Background: Since 1981, an increasing trend in HIV has been observed for transmission
via injection drug users (IDUs), sexual transmission and mother-to-child transmission. The IDUs
are blamed for early increases in HIV-positive cases in China.
Objective: HIV genotypes of IDUs were comprehensively analysed to trace the source and relationships
of the AIDS epidemic in China.
Methods: Relevant databases written in English and Chinese were searched. Overall, 7,149 publications
were identified in six databases. After screening 7,104 articles according to the inclusion and
exclusion criteria, 45 studies consisting of 2,765 cases were finally identified. A meta-analysis was
conducted using R MATLAB software, RevMan and SPSS. Subgroup analyses focused on time
frame, region, and location of different genotypes of IDUs in China.
Results: There were five dominant HIV-1 genotypes among the 2,765 IDU cases. The proportions
of CRF07_BC, CRF01_AE, CRF08_BC, subtype B/B', and subtype C were 45.18% (95% CI:
33.55-57.08%), 16.00% (95% CI: 9.39-23.82%), 13.43% (95% CI: 7.32-20.84%), 3.58% (95% CI:
1.52-6.24%), and 0.90% (95% CI: 0.04-2.43%), respectively. HIV genotypes transmitted among
IDUs in China are primarily CRF07-BC, followed by CRF01-AE and CRF08-BC. Across the different
time frames and regions, CRF07_BC was the most prevalent HIV-1 genotype among IDUs,
while CRF08_BC was the most prevalent genotype in the southwest region.
Conclusion: Our study reveals that CRF07-BC was the dominant prevalent strain among IDUs
from 1991 to 2015 in China, while CRF08-BC was the dominant prevalent strain among IDUs in
southwestern China. This systematic review and meta-analysis shows evidence of the comprehensive
prevalence of different genotypes, data and characteristics of HIV among IDUs in China.