Second-line anti-retroviral treatment failure and its predictors among patients with HIV in Ethiopia: A systematic review and meta-analysis

• Published in: PLOS global public health 2024, Vol.4 (4), p.e0003138-e0003138
• Main Authors: Kassie, Gizachew Ambaw, Wolda, Getahun Dendir, Woldegeorgis, Beshada Zerfu, Gebrekidan, Amanuel Yosef, Haile, Kirubel Eshetu, Meskele, Mengistu, Asgedom, Yordanos Sisay
• Format: Article
• Language: English
• Subjects: Biology and Life Sciences; Medicine and Health Sciences; People and Places; Physical Sciences; Research and Analysis Methods
• ISSN: 2767-3375; 2767-3375
• DOI: 10.1371/journal.pgph.0003138

Antiretroviral therapy (ART) treatment failure remains a major public health concern, with multidimensional consequences, including an increased risk of drug resistance, compromised quality of life, and high healthcare costs. However, little is known about the outcomes of second-line ART in Ethiopia. Therefore, this systematic review and meta-analysis aimed to determine the incidence and determinants of second-line ART treatment failure. Articles published in PubMed, Google Scholar, Science Direct, and Scopus databases were systematically searched. All observational studies on the incidence and predictors of treatment failure among patients with HIV on second-line ART were included. A random-effects model was used to estimate the pooled incidence, and subgroup analysis was performed to identify the possible sources of heterogeneity. Publication bias was checked using forest plot, Begg's test, and Egger's test. The pooled odds ratio was also computed for associated factors. Seven studies with 3,962 study participants were included in this study. The pooled incidence of second-line antiretroviral treatment failure was 5.98 (95% CI: 4.32, 7.63) per 100 person-years of observation. Being in the advanced WHO clinical stage at switch (AHR = 2.98, 95% CI: 2.11, 4.25), having a CD4 count