Prevalence of Different Genotypes of HIV-1 in Injection Drug Users in China: A Systematic Review and Meta-Analysis

Abstract

Background: Since 1981, an increasing trend in HIV has been observed for transmission via injection drug users (IDUs), sexual transmission and mother-to-child transmission. The IDUs are blamed for early increases in HIV-positive cases in China. Objective: HIV genotypes of IDUs were comprehensively analysed to trace the source and relationships of the AIDS epidemic in China. Methods: Relevant databases written in English and Chinese were searched. Overall, 7,149 publications were identified in six databases. After screening 7,104 articles according to the inclusion and exclusion criteria, 45 studies consisting of 2,765 cases were finally identified. A meta-analysis was conducted using R MATLAB software, RevMan and SPSS. Subgroup analyses focused on time frame, region, and location of different genotypes of IDUs in China. Results: There were five dominant HIV-1 genotypes among the 2,765 IDU cases. The proportions of CRF07_BC, CRF01_AE, CRF08_BC, subtype B/B', and subtype C were 45.18% (95% CI: 33.55-57.08%), 16.00% (95% CI: 9.39-23.82%), 13.43% (95% CI: 7.32-20.84%), 3.58% (95% CI: 1.52-6.24%), and 0.90% (95% CI: 0.04-2.43%), respectively. HIV genotypes transmitted among IDUs in China are primarily CRF07-BC, followed by CRF01-AE and CRF08-BC. Across the different time frames and regions, CRF07_BC was the most prevalent HIV-1 genotype among IDUs, while CRF08_BC was the most prevalent genotype in the southwest region. Conclusion: Our study reveals that CRF07-BC was the dominant prevalent strain among IDUs from 1991 to 2015 in China, while CRF08-BC was the dominant prevalent strain among IDUs in southwestern China. This systematic review and meta-analysis shows evidence of the comprehensive prevalence of different genotypes, data and characteristics of HIV among IDUs in China.

Using Molecular Transmission Networks to Reveal the Epidemic of Pretreatment HIV-1 Drug Resistance in Guangxi, China

“…Moreover, PDR transmission and the DRM sharing patterns within networks in this region were both associated with the CRF08_BC subtype. Previous studies have found that CRF08_BC was one of the primary drivers of HIV-1 infection among IDUs, especially in Southwest China (He et al, 2012;Jiang et al, 2019). Frequent needle exchange and poor ART adherence among IDUs could lead to a higher risk of drug-resistant strains spreading in this population (Bangsberg et al, 2007;Thanh et al, 2009;Muyldermans and Sasse, 2014;Liu et al, 2019).…”

Evaluation of the performance of a novel HIV‐1 viral load assay for HIV quantification in China

“…Several HIV-1 subtypes were heterogeneously distributed in China. The dominant circulating subtypes were CRF01_AE and CRF07_BC, followed by CRF08_BC, subtype B, and CRF55_01B [10][11][12][13]. Previous studies have shown that HIV-1 genetic diversity in China, especially clades BC and AE, were likely to impact the quantitation of VL using different assays [14].…”

Transmission network and phylogenetic analysis reveal older male-centered transmission of CRF01_AE and CRF07_BC in Guangxi, China

“…However, CRF08_BC originated in Yunnan Province and was prevalent among both IDUs and heterosexuals [ 56 , 57 ]. In this study, approximately 40.0% of CRF08_BC in Qinzhou occurred among IDUs with a predominantly YM population, and the risk of transmission was high [ 58 , 59 ]. Therefore, CRF08_BC is easily transmitted from the YM population to other subpopulations.…”