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

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. 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. 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. 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.