Virological failure and associated factors among patients receiving anti-retroviral therapy in Ethiopia: A systematic review and meta-analysis

Objective This study aimed to pool the prevalence of virological failure and associated factors.Design Systematic review and meta-analysis.Primary outcome measure Prevalence of virological failure.Secondary outcome measure Factors affecting virological failure.Analysis The extracted data were export...

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Main Authors: Sintayehu Asnakew, Getasew Legas, Amare Kassaw, Tigabu Munye Aytenew, Solomon Demis Kebede, Worku Necho Asferie, Netsanet Ejigu, Binyam Minuye Birhane, Yenework Mulu Tiruneh, Birhanu Mengist Munie, Bekalu Mekonnen Belay, Mengistu Ewunetu, Demewoz Kefale
Format: Article
Language:English
Published: BMJ Publishing Group 2024-11-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/14/11/e087569.full
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author Sintayehu Asnakew
Getasew Legas
Amare Kassaw
Tigabu Munye Aytenew
Solomon Demis Kebede
Worku Necho Asferie
Netsanet Ejigu
Binyam Minuye Birhane
Yenework Mulu Tiruneh
Birhanu Mengist Munie
Bekalu Mekonnen Belay
Mengistu Ewunetu
Demewoz Kefale
author_facet Sintayehu Asnakew
Getasew Legas
Amare Kassaw
Tigabu Munye Aytenew
Solomon Demis Kebede
Worku Necho Asferie
Netsanet Ejigu
Binyam Minuye Birhane
Yenework Mulu Tiruneh
Birhanu Mengist Munie
Bekalu Mekonnen Belay
Mengistu Ewunetu
Demewoz Kefale
author_sort Sintayehu Asnakew
collection DOAJ
description Objective This study aimed to pool the prevalence of virological failure and associated factors.Design Systematic review and meta-analysis.Primary outcome measure Prevalence of virological failure.Secondary outcome measure Factors affecting virological failure.Analysis The extracted data were exported to STATA V.17 for statistical analysis. A random-effects DerSimonian-Laird model was used to compute the pooled prevalence of virological failure.Setting Ethiopia.Participants Patients receiving anti-retroviral therapy.Results A total of 51 primary studies with a sample size of 38, 789 participants were included in the final meta-analysis. The pooled prevalence of virological failure among patients receiving anti-retroviral therapy (ART) in Ethiopia was 15.95% (95% CI: 12.63, 19.27; I2=97.99%; p<0.001). Substance use (adjusted OR (AOR)=2.37, 95% CI: 1.28, 4.39), non-disclosure of HIV status (AOR=4.63, 95% CI: 3.51, 6.11), interruption of ART (AOR=2.61, 95% CI: 1.55, 4.40), poor adherence to ART (AOR=4.31, 95% CI: 2.73, 6.79), baseline CD4 cell count <200 cells/mm3 (AOR=2.65, 95% CI: 1.62, 4.33), baseline advanced WHO clinical stage (WHO clinical stages III and IV) (AOR=3.02, 95% CI: 1.67, 5.45), baseline viral load >1000 copies/mL (AOR=4.63, 95% CI: 2.60, 8.26), opportunistic infections (AOR=3.58, 95% CI: 2.58, 4.96) and TB-HIV coinfection (AOR=3.97, 95% CI: 2.41, 6.54) were significantly associated with virological failure among patients receiving anti-retroviral therapy in Ethiopia.Conclusions The pooled prevalence of virological failure among patients receiving anti-retroviral therapy was high in Ethiopia. Therefore, due attention should be given to patients with these identified factors. Moreover, we recommend researchers to conduct a triangulated study that can address additional factors associated with virological failure.PROSPERO registration number The protocol was registered with the Prospero database (PROSPERO, 2024: CRD42024512411).
