INTRODUCTION: Hepatitis B virus (HBV) and Human Immunodeficiency virus (HIV) infections are both major public health concerns in sub-Saharan Africa. Co-infection with these virus accelerates liver disease progression, increases hepatotoxicity, undermines treatment effectiveness, and raises mortality risk. We conducted a systematic review and meta-analysis to determine the pooled prevalence of HBV-HIV co-infection in Nigeria. METHODS: We searched databases (PubMed, Scopus, and Embase) from their respective start dates (ranging from 1946 to 1970) through December 31, 2024, to ensure a historical capture of co-infection data in Nigeria. Google scholar was searched to identify relevant grey literature and locally published studies in Nigeria. A random-effects meta-analysis was performed to estimate pooled prevalence and account for between-study variability. RESULTS: A total of 28 studies were included, resulting in an overall HBV-HIV co-infection prevalence of 7% (95% CI: 5-11%). Heterogeneity was very high (I² = 95.7%), and the prediction interval ranged widely from 1 to 47% resulting in very low certainty of evidence rating. Subgroup analysis showed similar prevalence in adults and children (7% for both). The children's estimate was homogeneous (I² = 3.7%, 95% CI: 5-8%) with low certainty rating while the adult estimate remained highly heterogeneous (I² = 96.3%, 95% CI: 4-12%;). Regionally, prevalence was higher in the Northern zones 9% (95% CI: 7-12%; I² = 77.2%) than in the Southern zones 6% (95% CI: 3-12%; I² = 96.9%). CONCLUSION: This comprehensive systematic review and meta-analysis revealed a significant but highly variable landscape of HIV-HBV co-infection in Nigeria. While stable prevalence was observed in specific subpopulation like children, the high heterogeneity across the broader population suggests that diverse regional and demographic factors might be responsible. Therefore, strengthening integrated HIV-HBV screening and management must prioritize standardized practices, particularly within paediatric care to ensure early intervention and improve surveillance. There is the need for further research to identify the specific drivers of transmission in high-variability areas. CLINICAL TRIAL: Clinical trial number not applicable.
Bagayang et al. (Wed,) studied this question.