Evidence map›Paper›PMID 40143265›Full record

SynthesisViruses2025

Challenges in Elucidating HIV-1 Genetic Diversity in the Middle East and North Africa: A Review Based on a Systematic Search.

Malik Sallam, Arwa Omar Al-Khatib, Tarneem Sabra, Saja Al-Baidhani, Kholoud Al-Mahzoum, Maryam A Aleigailly, Mohammed Sallam

Abstract readSystematic Review
In one paragraph

Synthesis in Viruses, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Malik SallamDepartment of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman 11942, Jordan.ORCID 0000-0002-0165-9670
Arwa Omar Al-KhatibFaculty of Pharmacy, Hourani Center for Applied Scientific Research, Al-Ahliyya Amman University, Amman 19111, Jordan.
Tarneem SabraDepartment of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman 11942, Jordan.
Saja Al-BaidhaniDepartment of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman 11942, Jordan.
Kholoud Al-MahzoumSheikh Jaber Al-Ahmad Al-Sabah Hospital, Ministry of Health, Kuwait City 13001, Kuwait.
Maryam A AleigaillyBiomedical Engineering Department, College of Engineering, University of Warith Alanbiyaa, Karbala 56001, Iraq.ORCID 0009-0005-3744-2480
Mohammed SallamDepartment of Pharmacy, Mediclinic Parkview Hospital, Mediclinic Middle East, Dubai P.O. Box 505004, United Arab Emirates.ORCID 0000-0003-3273-524X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The extensive genetic diversity of HIV-1 represents a major challenge to public health interventions, treatment, and successful vaccine design. This challenge is particularly pronounced in the Middle East and North Africa (MENA) region, where limited data among other barriers preclude the accurate characterization of HIV-1 genetic diversity. The objective of this review was to analyze studies conducted in the MENA region to delineate possible barriers that would hinder the accurate depiction of HIV-1 genetic diversity in this region. A systematic search of PubMed/MEDLINE and Google Scholar was conducted for published records on HIV-1 genetic diversity in the English language up until 1 October 2024 across 18 MENA countries. The pre-defined themes of challenges/barriers included limited sampling, data gaps, resource and infrastructure constraints, HIV-1-specific factors, and socio-cultural barriers. A total of 38 records were included in the final review, comprising original articles (55.3%), reviews (21.1%), and sequence notes (10.5%). Libya (15.8%), Morocco (13.2%), Saudi Arabia, and MENA as a whole (10.5% for each) were the primary sources of the included records. Of the 23 records with original MENA HIV-1 sequences, the median number of sequences was 46 (range: 6-193). The identified barriers included the following: (1) low sampling density; (2) limited clinical data (21.7% with no data, 60.9% partial data, and 17.4% with full data); (3) reliance solely on population sequencing and insufficient use of advanced sequencing technologies; (4) lack of comprehensive recombination analysis; and (5) socio-cultural barriers, including stigma with subsequent under-reporting among at-risk groups. The barriers identified in this review can hinder the ability to map the genetic diversity of HIV-1 in the MENA. Poor characterization of HIV-1's genetic diversity in the MENA would hinder efforts to optimize prevention strategies, monitor drug resistance, and develop MENA-specific treatment protocols. To overcome these challenges, investment in public health/research infrastructure, policy reforms to reduce stigma, and strengthened regional collaboration are recommended.

Indexed as

Genetic VariationHIV-1HIV InfectionsAfrica, NorthernHumansMiddle EastPhylogenyAIDSHIV infectionmolecular epidemiologyphylogeneticsunder-reporting

Identifiers

PMID40143265
PMCPMC11945966

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.