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oai:repisalud.isciii.es:20.500.12105/168252024-11-29T12:17:44Zcom_20.500.12105_2052com_20.500.12105_2051com_20.500.12105_15322col_20.500.12105_19609col_20.500.12105_16988

00925njm 22002777a 4500 dc Nchinda, Nkazi author Elangovan, Ramyiadarsini author Yun, Jason author Dickson-Tetteh, Leslie author Kirtley, Shona author Hemelaar, Joris author WHO-UNAIDS Network for HIV Isolation and Characterisation author Amo, Julia del author Delgado, Elena author Najera-Morrondo, Rafael author Perez-Alvarez, Lucia author Thomson, Michael M author 2023-07 Introduction: Global HIV infections due to HIV-1 recombinants are increasing and impede prevention and treatment efforts. Key populations suffer most new HIV infections, but their role in the spread of HIV-1 recombinants is unknown. We conducted a global analysis of the associations between key populations and HIV-1 recombinants. Methods: We searched PubMed, EMBASE, CINAHL, and Global Health for HIV-1 subtyping studies published from 1/1/1990 to 31/12/2015. Unpublished data was collected through a global survey. We included studies with HIV-1 subtyping data of key populations collected during 1990-2015. Key populations assessed were heterosexual people (HET), men who have sex with men (MSM), people who inject drugs (PWID), vertical transmissions (VERT), commercial sex workers (CSW), and transfusion-associated infections (BLOOD). Logistic regression was used to determine associations of key populations with HIV-1 recombinants. Subgroup analyses were performed for circulating recombinant forms (CRFs), unique recombinant forms (URFs), regions, and time periods. Results: Eight hundred and eighty five datasets including 77,284 participants from 83 countries were included. Globally, PWID were associated with the greatest odds of recombinants and CRFs (OR 2.6 [95% CI 2.46-2.74] and 2.99 [2.83-3.16]), compared to HET. CSW were associated with increased odds of recombinants and URFs (1.59 [1.44-1.75] and 3.61 [3.15-4.13]). VERT and BLOOD were associated with decreased odds of recombinants (0.58 [0.54-0.63] and 0.43 [0.33-0.56]). MSM were associated with increased odds of recombinants in 2010-2015 (1.43 [1.35-1.51]). Subgroup analyses supported our main findings. Discussion: As PWID, CSW, and MSM are associated with HIV-1 recombinants, increased preventative measures and HIV-1 molecular surveillance are crucial within these key populations. Systematic review registration: PROSPERO [CRD42017067164]. Front Public Health. 2023 Jul 27:11:1153638. http://hdl.handle.net/20.500.12105/16825 37575094 10.3389/fpubh.2023.1153638 2296-2565 Frontiers in public health CRF HIV URF Key populations Molecular epidemiology Recombinant Global associations of key populations with HIV-1 recombinants: a systematic review, global survey, and individual participant data meta-analysis