Global prevalence and associated factors of liver fibrosis among people living with HIV: a systematic review and meta-analysis

Liver fibrosis is recognized as one of the serious effects related to HIV infection. To maintain the health of people living with HIV, it is important to examine the prevalence of liver fibrosis and its determinants among these patients. This systematic review and meta-analysis aimed to investigate the global prevalence and associated factors of liver fibrosis among people living with HIV. A comprehensive search was conducted in four databases, including Web of Science, PubMed, Scopus, and Google Scholar. Two researchers independently screened articles. Subsequently, data were extracted from the selected articles. The quality of the papers was evaluated using the Joanna Briggs Institute (JBI) checklists. Moreover, a meta-analysis was performed. The pooled prevalence of liver fibrosis in people living with HIV mono-infection and HIV co-infection was 13.09% (95% CI: 10.63–16.02) [ p < 0.001; I 2 = 97.91] and 25.81% (95% CI: 22.76–29.12) [ p < 0.001; I 2 = 98.07], respectively. These values indicate high heterogeneity. The possible factors associated with liver fibrosis in these patients were classified into eight groups, including metabolic and anthropometric factors, liver-specific factors, viral co-infection factors, HIV disease severity and immune dysfunction factors, antiretroviral therapy factors, demographic factors, lifestyle and behavioral factors, and endocrine factors and other diseases. It is suggested that some measures are implemented to reduce the incidence of liver fibrosis in people living with HIV. However, given the high heterogeneity in the results of the studies, the findings of this review must be used with caution. These findings support targeted liver fibrosis screening, comprehensive management of metabolic risk factors, prevention and treatment of viral hepatitis co-infections, optimization of antiretroviral therapy, reduction of harmful alcohol use, and regular clinical monitoring to facilitate early detection and prevention of liver fibrosis. Not applicable.