全面了解全球双重HIV感染(DI)概况,数据库Cochrane图书馆,Embase,PubMed,和WebofScience是截至2024年3月31日的数据源(PROSPERO:CRD42023388328)。使用Stata和R语言软件对提取的数据进行分析。使用Egger检验评估发表偏倚。进行敏感性分析以评估组合效应值的稳定性。来自四大洲17项符合条件的研究的数据(非洲,亚洲,欧洲,和北美)使用了1,475名受试者。合并双重感染率(DIR)为10.47%(95%CI:7.11%-14.38%),无时间趋势(p=0.105)。目标人群的DIR差异显著,FSW的DIR最高(15.14%),其次是一般人口(12.08%),MSM(11.84%),和DU(9.76%)。提取122例双重感染患者的亚型谱,结果表明,在合并感染组(16/22,72.73%)和重复感染组(68/100,68.00%)中,其中亚型模式B和B所占比例最大。全球双重感染率可能被低估了,尽管数据在10%左右波动,没有时间趋势。DI的发生表明,即使在初次感染后,个体仍然没有获得对HIV的足够抗性,这可能会损害患者的治疗效果,并导致新亚型的出现,对艾滋病毒预防构成重大挑战,control,和治疗,这表明,在抗病毒治疗期间,对所有HIV感染者的行为咨询和健康教育仍然至关重要。
To understand the global dual HIV infection (DI) profiles comprehensively, the databases Cochrane Library, Embase, PubMed, and Web of Science were the data sources up to March 31, 2024 (PROSPERO: CRD42023388328). Stata and R-language software were used to analyze the extracted data. Publication bias was assessed using Egger\'s test. Sensitivity analysis was conducted to evaluate the stability of the combined effect values. Data from 17 eligible studies across four continents (Africa, Asia, Europe, and North America) with 1,475 subjects were used. The combined dual infection rate (DIR) was 10.47% (95% CI: 7.11%-14.38%) without a time trend (p = 0.105). The DIRs of target population groups differed significantly, with FSWs having the highest DIR (15.14%), followed by general population (12.08%), MSM (11.84%), and DUs (9.76%). The subtype profiles of 122 patients with dual infection were extracted, and the results showed that intrasubtype infections were predominant in
coinfection (16/22, 72.73%) and superinfection (68/100, 68.00%) groups, with the subtype pattern B and B accounts for the largest proportion. The global dual infection rate may be underestimated, even though the data fluctuated around 10% and showed no time trend. The occurrence of DI indicated that individuals still do not acquire sufficient resistance to HIV even after primary infection, which could potentially compromise the patient\'s treatment effect and lead to the emergence of new subtypes, posing a significant challenge to HIV prevention, control, and treatment, suggesting that behavioral counseling and health education for all HIV-infected individuals are still crucial during the antiviral therapy.