A Systematic Review and Meta-Analysis of the Prevalence of Triplex Infections (Combined Human Immunodeficiency Virus, Hepatitis B Virus, and Hepatitis C Virus) among Pregnant Women in Nigeria
Authors: Eleje George Uchenna , Loto Olabisi Morebise , Usman Hadiza Abdullahi , Onubogu Chinyere Ukamaka , Fiebai Preye Owen , Akaba Godwin Otuodichinma , Rabiu Ayyuba , Mbachu Ikechukwu Innocent , Chibuzor Moriam Taiwo , Chukwuanukwu Rebecca Chinyelu , Joe-Ikechebelu Ngozi Nneka , Igbodike Emeka Philip , Egeonu Richard Obinwanne , Oppah Ijeoma Chioma , Ogwaluonye Uchenna Chukwunonso , Nwankwo Chike Henry , Kalu Stephen Okoroafor , Chigbo Chisom God’swill , Ogbuagu Chukwuanugo Nkemakonam , Chukwurah Shirley Nneka , Uzochukwu Chinwe Elizabeth , Ahmed Aishat , Jibuaku Chiamaka Henrietta , Inuyomi Samuel Oluwagbenga , Adesoji Bukola Abimbola , Anyang Ubong Inyang , Emeka Ekene Agatha , Igue Odion Emmanuel , Okoro Ogbonna Dennis , Aja Prince Ogbonnia , Chidozie Chiamaka Perpetua , Ibrahim Hadiza Sani , Aliyu Fatima Ele , Ugwuoroko Harrison Chiro , Numan Aisha Ismaila , Omoruyi Solace Amechi , Umeononihu Osita Samuel , Okoro Chukwuemeka Chukwubuikem , Nwaeju Ifeanyi Kingsley , Onwuegbuna Arinze Anthony , Eleje Lydia Ijeoma , Ikwuka David Chibuike , Umeh Eric Okechukwu , Nweje Sussan Ifeyinwa , Ajuba Ifeoma Clara , Ugwu Angela Ogechukwu , Ebubedike Uzoamaka Rufina , Malachy Divinefavour Echezona , Okafor Chigozie Geoffrey , Obiegbu Nnaedozie Paul , Ugwu Emmanuel Onyebuchi , Yakasai Ibrahim Adamu , Ezechi Oliver Chukwujekwu , Ikechebelu Joseph Ifeanyichukwu 
Published: July 2023

Objective. We systematically identified the prevalence of triplex infections (combined human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV)) in pregnancy. Methods. To gather information on the frequency of triplex infections, we searched the databases of PubMed, CINAHL, and Google Scholar. Without regard to language, we utilized search terms that covered HIV, HBV, HCV, and pregnancy. Pregnant women with triplex infections of HIV, HBV, and HCV were included in studies that also examined the prevalence of triplex infections. Review Manager 5.4.1 was employed to conduct the meta-analysis. Critical appraisal and bias tool risk data were provided as percentages with 95% confidence intervals (95% CIs), and I2 was used as the statistical measure of heterogeneity. The checklist was created by Hoy and colleagues. The study protocol was registered on PROSPERO, under the registration number CRD42020202583. Results. Eight studies involving 5314 women were included. We identified one ongoing study. Pooled prevalence of triplex infections was 0.03% (95% CI: 0.02–0.04%) according to meta-analysis. Subgroup analysis demonstrated a significantly high prevalence of 0.08% (95% CI: 0.06–0.10%; 3863 women) in HIV-positive population than 0.00% (95% CI:−0.00-0.00; 1451 women;

P
<
0.001

) in general obstetric population. Moreover, there was a significant difference in the pooled prevalence between studies published between 2001 and 2010 and between 2011 and 2021 (0.14% (95% CI: 0.12 to 0.16 versus 0.03% (95% CI: 0.02 to 0.04%;

P
<
0.001

))) and participants recruited in the period between 2001 and 2011 and between 2012 and 2021 (0.13% (95% CI: 0.05 to 0.21;

p
=
0.002

versus 0.00% (95% CI: −0.00 to 0.00%;

p
=
1.00

))), respectively. Conclusion. The combined prevalence of prenatal triplex infections was 0.03%, with rates notably higher among the group of pregnant women who were HIV-positive and during the recruitment period that took place before 2012. This prevalence still necessitates screening for these infections as necessary.