Burden of tuberculosis and hepatitis co-infection among people living with HIV in Nepal: A systematic review and meta-analysis


People living with HIV (PLHIV) are prone to tuberculosis (TB) and hepatitis co-infections, which cause substantial burden on morbidity and mortality. However, data on the burden of HIV co-infection from a specific low- and middle-income country are limited. To address this gap in evidence, a meta-analysis of published literature and country surveillance report was conducted to estimate the burden of TB, hepatitis B (HBV) and hepatitis C (HCV) co-infection among PLHIV in Nepal. Twenty-three studies, including 5900 PLHIV, were included in the meta-analysis. The pooled prevalence of HIV-TB, HIV-HBV and HIV-HCV co-infection was 19% (95% CI, 10–28%), 3% (2–5%) and 19% (4–33%), respectively. Low CD4 cell count (pooled odds ratio [OR] 4.38, 95% CI 1.11–17.25), smoking (3.07, 1.48–6.37) and alcohol drinking (3.12, 1.52–6.43) were significantly correlated with HIV-TB co-infection. The odds of HCV co-infection was greater in PLHIV, who were male (5.39, 1.54–18.89) and drug users (166.26, 15.94–1734.44). PLHIV who were on antiretroviral therapy had a reduced risk of HCV co-infection (0.49, 0.36–0.66) than the general PLHIV population. The burden of TB and hepatitis co-infection among PLHIV in Nepal was high. Regular screening of PLHIV for co-infections and prompt initiation of treatment are essential to reduce the transmission of infection and improve quality of life.


Gc S, Khanal A, Gc VS, Bhattarai S, Panthee S, Khanal A, Gaire A, Poudel S, Ghimire R, Wasti SP




  • Epidemiology and Determinants of Health
    • Epidemiology
    • Determinants of Health
  • Determinants of Health
    • Income
  • Population(s)
    • General HIV+ population
  • Co-infections
    • Hepatitis B, C
    • Tuberculosis


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