中国通过异性传播的HIV-1亚型的地理分布和时间趋势:一项系统评价和荟萃分析
Geographic Distribution and Temporal Trends of HIV-1 Subtypes through Heterosexual Transmission in China: A Systematic Review and Meta-Analysis.
作者信息
Xiao Peipei, Li Jianjun, Fu Gengfeng, Zhou Ying, Huan Xiping, Yang Haitao
机构信息
Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing 210009, China.
Department of HIV/STD Prevention and Control, Jiangsu Provincial Center for Disease Prevention and Control, Nanjing 210009, China.
出版信息
Int J Environ Res Public Health. 2017 Jul 24;14(7):830. doi: 10.3390/ijerph14070830.
: 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. : 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 ² test was used to evaluate the proportion differences among subgroups. Sensitivity analysis was carried out to assess the stability of the overall prevalence estimates. 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. : 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.
异性传播已成为中国目前HIV-1流行的主要传播途径。本研究旨在通过已发表的研究探讨中国经异性传播的HIV-1亚型的地理分布及动态变化。通过检索多个电子数据库来确定相关研究,并采用Meta分析方法估计HIV-1亚型的总体流行率。按研究地区和时间段进行亚组分析。使用Egger检验评估发表偏倚。采用卡方检验评估亚组间的比例差异。进行敏感性分析以评估总体流行率估计值的稳定性。最终分析纳入了42项研究。CRF01_AE的总体流行率为46.34%(95%CI:40.56 - 52.17%),CRF07_BC为19.16%(95%CI:15.02 - 23.66%),B/B'为13.25%(95%CI:9.68 - 17.25%),CRF08_BC为10.61%(95%CI:7.08 - 14.70%),C为4.29%(95%CI:1.85 - 7.48%)。在亚组分析中,CRF01_AE和CRF07_BC的流行率随时间增加,而B/B'的流行率下降,自2010年起CRF07_BC和CRF08_BC的流行率已超过B/B'。在南方省份发现CRF01_AE的流行率显著较高,东部省份为CRF07_BC,西南省份为CRF08_BC和C,北方省份为B/B'。HIV-1流行毒株已演变成复杂多样的亚型,中国经异性传播的HIV-1亚型比例在不同地区和时期不断变化。这凸显了大力加强HIV-1疫情防控的迫切需求。
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