Global and regional genetic diversity of HIV-1 in 2010–21: systematic review and analysis of prevalence

IF 20.9 1区生物学 Q1 INFECTIOUS DISEASES

Lancet Microbe Pub Date : 2024-11-01 DOI:10.1016/S2666-5247(24)00151-4

Malavika Nair BA , Lucy Gettins MSc , Matthew Fuller BA , Shona Kirtley MSc , Prof Joris Hemelaar DPhil

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引用次数: 0

Abstract

Background

The extensive global genetic diversity of HIV-1 poses a major challenge to HIV vaccine development. We aimed to determine recent estimates of and changes in the global and regional distributions of HIV-1 genetic variants.

Methods

We conducted a systematic literature review by searching PubMed, Embase, Global Health, and CINAHL for studies containing country-specific HIV-1 subtyping data, published between Jan 1, 2010 and Sep 16, 2022. The proportions of HIV-1 subtypes, circulating recombinant forms (CRFs), and unique recombinant forms (URFs) in each country were weighted by UNAIDS estimates of the numbers of people living with HIV (PLHIV) in each country to obtain regional and global prevalence estimates of HIV-1 subtypes, CRFs, and URFs with 95% CIs for the time periods 2010–15 and 2016–21. The protocol is registered with PROSPERO, CRD42017067164.

Findings

We obtained 1044 datasets, containing HIV-1 subtyping data from 653 013 PLHIV from 122 countries in 2010–2021. In 2016–2021, subtype C accounted for 50·4% (95% CI 50·2–50·7; n=18 570 462 of 36 823 798) of global HIV infections, subtype A for 12·4% (12·2–12·6; n=4 571 250), subtype B for 11·3% (11·1–11·5; n=4 157 686), subtype G for 2·9% (2·9–3·0; n=1 083 568), subtype D for 2·6% (2·5–2·7; n=945 815), subtype F for 0·9% (0·8–0·9; n=316 724), CRFs for 15·1% (14·9–15·3; n=5 564 566), and URFs for 2·0% (1·9–2·1; n=733 374). Subtypes H, J, and K each accounted for 0·1% or less of infections. Compared with 2010–15, we observed significant (p<0·0001) increases in global proportions of subtype A (0·9%, 95% CI 0·7 to 1·1) and subtype C (3·4%, 3·0 to 3·7) and decreases in subtype D (–0·5%, –0·6 to –0·4), subtype G (–0·8%, –1·0 to –0·7), CRFs (–1·0%, –1·3 to –0·8), and URFs (–1·8%, –1·9 to –1·7), with no changes for subtypes B and F. The global proportion of infections attributed to recombinants decreased from 21·6% (95% CI 21·4 to 21·7; n=7 099 252 of 32 622 808) in 2010–15 to 19·3% (19·1 to 19·5; n=7 094 694 of 36 823 798) in 2016–21 (–2·3%, 95% CI –2·6 to –2·0; p<0·0001). Regional distributions of HIV-1 variants were complex and evolving, with global trends in the prevalence of HIV-1 variants supported by trends across the regions.

Interpretation

Global and regional HIV-1 genetic diversity are complex and continue to evolve. Continued and improved surveillance of HIV-1 variants remains vital for HIV vaccine development and implementation.

Funding

None.

查看原文本刊更多论文

2010-21 年全球和地区 HIV-1 基因多样性：系统回顾和流行率分析。

背景：HIV-1 在全球范围内具有广泛的遗传多样性，这给 HIV 疫苗的开发带来了重大挑战。我们旨在确定全球和地区 HIV-1 基因变异体分布的最新估计值及其变化情况：我们通过检索 PubMed、Embase、Global Health 和 CINAHL，对 2010 年 1 月 1 日至 2022 年 9 月 16 日期间发表的包含特定国家 HIV-1 亚型数据的研究进行了系统性文献综述。每个国家的 HIV-1 亚型、循环重组型（CRF）和独特重组型（URF）的比例根据联合国艾滋病规划署估计的每个国家的 HIV 感染者（PLHIV）人数进行加权，从而得出 2010-15 年和 2016-21 年期间地区和全球 HIV-1 亚型、CRF 和 URF 的流行率估计值及 95% CI。该方案已在 PROSPERO 注册，编号为 CRD42017067164：我们获得了 1044 个数据集，其中包含 2010-2021 年间来自 122 个国家 653 013 名艾滋病毒感染者的 HIV-1 亚型数据。2016-2021年，C亚型占全球HIV感染的50-4%（95% CI 50-2-50-7; n=18 570 462 of 36 823 798），A亚型占12-4%（12-2-12-6; n=4 571 250），B亚型占11-3%（11-1-11-5；A亚型占 12-4%（12-2-12-6；n=4 571 250），B亚型占 11-3%（11-1-11-5；n=4 157 686），G亚型占 2-9%（2-9-3-0；n=1 083 568），D亚型占 2-6%（2-5-2-7；n=945 815），F亚型占 0-9%（0-8-0-9；n=316 724），CRFs占 15-1%（14-9-15-3；n=5 564 566），URFs占 2-0%（1-9-2-1；n=733 374）。H、J 和 K 亚型各占感染病例的 0-1% 或更少。与 2010-15 年相比，我们观察到显著的（p解释：全球和地区 HIV-1 基因多样性非常复杂，并在继续演变。继续并改进对 HIV-1 变异的监测对 HIV 疫苗的开发和实施至关重要：无。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Lancet Microbe Multiple-

CiteScore

27.20

自引率

0.80%

发文量

278

审稿时长

6 weeks

期刊介绍： The Lancet Microbe is a gold open access journal committed to publishing content relevant to clinical microbiologists worldwide, with a focus on studies that advance clinical understanding, challenge the status quo, and advocate change in health policy.