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CC BY-NC-ND 4.0 · Avicenna J Med 2022; 12(01): 003-009
DOI: 10.1055/s-0041-1739236
Review Article

Detection of Cytomegalovirus Infection in Infants with Biliary Atresia: A Meta-analysis

Sagad Omer Obeid Mohamed 
1   Department of Surgery, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
,
Almutasim B. E. Elhassan
1   Department of Surgery, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
,
Ibrahim H. E. Elkhidir 
1   Department of Surgery, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
,
Almigdad H.M. Ali
1   Department of Surgery, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
,
Mohamed Elata Hassan Elbathani
1   Department of Surgery, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
,
Osman Omer Ali Abdallah
1   Department of Surgery, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
,
Asaad Ahmed Mohamed Ahmed
1   Department of Surgery, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
,
Abazr A. H. Ibrahim
1   Department of Surgery, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
,
Mohammed Suliman Tawer Salman
1   Department of Surgery, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
,
Mahmoud Elnil
1   Department of Surgery, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
,
Mazin A.M. Elhassan
1   Department of Surgery, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
,
Abdelhamid Ibrahim Hassan Abuzied
1   Department of Surgery, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
› Author Affiliations Funding This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
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Abstract

Objectives Biliary atresia (BA) is the most common indication of liver transplantation in children. Several reports attributed BA to both prenatal and perinatal etiologies, including a viral infection-induced autoimmune response that targets the bile ducts. Cytomegalovirus (CMV) remains the most common virus being linked to BA. This meta-analysis aimed to estimate to what extent CMV infection is detected in patients with BA.

Methods This study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The databases of MEDLINE, Embase, Scopus, WHO-Virtual Health Library (VHL), ScienceDirect, and Google Scholar were used for the systematic search. The risk of bias was assessed using the Newcastle–Ottawa scale. Random effects model was used to estimate the pooled prevalence estimate with the corresponding 95% confidence interval (CI) using Comprehensive Meta-Analysis Software version 3.3.

Results A total of 19 studies that fulfilled the eligibility criteria were included in the meta-analysis. The total number of infants with BA was 630 patients, and the pooled overall prevalence of CMV infection among them was 25.4% (95% CI: 15.9%–38.0%). There was high heterogeneity among studies (I2 = 85.1%, p < .001), and subgroup analyses showed significant regional differences (X2 = 48.9, p <.001). Data on the prognosis of CMV-associated BA were scarce and obtainable from few studies that suggested an association between detection of CMV infection and poor prognosis of BA.

Conclusions The limited available data demonstrates that the rate of detection of CMV infection is high in infants with BA. There is still a need for large studies with appropriate controls for obtaining more reliable results about the various aspects of the association between CMV infection and BA.

Keywords

Cytomegalovirus - biliary atresia - prevalence - meta-analysis

Authors Contribution

S.M. conceptualized the research idea and designed the study; S.M., A.A., M.E. and A.I. undertook articles searching, articles assessment, and review; S.M., M.E., and A.E. undertook data extraction and analysis; All authors interpreted the results and drafted the manuscript. All authors revised and approved the final manuscript.




Publication History

Article published online:
14 December 2021

© 2021. Syrian American Medical Society. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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