Our systematic review and meta-analysis documented a substantial decline in HCV prevalence among Brazilian haemodialysis patients from 1992 to 2015. confirmatory PCR (i.e., active contamination), respectively. A comprehensive set of different methods and procedures were used: forest plots and respective statistics, polynomial regression, meta-regression, subgroup influence, quality assessment, and trim-and-fill analysis. 29 studies and 11,290 individuals were assessed. The average time patients were in haemodialysis diverse from 23.5 to 56.3?months. Prevalence of HCV contamination was highly heterogeneous, with a pronounced decrease from 1992 to 2001, followed by a plateau and a slight decrease in recent years. The summary measure for HCV prevalence was 34% (95% CI 26C43%) for studies implemented before 2001. For studies implemented after 2001, the corresponding summary measure was 11% (95% CI 8C15%). Estimates for prevalence of active HCV contamination were also Rabbit Polyclonal to MRPS12 highly heterogeneous. There was a marked decline from 1996 to 2001, followed by a plateau and a slight increase after 2010. The summary measure for active HCV contamination was 19% (95% CI 15C25%) in studies carried out before 2001. For studies implemented after 2001, the corresponding summary measure was 9% (95% CI 6C13%). Heterogeneity was pervasive, but different analyses helped to identify its underlying sources. Besides the 12 months each study was conducted, the findings differed markedly between geographic regions and were heavily influenced by the size of the studies and publication biases. Our systematic review and meta-analysis documented a substantial decline in HCV prevalence among Brazilian haemodialysis patients from 1992 to 2015. CKD should be targeted with specific interventions to prevent HCV contamination, and if prevention fails, prompt diagnosis and treatment. Although the goal of HCV removal by 2030 in Brazil remains elusive, it is necessary to adopt measures to achieve micro-elimination and to launch initiatives towards targeted interventions to curb the spread of HCV in people with CKD, among other high-risk groups. This is of particular concern in the context of a protracted COVID-19 pandemic and a major economic and political crisis. followed a binomial distribution, with a parameter corresponding to the number of patients tested in the context of each study and (ii) the a priori distribution was also assumed as uniform (0, 1) for the different studies. The subsequent distribution of studies was defined as a beta () distribution (y?+?1, n-y?+?1). The 95% credibility intervals were calculated based on this distribution. The graphs were produced by fitted a local polynomial regression (not informed, amedian calculated via linear interpolation of accumulated distribution of time in dialysis; bweighted mean of medians. Considering the 23 studies with data around the central tendency measures of patients age, the lowest age was 42.2 years20 Sugammadex sodium and the highest was 56.9 years44. The weighted average for the 23 studies with available data on age was 48.3?years, with lower ages in studies before 2001 (n?=?8; 45.7?years) and higher ages (49.9?years) in studies after 2001 (n?=?15) (Table ?(Table22). Information on age range was available in 16 studies. Sugammadex sodium Half of the studies only included patients over Brazils age of majority (18), whilst the other half also included children and adolescents. Data around the latter (figures and/or proportions) were not available in the original studies and could not be obtained from the authors (Table ?(Table22 and Web Appendix 2). The average time patients were in haemodialysis Sugammadex sodium diverse from 23.5 months33 to 56.3 months41. The weighted average (considering studies with available data [n?=?20] and their respective samples) was 39.3?months; lower (35.1?months) for studies launched before 2001 (n?=?6) and higher (40.9?months) for those after 2001 (n?=?14) (Table ?(Table22). The proportion (%) of patients that reported having received blood and/or blood products varied from 32.945 to 96.0%33. The weighted average for studies that provided this information (n?=?15) was 74.3%; higher (75.4%) among studies launched before 2001 (n?=?3) and lower (73.8%) for those after 2001 (n?=?12) (Table ?(Table22). Prevalence of HCV contamination (defined as a positive HCV antibody test) among the pool of studies on haemodialysis patients was highly heterogeneous (I2?=?98), with a pronounced decrease from 1992 to 2001, followed by a plateau and a slight decrease in recent years (Fig.?2). Open Sugammadex sodium in a separate window Physique 2 Prevalence rates of HCV contamination and 95% credibility intervals in haemodialysis patients in Brazil from 1992 to 2015 according to major geographic region. Additional analyses presented in detail in the Sugammadex sodium Web Appendix 3 show that such heterogeneities involve a complex combination of several factors, among them the year each study was carried out and the geographic.