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Global and regional epidemiology of HIV-1 recombinants in 1990–2015: a systematic review and global survey

Joris Hemelaar 1, 2 Ramyiadarsini Elangovan 2 Jason yun 2 Leslie Dickson-Tetteh 2 Shona Kirtley 3 Eleanor Gouws-Williams 4 Peter Ghys 4 Alash'Le Abimiku Simon Agwale Chris Archibald Boaz Avidor María Gabriela Barbás Francoise Barre-Sinoussi Banson Barugahare El Hadj Belabbes Silvia Bertagnolio Deborah Birx Aleksei Bobkov James Brandful Helba Bredell Catherine Brennan James Brooks Marie Bruckova Luigi Buonaguro Franco Buonaguro Stefano Buttò Anne Buvé Mary Campbell Jean Carr Alex Carrera Manuel Gómez Carrillo Connie Celum Beth Chaplin Macarthur Charles Dimitrios Chatzidimitriou Zhiwei Chen Katsumi Chijiwa David Cooper Philip Cunningham Anoumou Dagnra Cillian de Gascun Julia del Amo Elena Delgado Ursula Dietrich Dominic Dwyer Dennis Ellenberger Barbara Ensoli Max Essex Hervé Fleury Peter Fonjungo Vincent Foulongne 5, 6 Deepak Gadkari Feng Gao Federico García Roger Garsia Guy Michel Gershy-Damet Judith Glynn Ruth Goodall Zehava Grossman Monick Lindenmeyer-Guimarães Beatrice Hahn Raph Hamers Osamah Hamouda Ray Handema Xiang He Joshua Herbeck David Ho Africa Holguin Mina Hosseinipour Gillian Hunt Masahiko Ito Mohamed Ali Bel Hadj Kacem Erin Kahle Pontiano Kaleebu Marcia Kalish Adeeba Kamarulzaman Chun Kang Phyllis Kanki Edward Karamov Jean-Claude Karasi Kayitesi Kayitenkore Tony Kelleher Dwip Kitayaporn Leondios Kostrikis Claudia Kucherer Claudia Lara Thomas Leitner Kirsi Liitsola Jai Lingappa Marek Linka Ivette Lorenzana de Rivera Vladimir Lukashov Shlomo Maayan Luzia Mayr Francine Mccutchan Nicolas Meda Elisabeth Menu Fred Mhalu Doreen Mloka John Mokili Brigitte Montes Orna Mor Mariza Morgado Fausta Mosha Awatef Moussi James Mullins Rafael Najera Mejda Nasr Nicaise Ndembi Joel Neilson Vivek Nerurkar Florian Neuhann Claudine Nolte Vlad Novitsky Philippe Nyambi Marianna Ofner Fem Paladin Anna Papa Jean Pape Neil Parkin Chris Parry Martine Peeters Alexandra Pelletier Lucía Pérez-Álvarez Deenan Pillay Angie Pinto Trinh Duy Quang Cecilia Rademeyer Filimone Raikanikoda Mark Rayfield Jean-Marc Reynes Tobias Rinke de Wit Kenneth Robbins Morgane Rolland Christine Rousseau Jesus Salazar-Gonzales Hanan Salem Mika Salminen Horacio Salomon Paul Sandstrom Mario Santiago Abdoulaye Sarr Bryan Schroeder Michel Segondy 5, 6 Philippe Selhorst Sylvester Sempala Jean Servais Ansari Shaik yiming Shao Amine Slim Marcelo Soares Elijah Songok Debbie Stewart Julie Stokes Shambavi Subbarao Ruengpung Sutthent Jun Takehisa Amilcar Tanuri Kok Keng Tee Kiran Thapa Michael Thomson Tyna Tran Willy Urassa Hiroshi Ushijima Philippe van de Perre 5, 6 Guido van Der Groen Kristel van Laethem Joep van Oosterhout Ard van Sighem Eric van Wijngaerden Anne-Mieke Vandamme Jurgen Vercauteren Nicole Vidal Lesley Wallace Carolyn Williamson Dawit Wolday Jianqing Xu Chunfu yang Linqi Zhang Rong Zhang 
