Viral load suppression rate of third-line antiretroviral therapy and its association with gender among HIV patients after second-line treatment failure in Africa: a systematic review and meta-analysis
Abstract Introduction Previous works of literatures on the viral load suppression rate of third line antiretroviral therapy in Africa has produced inconsistent and inconclusive results, with rates varying between 62% and 95%. This variability poses challenges for policymakers and healthcare provider...
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2025-02-01
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| Series: | BMC Infectious Diseases |
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| Online Access: | https://doi.org/10.1186/s12879-025-10576-4 |
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| author | Tilahun Degu Tsega Sintayehu Simie Tsega Asaye Alamneh Gebeyehu Getaneh Atikilt Yemata Rahel Mulatie Anteneh Almaw Genet Yeshiwas Getasew Yirdaw Chalachew Yenew Anley Shiferaw Enawgaw Amare Genetu Ejigu Ahmed Fentaw Ahmed Zeamanuel Anteneh Yigzaw Berhanu Abebaw Mekonnen Meron Asmamaw Alemayehu Abathun Temesgen Abebaw Molla Habitamu Mekonen Assefa Andargie Kassa Gashaw Melkie Bayeh |
| author_facet | Tilahun Degu Tsega Sintayehu Simie Tsega Asaye Alamneh Gebeyehu Getaneh Atikilt Yemata Rahel Mulatie Anteneh Almaw Genet Yeshiwas Getasew Yirdaw Chalachew Yenew Anley Shiferaw Enawgaw Amare Genetu Ejigu Ahmed Fentaw Ahmed Zeamanuel Anteneh Yigzaw Berhanu Abebaw Mekonnen Meron Asmamaw Alemayehu Abathun Temesgen Abebaw Molla Habitamu Mekonen Assefa Andargie Kassa Gashaw Melkie Bayeh |
| author_sort | Tilahun Degu Tsega |
| collection | DOAJ |
| description | Abstract Introduction Previous works of literatures on the viral load suppression rate of third line antiretroviral therapy in Africa has produced inconsistent and inconclusive results, with rates varying between 62% and 95%. This variability poses challenges for policymakers and healthcare providers in making informed decisions. This systematic review and meta-analysis aimed to determine the overall viral load suppression rate of third line antiretroviral therapy in Africa and to clarify the contradictory relationship between gender and viral load suppression, based on existing primary studies. Methods A systematic review and meta-analysis were conducted using PubMed, Medline, Cochrane Library, Henari, African Journals Online (AJOL), Web of science, and Google Scholar to access studies up to December 6, 2024. The PRISMA guideline, JBI, and Newcastle Ottawa quality assessment scale checklists were used. Heterogeneity was evaluated with Cochrane’s Q and I2 statistics. Publication bias was checked using a funnel plot, Begg’s and Egger’s test, followed by the DerSimonian and Laird random effects model. Meta-regression, subgroup and sensitivity analyses were also performed. The odds ratio with a 95% confidence interval was used to assess the association of gender with the viral load suppression rate in patients on third-line antiretroviral therapy. All analyses were conducted using Stata 18. Results A total of 14 primary studies with a total sample size of 1791 were included. The pooled magnitude of the viral load suppression rate was 79.82% (95%CI: 75.75%, 83.90%). Around 75% of the included studies’ heterogeneity were explained by country, study year, study settings and quality level of the study level variables. There was not statistically significant association of gender with viral load suppression rate of third line antiretroviral therapy. Conclusion and recommendation The pooled magnitude of the viral load suppression rate was 79.82%. There was not statistically significant association of gender with viral load suppression rate of third line antiretroviral therapy. Therefore, to maintain and further improve the strong viral load suppression rates of TLARVT in Africa, it is essential to focus on appropriate regimen selection, patient counseling and switching, adherence support, and regular viral load testing. Future studies with larger sample sizes should explore the association between gender and viral load suppression to provide conclusive findings. |
| format | Article |
| id | doaj-art-e21637eba3ae4d73bc7c00a8c15be049 |
| institution | Kabale University |
| issn | 1471-2334 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj-art-e21637eba3ae4d73bc7c00a8c15be0492025-02-09T12:14:50ZengBMCBMC Infectious Diseases1471-23342025-02-0125111710.1186/s12879-025-10576-4Viral load suppression rate of third-line antiretroviral therapy and its association with gender among HIV patients after second-line treatment failure in Africa: a systematic review and meta-analysisTilahun Degu Tsega0Sintayehu Simie Tsega1Asaye Alamneh Gebeyehu2Getaneh Atikilt Yemata3Rahel Mulatie Anteneh4Almaw Genet Yeshiwas5Getasew Yirdaw6Chalachew Yenew7Anley Shiferaw Enawgaw8Amare Genetu Ejigu9Ahmed Fentaw Ahmed10Zeamanuel Anteneh Yigzaw11Berhanu Abebaw Mekonnen12Meron Asmamaw Alemayehu13Abathun Temesgen14Abebaw Molla15Habitamu Mekonen16Assefa Andargie Kassa17Gashaw Melkie Bayeh18Department of Public Health, College of Medicine and Health Sciences, Injibara UniversityDepartment of Medical Nursing, School of Nursing, College of Medicine and Health Science, University of GondarDepatment of Public Health, College of Health Science, Debre Tabor UniversityDepatment of Public Health, College of Health Science, Debre Tabor UniversityDepatment of Public Health, College of Health Science, Debre Tabor UniversityDepartment of Environmental Health, College of Medicine and Health Sciences, Injibara UniversityDepartment of Environmental Health Science, College of Medicine and Health Sciences, Debre Markos UniversityDepartment of Environmental Health Sciences, Public Health, College of Health Sciences, Debre Tabor UniversityDepartment of Public Health, College of Health