Prevalence of hepatitis B in Latin America and the Caribbean: a systematic review and meta-analysis

Hepatitis B is a health threat with regional variations in prevalence. Our aim was to conduct a systematic review and meta-analysis of available data on the prevalence of hepatitis B virus (HBV) in Latin America and the Caribbean (LAC). A literature search was conducted from 2000 to 2024 using the databases Medline, Embase, LILACS and Web of Science, following PRISMA guideline. Search terms included: “hepatitis B virus”, “HBsAg”, “HBV”, “prevalence”, and “Latin America and the Caribbean”. Random-effects meta-analysis was performed to estimate the prevalence of HBV (HBsAg), and the I2 statistic was used to assess heterogeneity between studies. Subgroup and meta-regression analyses were performed to investigate possible sources of heterogeneity. In total, 190 studies were included in the analysis and the estimated global prevalence of HBV was 1.0% (95% CI: 1.0%-1.0%). In population subgroup analyses, the prevalence in general population was 1.0%, indigenous people was 6.0%, HIV-infected individuals was 5.0%, and inmates was 1.0%. The prevalence found was 2.0% in the period of 2000–2008, 1.0% in 2009–2016, and 1.0% in 2017–2024. The prevalence trends over time in the general population, indigenous people, HIV-infected individuals and inmate subgroups were 1.0%, 11.0%, 6.0% and 12.0% in the period of 2000–2008, 1.0%, 4.0%, 3.0% and 0.0% in 2009–2016, and 1.0%, 5.0%, 8.0% and 0.1% in 2017–2024, respectively. In LAC, HBV prevalence decreases over time, but risk subgroups stand out with elevated prevalence, such as indigenous people and HIV-infected individuals. Strategies to expand testing, treatment and vaccination with a focus on these subgroups may be relevant to reduce the prevalence of HBV.