Hepatitis B Virus Infection in Iran: A Systematic Review

Hepatitis B virus (HBV) infection is a worldwide problem. It is estimated that 400 million people are suffering from this infection. We conducted a systematic review to put all evidence on HBV infection in I.R. Iran and to make an accurate estimate of HBV infection prevalence in Iran for further planning to control the infection.Study Design: Meta-analysis and survey data analysis of all national and international papers, theses, congresses, reports, Iranian medical universities projects, research centers, reports of Deputy for Health affairs (published or unpublished).Setting & Population: Iranian general population with positive HBsAg in blood samplesSelection Criteria for Studies: All descriptive/analytical cross-sectional studies/surveys from April 2001 to March 2007 that have sufficiently declared objectives, proper sampling method with identical and valid measurement instruments for all study subjects and proper analysis methods regarding sampling design and demographic adjustmentsOutcomes: Presence of positive HBsAg in blood samples of study samples Fourteen studies met the inclusion criteria. They were from 7 (out of 30) provinces in which about 40 percent of the country population live. These provinces (HBsAg positive prevalence) were Golestan (6.3%), Tehran (2.2%), East Azarbaijan (1.3%), Hamedan (2.3%), Isfahan (1.3%), Kermanshah (1.3%) and Hormozgan (2.4%). The HBV infection prevalence in Iran is estimated to be 2.14 percent (95%CI: 1.92-2.35), in men and women 2.55 percent (95%CI: 2.25- 2.85) and 2.03 percent (95%CI: 1.6-2.46 percent) respectively. About 1.5 million people in Iran are living with HBV infection (mild to moderate prevalence according to WHO classification) and it is assumed that 15% to 40% of them are at risk of developing cirrhosis and/or hepatocellular carcinoma (HCC) without intervention. The prevalence of HBV infection has been reported higher in more recent studies compared to the study in 2000-2001.