Clinical relevance of viral load in human bocavirus infection; a comprehensive systematic review and meta-analysis

The Human bocavirus (HBoV), a parvovirus linked to respiratory and gastrointestinal infections, is frequently detected alongside other pathogens, complicating its clinical interpretation. High viral load (HVL) of HBoV mostly corresponds with symptomatic infection, the presentation of a correlation between viral load and severity of disease in humans remains elusive. This systematic review and meta-analysis, registered in PROSPERO (CRD42024622377) and adhering to PRISMA guidelines, evaluated the association between HBoV viral load (HVL) and disease severity, comparing mono-infections and coinfections. From 19 studies (23,546 patients; 2305 HBoV-positive cases), coinfection prevalence (57.7%) exceeded mono-infection (42.3%). Overall, odds of HVL in HBoV infection were significantly lower as compared to LVL across all HBoV positive cases (OR = 0.32; 95% CI: 0.29–0.36; p p