Инфекция и иммунитет (Sep 2018)
THE PREVALENCE OF HIV RECOMBINANT FORMS IN RUSSIA AND COUNTRIES OF THE CIS: SYSTEMATIC REVIEW AND METAANALYSIS
Abstract
This review was to aimed to access the prevalence of HIV recombinant forms in Russia and countries of the CIS, which have close social and economic ties. We conducted a search in Russian Science Citation Index and PubMed for a depth of 8 years. We included 22 articles, which contained the results of 35 independent cross-sectional studies, in our review. Meta-analysis of HIV recombinant forms prevalence was conducted in Open Meta-analyst with the use of Der Simonian & Laird method, arcsin transformation and correction factor for zero values. Subgroup analysis was used along with meta-regression (by date of collection). Pooled prevalence of HIV recombinant forms was 21.3% (95% CI 16.2–26.5) and was highly heterogeneous. Blood samples from 3,494 HIV patients living in various regions of the Russian Federation and CIS countries — Belarus, Kazakhstan, Kyrgyzstan, Uzbekistan, Tajikistan, Armenia, Georgia — were examined. Among subtypes of HIV-1, the main share was occupied by subtype A — 75.6% (n = 2643), subtype B — 5.5% (n = 193), C — 0.8% (n = 31), G — 0.2% (n = 7), F — 0.14% (n = 5). Among the recombinant forms (n = 616), the fraction of CRF02_ AG was 39.6% (n = 244), CRF02_AG/A was 32.9% (n = 203), CRF63_02A1 was 15.9% (n = 98), CRF03_AB — 5.2% (n = 32), CRF06_cpx — 2.1% (n = 13). Unique recombinant forms were 2.7% (n = 17), including URF63_A1 (2.5%). In Russia, the highest prevalence of recombinant forms of HIV-1 was registered in the Siberian Federal District (33.2% (95% CI 12.2– 54.1), the lowest in the Northwest Federal District — 1.6% (95% CI 0.9–2.3). In the CIS countries, the highest prevalence of recombinant forms of HIV-1 is found in a subgroup of the Central Asian republics — Uzbekistan, Tajikistan, Kyrgyzstan, Kazakhstan — 51.7% (95% CI 38.5–64.9). The significant upward trend was shown with a meta-regression. Our review is the first such research in Russia and thus is of significant interest, but the result should be applied with caution due to high risk of publication bias as well as significant heterogeneity of our results.
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