Sciences, Debre Markos UniversityDepartment of Midwifery, College of Medicine and Health Sciences, Injibara UniversityDepartment of Public Health, College of Medicine and Health Sciences, Injibara UniversityDepartment of Health Promotion and Behavioral Sciences, School of Public Health, College of Medicine and Health Sciences, Bahir Dar UniversityDepartment of Nutrition and Dietetics, School of Public Health, College of Medicine and Health Sciences, Bahir Dar UniversityDepartment of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of GondarDepartment of Environmental Health, College of Medicine and Health Sciences, Injibara UniversityDepartment of Public Health, College of Medicine and Health Sciences, Injibara UniversityDepartment of Human Nutrition, Collage of Health Science, Debre Markos UniversityDepartment of Public Health, College of Medicine and Health Sciences, Injibara UniversityDepartment of Environmental Health, College of Medicine and Health Sciences, Injibara UniversityAbstract Introduction Previous works of literatures on the viral load suppression rate of third line antiretroviral therapy in Africa has produced inconsistent and inconclusive results, with rates varying between 62% and 95%. This variability poses challenges for policymakers and healthcare providers in making informed decisions. This systematic review and meta-analysis aimed to determine the overall viral load suppression rate of third line antiretroviral therapy in Africa and to clarify the contradictory relationship between gender and viral load suppression, based on existing primary studies. Methods A systematic review and meta-analysis were conducted using PubMed, Medline, Cochrane Library, Henari, African Journals Online (AJOL), Web of science, and Google Scholar to access studies up to December 6, 2024. The PRISMA guideline, JBI, and Newcastle Ottawa quality assessment scale checklists were used. Heterogeneity was evaluated with Cochrane’s Q and I2 statistics. Publication bias was checked using a funnel plot, Begg’s and Egger’s test, followed by the DerSimonian and Laird random effects model. Meta-regression, subgroup and sensitivity analyses were also performed. The odds ratio with a 95% confidence interval was used to assess the association of gender with the viral load suppression rate in patients on third-line antiretroviral therapy. All analyses were conducted using Stata 18. Results A total of 14 primary studies with a total sample size of 1791 were included. The pooled magnitude of the viral load suppression rate was 79.82% (95%CI: 75.75%, 83.90%). Around 75% of the included studies’ heterogeneity were explained by country, study year, study settings and quality level of the study level variables. There was not statistically significant association of gender with viral load suppression rate of third line antiretroviral therapy. Conclusion and recommendation The pooled magnitude of the viral load suppression rate was 79.82%. There was not statistically significant association of gender with viral load suppression rate of third line antiretroviral therapy. Therefore, to maintain and further improve the strong viral load suppression rates of TLARVT in Africa, it is essential to focus on appropriate regimen selection, patient counseling and switching, adherence support, and regular viral load testing. Future studies with larger sample sizes should explore the association between gender and viral load suppression to provide conclusive findings.https://doi.org/10.1186/s12879-025-10576-4Third line antiretroviral therapyViral load suppressionAfricaHIVSystematic review and meta-analysis |
| spellingShingle | Tilahun Degu Tsega Sintayehu Simie Tsega Asaye Alamneh Gebeyehu Getaneh Atikilt Yemata Rahel Mulatie Anteneh Almaw Genet Yeshiwas Getasew Yirdaw Chalachew Yenew Anley Shiferaw Enawgaw Amare Genetu Ejigu Ahmed Fentaw Ahmed Zeamanuel Anteneh Yigzaw Berhanu Abebaw Mekonnen Meron Asmamaw Alemayehu Abathun Temesgen Abebaw Molla Habitamu Mekonen Assefa Andargie Kassa Gashaw Melkie Bayeh Viral load suppression rate of third-line antiretroviral therapy and its association with gender among HIV patients after second-line treatment failure in Africa: a systematic review and meta-analysis BMC Infectious Diseases Third line antiretroviral therapy Viral load suppression Africa HIV Systematic review and meta-analysis |
| title | Viral load suppression rate of third-line antiretroviral therapy and its association with gender among HIV patients after second-line treatment failure in Africa: a systematic review and meta-analysis |
| title_full | Viral load suppression rate of third-line antiretroviral therapy and its association with gender among HIV patients after second-line treatment failure in Africa: a systematic review and meta-analysis |
| title_fullStr | Viral load suppression rate of third-line antiretroviral therapy and its association with gender among HIV patients after second-line treatment failure in Africa: a systematic review and meta-analysis |
| title_full_unstemmed | Viral load suppression rate of third-line antiretroviral therapy and its association with gender among HIV patients after second-line treatment failure in Africa: a systematic review and meta-analysis |
| title_short | Viral load suppression rate of third-line antiretroviral therapy and its association with gender among HIV patients after second-line treatment failure in Africa: a systematic review and meta-analysis |
| title_sort | viral load suppression rate of third line antiretroviral therapy and its association with gender among hiv patients after second line treatment failure in africa a systematic review and meta analysis |
| topic | Third line antiretroviral therapy Viral load suppression Africa HIV Systematic review and meta-analysis |
| url | https://doi.org/10.1186/s12879-025-10576-4 |
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