AUTHOR=Nchinda Nkazi , Elangovan Ramyiadarsini , Yun Jason , Dickson-Tetteh Leslie , Kirtley Shona , Hemelaar Joris , WHO-UNAIDS Network for HIV Isolation and Characterisation , Abimiku Alash'le G. , Agwale Simon , Archibald Chris , Avidor Boaz , María Gabriela Barbás , Barre-Sinoussi Francoise , Barugahare Banson , Belabbes El Hadj , Bertagnolio Silvia , Birx Deborah , Bobkov Aleksei F. , Brandful James , Bredell Helba , Brennan Catherine A. , Brooks James , Bruckova Marie , Buonaguro Luigi , Buonaguro Franco , Buttò Stefano , Buve Anne , Campbell Mary , Carr Jean , Carrera Alex , Carrillo Manuel Gómez , Celum Connie , Chaplin Beth , Charles Macarthur , Chatzidimitriou Dimitrios , Chen Zhiwei , Chijiwa Katsumi , Cooper David , Cunningham Philip , Dagnra Anoumou , Gascun Cillian F. de , Amo Julia Del , Delgado Elena , Dietrich Ursula , Dwyer Dominic , Ellenberger Dennis , Ensoli Barbara , Essex Max , Fleury Herve , Fonjungo Peter N. , Foulongne Vincent , Gadkari Deepak A. , Gao Feng , García Federico , Garsia Roger , Gershy-Damet Guy Michel , Glynn Judith R. , Goodall Ruth , Grossman Zehava , Guimarães Monick Lindenmeyer , Hahn Beatrice , Hamers Raph L. , Hamouda Osamah , Handema Ray , He Xiang , Herbeck Joshua , Ho David D. , Holguin Africa , Hosseinipour Mina , Hunt Gillian , Ito Masahiko , Kacem Mohamed Ali Bel Hadj , Kahle Erin , Kaleebu Pontiano , Kalish Marcia , Kamarulzaman Adeeba , Kang Chun , Kanki Phyllis , Karamov Edward , Karasi Jean-Claude , Kayitenkore Kayitesi , Kelleher Tony , Kitayaporn Dwip , Kostrikis Leondios G. , Kucherer Claudia , Lara Claudia , Leitner Thomas , Liitsola Kirsi , Lingappa Jai , Linka Marek , Rivera Ivette Lorenzana de , Lukashov Vladimir , Maayan Shlomo , Mayr Luzia , McCutchan Francine , Meda Nicolas , Menu Elisabeth , Mhalu Fred , Mloka Doreen , Mokili John L. , Montes Brigitte , Mor Orna , Morgado Mariza , Mosha Fausta , Moussi Awatef , Mullins James , Najera Rafael , Nasr Mejda , Ndembi Nicaise , Neilson Joel R. , Nerurkar Vivek R. , Neuhann Florian , Nolte Claudine , Novitsky Vlad , Nyambi Philippe , Ofner Marianna , Paladin Fem J. , Papa Anna , Pape Jean , Parkin Neil , Parry Chris , Peeters Martine , Pelletier Alexandra , Pérez-Álvarez Lucía , Pillay Deenan , Pinto Angie , Quang Trinh Duy , Rademeyer Cecilia , Raikanikoda Filimone , Rayfield Mark A. , Reynes Jean-Marc , Wit Tobias Rinke de , Robbins Kenneth E. , Rolland Morgane , Rousseau Christine , Salazar-Gonzales Jesus , Salem Hanan , Salminen Mika , Salomon Horacio , Sandstrom Paul , Santiago Mario L. , Sarr Abdoulaye D. , Schroeder Bryan , Segondy Michel , Selhorst Philippe , Sempala Sylvester , Servais Jean , Shaik Ansari , Shao Yiming , Slim Amine , Soares Marcelo A. , Songok Elijah , Stewart Debbie , Stokes Julie , Subbarao Shambavi , Sutthent Ruengpung , Takehisa Jun , Tanuri Amilcar , Tee Kok Keng , Thapa Kiran , Thomson Michael , Tran Tyna , Urassa Willy , Ushijima Hiroshi , Perre Philippe van de , Groen Guido van der , Laethem Kristel van , Oosterhout Joep van , Sighem Ard van , Wijngaerden Eric van , Vandamme Anne-Mieke , Vercauteren Jurgen , Vidal Nicole , Wallace Lesley , Williamson Carolyn , Wolday Dawit , Xu Jianqing , Yang Chunfu , Zhang Linqi , Zhang Rong TITLE=Global associations of key populations with HIV-1 recombinants: a systematic review, global survey, and individual participant data meta-analysis JOURNAL=Frontiers in Public Health VOLUME=11 YEAR=2023 URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2023.1153638 DOI=10.3389/fpubh.2023.1153638 ISSN=2296-2565 ABSTRACT=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].