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Meta-Analysis
. 2023 Nov 28;228(11):1583-1591.
doi: 10.1093/infdis/jiad327.

Geographic and Population Distributions of Human Immunodeficiency Virus (HIV)-1 and HIV-2 Circulating Subtypes: A Systematic Literature Review and Meta-analysis (2010-2021)

Alexandria Williams  1 , Sonia Menon  1 , Madeleine Crowe  1 , Neha Agarwal  1 , Jorne Biccler  1 , Nicholas Bbosa  2 , Deogratius Ssemwanga  2 , Ferdinard Adungo  3 , Christiane Moecklinghoff  4 , Malcolm Macartney  5 , Valerie Oriol-Mathieu  6
Affiliations
Meta-Analysis

Geographic and Population Distributions of Human Immunodeficiency Virus (HIV)-1 and HIV-2 Circulating Subtypes: A Systematic Literature Review and Meta-analysis (2010-2021)

Alexandria Williams et al. J Infect Dis. .

Abstract

Background: HIV poses significant challenges for vaccine development due to its high genetic mutation and recombination rates. Understanding the distribution of HIV subtypes (clades) across regions and populations is crucial. In this study, a systematic review of the past decade was conducted to characterize HIV-1/HIV-2 subtypes.

Methods: A comprehensive search was performed in PubMed, EMBASE, and CABI Global Health, yielding 454 studies from 91 countries.

Results: Globally, circulating recombinant forms (CRFs)/unique recombinant forms (URFs) accounted for 29% of HIV-1 strains, followed by subtype C (23%) and subtype A (17%). Among studies reporting subtype breakdowns in key populations, 62% of HIV infections among men who have sex with men (MSM) and 38% among people who inject drugs (PWIDs) were CRF/URFs. Latin America and the Caribbean exhibited a 25% increase in other CRFs (excluding CRF01_AE or CRF02_AG) prevalence between 2010-2015 and 2016-2021.

Conclusions: This review underscores the global distribution of HIV subtypes, with an increasing prevalence of CRFs and a lower prevalence of subtype C. Data on HIV-2 were limited. Understanding subtype diversity is crucial for vaccine development, which need to elicit immune responses capable of targeting various subtypes. Further research is needed to enhance our knowledge and address the challenges posed by HIV subtype diversity.

Keywords: HIV subtypes; HIV-1; HIV-2; epidemiology; prevalence.

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Conflict of interest statement

Potential conflicts of interest. C. M., M. M., and V. O.-M. are current employees of Janssen (respectively, Janssen-Cilag Limited, Janssen-Cilag GmbH, and Janssen Vaccines & Prevention B.V.), all Johnson & Johnson companies, and they may own stock or stock options in that company. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

Figures

Figure 1.
Figure 1.
Unweighted proportion (%) of HIV global circulating recombinant forms (2010–2021).
Figure 2.
Figure 2.
Global map of weighted HIV-1 subtype distributions (2010–2021). Others = subtypes D, F, G, H, J, other/unknown (as reported by authors); circulating recombinant form (CRF)/unique recombinant form (URF) does not include CRF01_AE or CRF02_AG since these are presented separately.
Figure 3.
Figure 3.
Global proportion of HIV-1 subtypes across time (2010–2021). *Other CRFs = any reported circulating recombinant forms other than CRF01_AE and CRF02_AG. **Other/unknown = subtypes reported by authors as such. Abbreviations: CRF, circulating recombinant form; URF, unique recombinant form.
See this image and copyright information in PMC

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