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Int. J. Environ. Res. Public Health 2017, 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

1
Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing 210009, China
2
Department of HIV/STD Prevention and Control, Jiangsu Provincial Center for Disease Prevention and Control, Nanjing 210009, China
3
Jiangsu Research Institute of Schistosomiasis Control, Wuxi 214064, China
These authors contributed equally to this work.
*
Author to whom correspondence should be addressed.
Received: 4 June 2017 / Revised: 9 July 2017 / Accepted: 21 July 2017 / Published: 24 July 2017
(This article belongs to the Section Global Health)
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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. View Full-Text
Keywords: HIV-1; subtypes; heterosexual transmission; China HIV-1; subtypes; heterosexual transmission; China
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Xiao, P.; Li, J.; Fu, G.; Zhou, Y.; Huan, X.; Yang, H. Geographic Distribution and Temporal Trends of HIV-1 Subtypes through Heterosexual Transmission in China: A Systematic Review and Meta-Analysis. Int. J. Environ. Res. Public Health 2017, 14, 830.

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