Daw Mohamed A, Ahmed Mohamed O
Department of Medical Microbiology and Immunology, Faculty of Medicine, University of Tripoli, Tripoli cc82668, Tripoli, Libya.
Department of Microbiology and Parasitology, Faculty of Veterinary Medicine, University of Tripoli, Tripoli cc82668, Tripoli, Libya.
World J Virol. 2021 Mar 25;10(2):69-85. doi: 10.5501/wjv.v10.i2.69.
Human immunodeficiency virus (HIV) infection is a major global public health concern North African countries carry a disproportionate burden of HIV representing one of the highest rates in Africa.
To characterize the epidemiological and spatial trends of HIV infection in this region.
A systematic review was carried out on all the published data regarding HIV/acquired immunodeficiency syndrome in North African countries over ten years (2008-2017) following the PRISMA guidelines. We performed a comprehensive literature search using Medline PubMed, Embase, regional and international databases, and country-level reports with no language restriction. The quality, quantity, and geographic coverage of the data were assessed at both the national and regional levels. We used random-effects methods, spatial variables, and stratified results by demographic factors. Only original data on the prevalence of HIV infection were included and independently evaluated by professional epidemiologists.
A total of 721 records were identified but only 41 that met the criteria were included in the meta-analysis. There was considerable variability in the prevalence estimates of HIV within the countries of the region. The overall prevalence of HIV ranged from 0.9% [95% confidence interval (CI) 0.8-1.27] to 3.8% (95%CI 1.17-6.53). The highest prevalence was associated with vulnerable groups and particularly drug abusers and sexually promiscuous individuals. The dense HIV clustering noted varied from one country to another. At least 13 HIV subtypes and recombinant forms were prevalent in the region. Subtype B was the most common variant, followed by CRF02_AG.
This comprehensive review indicates that HIV infection in North African countries is an increasing threat. Effective national and regional strategies are needed to improve monitoring and control of HIV transmission, with particular emphasis on geographic variability and HIV clustering.
人类免疫缺陷病毒（HIV）感染是一个重大的全球公共卫生问题。北非国家承受着不成比例的HIV负担，是非洲感染率最高的地区之一。
描述该地区HIV感染的流行病学和空间趋势。
按照PRISMA指南，对过去十年（2008 - 2017年）有关北非国家HIV/获得性免疫缺陷综合征的所有已发表数据进行系统综述。我们使用Medline、PubMed、Embase、区域和国际数据库以及国家层面报告进行了全面的文献检索，无语言限制。在国家和区域层面评估数据的质量、数量和地理覆盖范围。我们使用随机效应方法、空间变量以及按人口因素分层的结果。仅纳入关于HIV感染流行率的原始数据，并由专业流行病学家独立评估。
共识别出721条记录，但只有41条符合标准的记录被纳入荟萃分析。该地区各国之间HIV流行率估计值存在相当大的差异。HIV的总体流行率范围为0.9% [95%置信区间（CI）0.8 - 1.27]至3.8%（95%CI 1.17 - 6.53）。最高流行率与弱势群体相关，特别是药物滥用者和性乱者。各国之间观察到的密集HIV聚集情况各不相同。该地区至少有13种HIV亚型和重组形式流行。B亚型是最常见的变体，其次是CRF02_AG。
这项全面综述表明，北非国家的HIV感染构成的威胁日益增加。需要有效的国家和区域战略来改善对HIV传播的监测和控制，尤其要重视地理变异性和HIV聚集情况。
