Tarbiat Modares University Infection Epidemiology and Microbiology 2588-4107 12 2 2026 09 01 Global Prevalence of Human Pegivirus-1 (HPgV-1) Infection among HIV-Positive Patients and the Impact of HPgV-1 on HIV Viral Load and CD4 Cell Count: A Systematic Review and Meta-Analysis 161 175 29040 10.52547/iem.12.2.161 EN Ahmad Piroozmand Autoimmune Diseases Research Center, Kashan University of Medical Sciences, Kashan, Iran Department of Microbiology and Immunology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran Mohammad Shayestehpour Autoimmune Diseases Research Center, Kashan University of Medical Sciences, Kashan, Iran Department of Bacteriology and Virology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. Journal Article 2026 02 01 <strong>Background:</strong> Human pegivirus-1 (HPgV-1) was first identified in 1996. The impact of HPgV-1 on HIV viral load and CD4 cell count is controversial. This study aimed to assess the global prevalence of HPgV-1/HIV coinfection and the impact of HPgV-1 <br>on HIV viral load and CD4 cell count. <br><strong>Materials & Methods:</strong> A literature search was performed in PubMed, Scopus, EMBASE, Web of Science, ProQuest, Cochrane, and Global Index Medicus (GIM) up to January 2026. The I2 statistic and Cochran’s Q test were used to assess heterogeneity. Subgroup analyses were carried out to find potential causes of heterogeneity. Funnel plot and Egger’s test were used to assess publication bias.<br><strong>Findings:</strong> A total of 86 studies with 19050 HIV-positive cases, published from 1997 to 2023 and covering 36 different countries, were included in this meta-analysis. The overall prevalence of HPgV-1 among HIV-positive patients was 25.3%. The prevalence of HIV/ HPgV-1 coinfection in different continents was as follows: 26.5% in Africa, 21.9% in Asia, 26.7% in Europe, 24.6% in North America, and 25.1% in South America. The overall mean of CD4 cell count was significantly different between HPgV-1-positive and HPgV-1-negative patients, while the overall mean of HIV viral load was not significantly different.<br><strong>Conclusion:</strong> In this meta-analysis, the global prevalence of HPgV-1/HIV coinfection was 25.3%, with coinfected patients showing higher CD4 cell counts (p= .004) but no impact on HIV viral load. The results suggest that HPgV-1 may modulate HIV progression, though mechanisms remain unclear. Larger longitudinal studies are needed to confirm clinical significance and explore genotype-specific effects. https://iem.modares.ac.ir/article_29040_8bd6aa50162ebeffc7294b652bc3ea4f.pdf