Abstract : Background: Global HIV-1 genetic diversity and evolution form a major challenge to treatment and prevention efforts. An increasing number of distinct HIV-1 recombinants have been identified worldwide, but their contribution to the global epidemic is unknown. We aimed to estimate the global and regional distribution of HIV-1 recombinant forms during 1990-2015. Methods: We assembled a global HIV-1 molecular epidemiology database through a systematic literature review and a global survey. We searched the PubMed, Embase (Ovid), CINAHL (Ebscohost), and Global Health (Ovid) databases for HIV-1 subtyping studies published from Jan 1, 1990, to Dec 31, 2015. Unpublished original HIV-1 subtyping data were collected through a survey among experts in the field who were members of the WHO-UNAIDS Network for HIV Isolation and Characterisation. We included prevalence studies with HIV-1 subtyping data collected during 1990-2015. Countries were grouped into 14 regions and analyses were done for four time periods (1990-99, 2000-04, 2005-09, and 2010-15). The distribution of circulating recombinant forms (CRFs) and unique recombinant forms (URFs) in individual countries was weighted according to the UNAIDS estimates of the number of people living with HIV in each country to generate regional and global estimates of numbers and proportions of HIV-1 recombinants in each time period. The systematic review is registered with PROSPERO, CRD42017067164. Findings: Our global data collection yielded an HIV-1 molecular epidemiology database of 383 519 samples from 116 countries in 1990-2015. We found that the proportion of recombinants increased over time, both globally and in most regions, reaching 22·8% (7 978 517 of 34 921 639) of global HIV-1 infections in 2010-15. Both the proportion and the number of distinct CRFs detected increased over time to 16·7% and 57 CRFs in 2010-15. The global and regional distribution of HIV-1 recombinants was diverse and evolved over time, and we found large regional variation in the numbers (0-44 CRFs), types (58 distinct CRFs), and proportions (0-80·5%) of HIV-1 recombinants. Globally, CRF02_AG was the most prevalent recombinant, accounting for 33·9% (2 701 364 of 7 978 517) of all recombinant infections in 2010-15. URFs accounted for 26·7% (2 131 450 of 7 978 517), CRF01_AE for 23·0% (1 838 433), and other CRFs for 16·4% (1 307 270) of all recombinant infections in 2010-15. Although other CRFs accounted for small proportions of infections globally (<1% each), they were prominent in regional epidemics, including in east and southeast Asia, west and central Africa, Middle East and north Africa, and eastern Europe and central Asia. In addition, in 2010-15, central Africa (21·3% [243 041 of 1 143 531]), west Africa (15·5% [838 476 of 5 419 010]), east Africa (12·6% [591 140 of 4 704 986]), and Latin America (9·6% [153 069 of 1 586 605]) had high proportions of URFs. Interpretation: HIV-1 recombinants are increasingly prominent in global and regional HIV epidemics, which has important implications for the development of an HIV vaccine and the design of diagnostic, resistance, and viral load assays. Continued and improved surveillance of the global molecular epidemiology of HIV is crucial. Funding: None.
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Soumis le : jeudi 24 juin 2021 - 16:38:11
Dernière modification le : mercredi 3 novembre 2021 - 07:52:32

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Joris Hemelaar, Ramyiadarsini Elangovan, Jason yun, Leslie Dickson-Tetteh, Shona Kirtley, et al.. Global and regional epidemiology of HIV-1 recombinants in 1990–2015: a systematic review and global survey. The Lancet HIV, 2020, 7 (11), pp.e772-e781. ⟨10.1016/S2352-3018(20)30252-6⟩. ⟨hal-03270331⟩

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