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Meta-Analysis
. 2017 Jul 24;14(7):830.
doi: 10.3390/ijerph14070830.

Geographic Distribution and Temporal Trends of HIV-1 Subtypes through Heterosexual Transmission in China: A Systematic Review and Meta-Analysis

Peipei Xiao  1 , Jianjun Li  2 , Gengfeng Fu  3 , Ying Zhou  4 , Xiping Huan  5 , Haitao Yang  6   7   8
Affiliations
Meta-Analysis

Geographic Distribution and Temporal Trends of HIV-1 Subtypes through Heterosexual Transmission in China: A Systematic Review and Meta-Analysis

Peipei Xiao et al. Int J Environ Res Public Health. .

Abstract

Background: Heterosexual transmission (HST) has become the current predominant transmission pathways of the HIV-1 epidemic in China. The aim of this study was to explore the geographic and dynamic change of HIV-1 subtypes through HST in China from published studies. Methods: Several electronic databases were searched to identify the studies, and the overall prevalence of HIV-1 subtypes was estimated by a meta-analysis method. Subgroup analysis was conducted by study region and time period. Publication bias was evaluated using Egger's test. The χ² test was used to evaluate the proportion differences among subgroups. Sensitivity analysis was carried out to assess the stability of the overall prevalence estimates. Results: 42 studies were included in our final analysis. The overall prevalence of CRF01_AE was 46.34% (95% CI: 40.56-52.17%), CRF07_BC was 19.16% (95% CI: 15.02-23.66%), B/B' was 13.25% (95% CI: 9.68-17.25%), CRF08_BC was 10.61% (95% CI: 7.08-14.70%), and C was 4.29% (95% CI: 1.85-7.48%). In subgroup analysis, the prevalence of CRF01_AE and CRF07_BC increased, while the prevalence of B/B' decreased over time, whereby the prevalence of CRF07_BC and CRF08_BC have exceeded that of B/B' since 2010. A significant higher prevalence of CRF01_AE was found in the South provinces, CRF07_BC in East provinces, CRF08_BC and C in Southwest provinces, and B/B' in North provinces. Conclusions: The HIV-1 prevalent strains have evolved into complicated and diverse subtypes, and the proportion of HIV-1 subtypes through HST has changed constantly in different regions and periods in China. This highlights the urgent need to vigorously strengthen the prevention and control of the HIV-1 epidemic.

Keywords: China; HIV-1; heterosexual transmission; subtypes.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of the study identification and selection process.
Figure 2
Figure 2
Calculation of the overall proportion by using a meta-analysis method from included studies reporting the proportions of different HIV-1 subtypes via HST in China: (a) The overall proportion of CRF01_AE; (b) The overall proportion of CRF07_BC; (c) The overall proportion of subtype B/B’; (d) The overall proportion of CRF08_BC; (e) The overall proportion of subtype C; (f) The overall proportion of other subtypes.
Figure 3
Figure 3
Trend of the prevalence of different HIV-1 subtypes via HST in recent years.
Figure 4
Figure 4
Proportion of HIV-1 subtypes via HST in different geographical provinces.
Figure 5
Figure 5
The forest plot of sensitivity analysis of the pooled proportion of CRF01_AE.
See this image and copyright information in PMC

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