title: Prevalence of different HIV-1 subtypes in sexual transmission in China: a systematic review and meta-analysis.
abstract: Sexual transmission has become the primary route of HIV transmission in China. Therefore, a comprehensive overview of HIV-1 subtype distribution is necessary for the prevention and control of the HIV epidemic. The present study aimed to provide a comprehensive prevalence estimate of different HIV-1 subtypes in sexual transmission in China. We conducted a systematic literature review for studies of HIV-1 subtypes in English and Chinese through several databases. Eligible articles were screened and selected by two authors independently. Random-effects model were applied to calculate the pooled prevalence of different HIV-1 subtypes, and subgroup analyses examined prevalence estimates across time, locations, and populations. A total of 130 eligible studies were identified, including 18 752 successfully genotyped samples. The pooled prevalence of CRF01_AE, subtype B, CRF07_BC, CRF08_BC, and subtype C were 44·54% (95% CI 40·81-48·30), 18·31% (95% CI 14·71-22·17), 16·45% (95% CI 13·82-19·25), 2·55% (95% CI 1·56-3·73), 0·37% (95% CI 0·11-0·72), respectively. The prevalence of subtype B in sexual transmission decreased, while the prevalence of CRF01_AE and CRF07_BC in sexual transmission, and CRF08_BC in heterosexual transmission increased. There is significant variation in HIV-1 subtype distribution between regions. The distribution of HIV-1 subtypes and circulating recombinant forms have changed significantly. The high genetic variability of HIV-1 poses a significant challenge for disease control and surveillance in China.
authors.affiliation: Department of Epidemiology and Health Statistics,School of Public Health,Southeast University,Nanjing,China.
authors.forename: R
authors.initials: R
authors.lastname: Yuan
authors.affiliation: Wuxi Center for Disease Control and Prevention,Wuxi,Jiangsu,China.
authors.forename: H
authors.initials: H
authors.lastname: Cheng
authors.affiliation: Department of Epidemiology and Health Statistics,School of Public Health,Southeast University,Nanjing,China.
authors.forename: L-S
authors.initials: LS
authors.lastname: Chen
authors.affiliation: Wuxi Center for Disease Control and Prevention,Wuxi,Jiangsu,China.
authors.forename: X
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Epidemiology and Health Statistics,School of Public Health,Southeast University,Nanjing,China.
authors.forename: B
authors.initials: B
authors.lastname: Wang
mesh_terms: D002681:China / Q000453:epidemiology; D005260:Female; D005838:Genotype; D015658:HIV Infections / Q000453:epidemiology* / Q000235:genetics* / Q000821:virology; D015497:HIV-1 / Q000502:physiology; D006801:Humans; D008297:Male; D015995:Prevalence
keywords: China; HIV-1; sexual transmission; subtype