区域亚组荟萃分析中，西非的患病率为 5.155%（95% = 2.671 至 8.392%），异质性（I2）为 92.25%（P < 0.0001），高于任何其他区域（P < 0.0.0001）。001）。与 2011 年至 2019 年发表的文章 (P < 0.001) 相比，2004 年至 2010 年发表的文章的患病率显着升高，为 6.356%（95% = 3.611 至 9.811%），异质性（I2）为 91.15%（P < 0.0001）。HIV 阳性队列的 HBV-HIV 合并感染率显着高于 8.312% (95% CI = 5.806 to 11.22%)，异质性 (I2) 为 94.90% (P < 0.0001) 2.152% (95% CI = 1.358 to 3.125%) (P < 0.001)。总体和亚组分析具有高异质性（I2 > 89%，P < 0.0001），但南非 (I2) = 78.4% (P = 0.0314) 异质性降低。年龄、婚姻状况和就业是与 HBV-HIV 合并感染风险显着相关的独立因素（P < 0.001），但与生育程度和教育水平无关（P > 0.05）。在对 HBsAg 阳性的出版年份和样本量进行元回归后，结果与样本量（P = 0.146）和出版年份（P = 0.560）的 HBV 汇总流行率没有显着相关性。经过敏感性分析，HBsAg 汇总患病率略微增加至 3.429%（95% CI = 2.459 至 4.554%），异质性 I2 = 96.59%（95% CI = 95.93 至 97.14%），P < 0.0001 迫切需要常规在撒哈拉以南非洲参加产前保健的 HIV 阳性孕妇中进行 HBV 筛查，以确定该队列中 HBV-HIV 合并感染的程度。未来的研究需要调查 HBV-HIV 合并感染的假定风险因素，并优先考虑合理的控制策略。结果与样本量 (P = 0.146) 和出版年份 (P = 0.560) 的 HBV 合并流行率没有显着相关性。经过敏感性分析，HBsAg 汇总患病率略微增加至 3.429%（95% CI = 2.459 至 4.554%），异质性 I2 = 96.59%（95% CI = 95.93 至 97.14%），P < 0.0001 迫切需要常规在撒哈拉以南非洲参加产前保健的 HIV 阳性孕妇中进行 HBV 筛查，以确定该队列中 HBV-HIV 合并感染的程度。未来的研究需要调查 HBV-HIV 合并感染的假定危险因素，并优先考虑合理的控制策略。结果与样本量 (P = 0.146) 和出版年份 (P = 0.560) 的 HBV 合并流行率没有显着相关性。经过敏感性分析，HBsAg 汇总患病率略微增加至 3.429%（95% CI = 2.459 至 4.554%），异质性 I2 = 96.59%（95% CI = 95.93 至 97.14%），P < 0.0001 迫切需要常规在撒哈拉以南非洲参加产前保健的 HIV 阳性孕妇中进行 HBV 筛查，以确定该队列中 HBV-HIV 合并感染的程度。未来的研究需要调查 HBV-HIV 合并感染的假定危险因素，并优先考虑合理的控制策略。459 至 4.554%) 具有异质性 I2 = 96.59% (95% CI = 95.93 至 97.14%)，P < 0.0001 迫切需要在撒哈拉以南非洲地区参加产前保健的 HIV 阳性孕妇中进行常规 HBV 筛查，以建立该队列中 HBV-HIV 合并感染的程度。未来的研究需要调查 HBV-HIV 合并感染的假定危险因素，并优先考虑合理的控制策略。459 至 4.554%) 具有异质性 I2 = 96.59% (95% CI = 95.93 至 97.14%)，P < 0.0001 迫切需要在撒哈拉以南非洲地区参加产前保健的 HIV 阳性孕妇中进行常规 HBV 筛查，以建立该队列中 HBV-HIV 合并感染的程度。未来的研究需要调查 HBV-HIV 合并感染的假定危险因素，并优先考虑合理的控制策略。