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spelling doaj-art-d9a2604f6eb2489aa1872b74541b3e632025-08-20T02:37:51ZengBMJ Publishing GroupBMJ Open2044-60552024-11-01141110.1136/bmjopen-2024-087569Virological failure and associated factors among patients receiving anti-retroviral therapy in Ethiopia: A systematic review and meta-analysisSintayehu Asnakew0Getasew Legas1Amare Kassaw2Tigabu Munye Aytenew3Solomon Demis Kebede4Worku Necho Asferie5Netsanet Ejigu6Binyam Minuye Birhane7Yenework Mulu Tiruneh8Birhanu Mengist Munie9Bekalu Mekonnen Belay10Mengistu Ewunetu11Demewoz Kefale12Department of Psychiatry, Debre Tabor University, Debre Tabor, Amhara, EthiopiaDepartment of Psychiatry, Debre Tabor University, Debre Tabor, Amhara, EthiopiaDepartment of Pediatrics and Child Health Nursing, Debre Tabor University, Debre Tabor, Amhara, EthiopiaDepartment of Nursing, Debre Tabor University, Debre Tabor, Amhara, EthiopiaDepartment of Maternity and Neonatal Nursing, Debre Tabor University, Debre Tabor, Amhara, EthiopiaDepartment of Matenity and Neonatal Nursing, Debre Tabor University, Debre Tabor, Amhara, EthiopiaDepartment of Midwifery, Dembiya Primary Hospital, Koladiba, Amhara, EthiopiaDepartment of Matenity and Neonatal Nursing, Debre Tabor University, Debre Tabor, Amhara, EthiopiaSchool of Nursing, University of Gondar, Gondar, Amhara, EthiopiaDepartment of Psychiatry, Debre Tabor University, Debre Tabor, Amhara, EthiopiaDepartment of Adult Health Nursing, Debre Tabor University, Debre Tabor, Amhara, EthiopiaDepartment of Adult Health Nursing, Debre Tabor University, Debre Tabor, Amhara, EthiopiaDepartment of Pediatrics and Child Health Nursing, Debre Tabor University, Debre Tabor, Amhara, EthiopiaObjective This study aimed to pool the prevalence of virological failure and associated factors.Design Systematic review and meta-analysis.Primary outcome measure Prevalence of virological failure.Secondary outcome measure Factors affecting virological failure.Analysis The extracted data were exported to STATA V.17 for statistical analysis. A random-effects DerSimonian-Laird model was used to compute the pooled prevalence of virological failure.Setting Ethiopia.Participants Patients receiving anti-retroviral therapy.Results A total of 51 primary studies with a sample size of 38, 789 participants were included in the final meta-analysis. The pooled prevalence of virological failure among patients receiving anti-retroviral therapy (ART) in Ethiopia was 15.95% (95% CI: 12.63, 19.27; I2=97.99%; p<0.001). Substance use (adjusted OR (AOR)=2.37, 95% CI: 1.28, 4.39), non-disclosure of HIV status (AOR=4.63, 95% CI: 3.51, 6.11), interruption of ART (AOR=2.61, 95% CI: 1.55, 4.40), poor adherence to ART (AOR=4.31, 95% CI: 2.73, 6.79), baseline CD4 cell count <200 cells/mm3 (AOR=2.65, 95% CI: 1.62, 4.33), baseline advanced WHO clinical stage (WHO clinical stages III and IV) (AOR=3.02, 95% CI: 1.67, 5.45), baseline viral load >1000 copies/mL (AOR=4.63, 95% CI: 2.60, 8.26), opportunistic infections (AOR=3.58, 95% CI: 2.58, 4.96) and TB-HIV coinfection (AOR=3.97, 95% CI: 2.41, 6.54) were significantly associated with virological failure among patients receiving anti-retroviral therapy in Ethiopia.Conclusions The pooled prevalence of virological failure among patients receiving anti-retroviral therapy was high in Ethiopia. Therefore, due attention should be given to patients with these identified factors. Moreover, we recommend researchers to conduct a triangulated study that can address additional factors associated with virological failure.PROSPERO registration number The protocol was registered with the Prospero database (PROSPERO, 2024: CRD42024512411).https://bmjopen.bmj.com/content/14/11/e087569.full
spellingShingle Sintayehu Asnakew
Getasew Legas
Amare Kassaw
Tigabu Munye Aytenew
Solomon Demis Kebede
Worku Necho Asferie
Netsanet Ejigu
Binyam Minuye Birhane
Yenework Mulu Tiruneh
Birhanu Mengist Munie
Bekalu Mekonnen Belay
Mengistu Ewunetu
Demewoz Kefale
Virological failure and associated factors among patients receiving anti-retroviral therapy in Ethiopia: A systematic review and meta-analysis
BMJ Open
title Virological failure and associated factors among patients receiving anti-retroviral therapy in Ethiopia: A systematic review and meta-analysis
title_full Virological failure and associated factors among patients receiving anti-retroviral therapy in Ethiopia: A systematic review and meta-analysis
title_fullStr Virological failure and associated factors among patients receiving anti-retroviral therapy in Ethiopia: A systematic review and meta-analysis
title_full_unstemmed Virological failure and associated factors among patients receiving anti-retroviral therapy in Ethiopia: A systematic review and meta-analysis
title_short Virological failure and associated factors among patients receiving anti-retroviral therapy in Ethiopia: A systematic review and meta-analysis
title_sort virological failure and associated factors among patients receiving anti retroviral therapy in ethiopia a systematic review and meta analysis
url https://bmjopen.bmj.com/content/14/11/e087569.full
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