Global associations of key populations with HIV-1 recombinants: a systematic review, global survey, and individual participant data meta-analysis

Frontiers in Public Health

Public Health

Shona Kirtley¹  Ramyiadarsini Elangovan²  Joris Hemelaar²  Leslie Dickson-Tetteh²  Jason Yun²  Nkazi Nchinda² 

[1] Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Botnar Research Centre, Oxford, United Kingdom;Nuffield Department of Population Health, Infectious Disease Epidemiology Unit, National Perinatal Epidemiology Unit, University of Oxford, Oxford, United Kingdom;

关键词: HIV;    key populations;    recombinant;    CRF;    URF;    molecular epidemiology;   

DOI  :  10.3389/fpubh.2023.1153638

 received in 2023-01-29, accepted in 2023-06-28,  发布年份 2023

来源: Frontiers

【 摘 要 】

IntroductionGlobal HIV infections due to HIV-1 recombinants are increasing and impede prevention and treatment efforts. Key populations suffer most new HIV infections, but their role in the spread of HIV-1 recombinants is unknown. We conducted a global analysis of the associations between key populations and HIV-1 recombinants.MethodsWe searched PubMed, EMBASE, CINAHL, and Global Health for HIV-1 subtyping studies published from 1/1/1990 to 31/12/2015. Unpublished data was collected through a global survey. We included studies with HIV-1 subtyping data of key populations collected during 1990-2015. Key populations assessed were heterosexual people (HET), men who have sex with men (MSM), people who inject drugs (PWID), vertical transmissions (VERT), commercial sex workers (CSW), and transfusion-associated infections (BLOOD). Logistic regression was used to determine associations of key populations with HIV-1 recombinants. Subgroup analyses were performed for circulating recombinant forms (CRFs), unique recombinant forms (URFs), regions, and time periods.ResultsEight hundred and eighty five datasets including 77,284 participants from 83 countries were included. Globally, PWID were associated with the greatest odds of recombinants and CRFs (OR 2.6 [95% CI 2.46–2.74] and 2.99 [2.83–3.16]), compared to HET. CSW were associated with increased odds of recombinants and URFs (1.59 [1.44–1.75] and 3.61 [3.15–4.13]). VERT and BLOOD were associated with decreased odds of recombinants (0.58 [0.54–0.63] and 0.43 [0.33–0.56]). MSM were associated with increased odds of recombinants in 2010–2015 (1.43 [1.35–1.51]). Subgroup analyses supported our main findings.DiscussionAs PWID, CSW, and MSM are associated with HIV-1 recombinants, increased preventative measures and HIV-1 molecular surveillance are crucial within these key populations.Systematic review registrationPROSPERO [CRD42017067164].

【 授权许可】

Unknown   
Copyright © 2023 Nchinda, Elangovan, Yun, Dickson-Tetteh, Kirtley, Hemelaar and WHO-UNAIDS Network for HIV Isolation and Characterisation.