Mitochondrial dysfunction among HIV-1 infected patients of South India and evaluation of mitochondrial DNA as a biomarker of mitochondrial toxicity

Background: As a risk-factor population for HIV infection, unsettled populations, in particular, refugees and migrants are understudied. Methods & Materials: Using the US Bureau of the Census database, all studies listed of high quality with keywords “refugee,” “asylum,” “immigrant,’ or “migrant” were collated. From this cohort, inapplicable and studies were deleted (eg, those listed as “non-migrants”). The data were analyzed using STATA 11, with respect to HIV prevalence, median year of collection, sample size, and age. Results: There were 645 eligible studies from 40 countries carried out between 1987 and 2015 deemed adequate for analysis. Most studies were from Asia (70%) or Africa (24%). The overall HIV prevalence among unsettled populations was 6.5% (SD 9.8, median, 2.5%). Over the last 5 years, among 446 studies, the mean prevalence was 6.5%. The 151 studies among only females showed a higher prevalence than those among only males (8.4% vs 6.4%, P =0.43). The sample size of 95 studies with data ranged from 5 to 930 persons, mean 359 (the mean HIV prevalence for this subset, 11.5%). Studies with a smaller sample size tended to show higher HIV prevalence (correlation coefficient, -0.52). There was a small increase in prevalence through time (correlation coefficient, 0.05). Studies before 2001 had a median prevalence of 7.7% while those after 2001 showed a median prevalence of 6.3%) (P = 0.0001, Kruskal Wallis. Age values were available for only 72 studies, with a mean prevalence of 10.5%, and slightly increased with age, correlation coefficient of 0.28. A regression analysis of age, sample size, and time of study against prevalence had only 24 studies but showed that only time of study as significant (P = 0.009, adjusted R square, 0.57). Conclusion: These data on globally unsettled populations show that while studies with small sample size, of females, and of older age populations show a higher HIV prevalence, the key factor remains time of study, with a slow increase in HIV prevalence through the interval analyzed, 1987-2015. With a mean recent prevalence of 6.5%, it is important that HIV prevention activities be directed toward unsettled populations, regardless of other risk factors.