Prevalence of Hepatitis C Virus in Iranian Prisoners: An Updated Systematic Review and Multilevel Meta-Analysis Study

Context: Hepatitis C is one of the most dangerous viral infections causing chronic liver disease. Objectives: The current study aimed to estimate the pooled prevalence of hepatitis C in Iranian prisoners. Evidence Acquisition: Articles were identified through searching international databases, including PubMed, Scopus, Elsevier, Google Scholar, andWeb of Science and Iranian databases, including Scientific Information Database (SID), Health.barakatkns, IranDoc, Civilica, and MagIran. We systematically reviewed all studies reporting the prevalence of HCV in Iranian prisoners. All studies conducted ELISA tests for the evaluation of HCV antibodies. In this study, a multilevel meta-analysis method was used to estimate the pooled prevalence. Results: The electronic search identified 147 records, 33 of which were relevant papers used for the pooled meta-analysis of HCV prevalence. Overall, the prevalence of HCV using a multilevel meta-analysis approach was 24.88% (95% CI = 19.12 - 31.69). The highest pooled HCVrate was related to Markazi province (59.47% [95% CI = 51.70 - 67.25]), while the lowest pooled HCVrate belonged to North Khorasan province (5.00% [95% CI = 2.44 - 7.55]). A decreasing HCV prevalence trend was observed between 1995 and 2018. Conclusions: The results of the study showed that the prevalence of HCVis significantly high among prisoners in Iran. An enhanced training program is needed for prisoners and prison staff to improve the prisoners' health status.