Prevalence of HIV, HCV and HBV in Central Asia and the Caucasus: A systematic review.

BACKGROUND: Human immunodeficiency virus (HIV), hepatitis C virus (HCV) and hepatitis B virus (HBV) are substantial public health threats in the region of Central Asia and the Caucasus, where the prevalence of these infections is currently rising. METHODS: A systematic review of MEDLINE, Embase and PsycINFO was conducted with no publication date or language restrictions through October 2019. Additional data were also harvested from national surveillance reports, references found in discovered sources, and other "grey" literature. It included studies conducted on high-risk populations (people who inject drugs (PWID), female sex workers (FSW), men who have sex with men (MSM), prisoners, and migrants) in Central Asia: Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, and Uzbekistan; and the Caucasus: Armenia, Azerbaijan, Georgia, and Northern Caucasus region of the Russian Federation. RESULTS: Wide ranges were noted for HIV prevalence: PWID 0-30.1%, MSM 0-25.1%, prisoners 0-22.8%, FSW 0-10.0%, and migrants 0.06-1.5%, with the highest prevalence of these high-risk groups reported in Kazakhstan (for PWID), Georgia (for MSM and prisoners) and Uzbekistan (for migrants). HCV prevalence also had a wide range: PWID 0.3-92.1%, MSM 0-18.9%, prisoners 23.8-49.7%, FSW 3.3-17.8%, and migrants 0.5-26.5%, with the highest prevalence reported in Georgia (92.1%), Kyrgyzstan (49.7%), and migrants from Tajikistan and Uzbekistan (26.5%). Similarly, HBV prevalence had a wide range: PWID 2.8-79.7%, MSM 0-22.2%, prisoners 2.7-6.2%, FSW 18.4% (one study), and migrants 0.3-15.7%. CONCLUSION: In Central Asia and the Caucasus, prevalence of HIV, HCV and HBV remains exceedingly high among selected populations, notably PWID and MSM.