The global epidemiology of viral-induced acute liver failure: a systematic review protocol

Jenna Patterson; Hannah Sophia Hussey; Leila Hussein Abdullahi; Sheetal Silal; Liz Goddard; Mashiko Setshedi; Wendy Spearman; Gregory D Hussey; Benjamin Kagina; Rudzani Muloiwa

doi:10.1136/bmjopen-2019-029819

The global epidemiology of viral-induced acute liver failure: a systematic review protocol

BMJ Open. 2019 Aug 30;9(8):e029819. doi: 10.1136/bmjopen-2019-029819.

Authors

Jenna Patterson^{1

2}, Hannah Sophia Hussey^{3

2}, Leila Hussein Abdullahi^{2

4}, Sheetal Silal^{5

6

7}, Liz Goddard⁸, Mashiko Setshedi⁹, Wendy Spearman¹⁰, Gregory D Hussey^{3

11}, Benjamin Kagina^{3

2}, Rudzani Muloiwa^{3

12}

Affiliations

¹ Vaccines for Africa Initiative, University of Cape Town, Cape Town, South Africa [email protected].
² School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
³ Vaccines for Africa Initiative, University of Cape Town, Cape Town, South Africa.
⁴ Somaliland Country Office, Save the Children International, Nairobi, Kenya.
⁵ Department of Statistical Sciences, University of Cape Town, Cape Town, South Africa.
⁶ Modelling and Simulation Hub Africa, University of Cape Town, Cape Town, South Africa.
⁷ Nuffield Department of Medicine, University of Oxford, Oxford, UK.
⁸ Department of Paediatrics, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.
⁹ Department of Medicine, Division of Gastroenterology, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa.
¹⁰ Department of Medicine, Division of Hepatology, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa.
¹¹ Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa.
¹² Department of Paediatrics, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa.

Abstract

Introduction: The burden of viral-induced acute liver failure (ALF) around the world still remains unclear, with little to no data collected regarding the disease incidence in general and synthesised data on the relative contribution of different viruses to the aetiology of ALF is missing in the field. The aim of this review is to estimate the burden (prevalence, incidence, mortality, hospitalisation) of ALF following infection HAV, HBV, HCV, HDV, HEV, EBV), HSV1, HSV2, VZV, parvo-virus B19, HPIVs, YFV, HVV-6, CMV, CA16 and/or HAdVs. Establishing the common aetiologies of viral-induced ALF, which vary geographically, is important so that: (1) treatment can be initiated quickly, (2) contraindications to liver transplant can be identified, (3) prognoses can be deterined more accurately, and most importantly, (4) vaccination against viral ALF aetiologies can be prioritised especially in under-resourced regions with public health risks associated with the relevant attributable diseases.

Methods and analysis: EBSCOhost, PubMed, ScienceDirect, Scopus and Web of Science databases will be searched for relevant literature published and grey literature from 2009 up to 2019. Published cross-sectional and cohort studies will be eligible for inclusion in this review. Qualifying studies will be formally assessed for quality and risk of bias using a standardised scoring tool. Following standardised data extraction, meta-analyses will be carried out using STATA. Depending on characteristics of included studies, subgroup analyses and meta-regression analyses will be performed. This review will be reported according to Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines.

Ethics and dissemination: No ethics approval is required as the systematic review will use only published data already in the public domain. Findings will be disseminated through publication in a peer-reviewed journal.

Prospero registration number: CRD42018110309.

Keywords: acute liver failure; epidemiology; global.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Global Health
Humans
Liver Failure, Acute / epidemiology*
Liver Failure, Acute / mortality
Liver Failure, Acute / therapy
Liver Failure, Acute / virology
Meta-Analysis as Topic
Research Design
Systematic Reviews as Topic
Virus Diseases / complications*