Abstract
BackgroundThe national burden of human immunodeficiency virus treatment failure and associated factors in the Ethiopian context is required to provide evidence towards a renewed ambitious future goal.MethodsWe accessed Ethiopian Universities’ online repository library, Google Scholar, PubMed, Web of Science, and Scopus to get the research articles. We run I-squared statistics to see heterogeneity. Publication bias was checked by using Egger’s regression test. The pooled prevalence was estimated using the DerSimonian-Laird random-effects model. We employed the sensitivity analysis to see the presence of outlier result in the included studies.ResultsThe overall human immunodeficiency treatment failure was 15.9% (95% confidence interval: 11.6–20.1%). Using immunological, virological, and clinical definition, human immunodeficiency treatment failure was 10.2% (95% confidence interval: 6.9–13.6%), 5.6% (95% confidence interval: 2.9–8.3%), and 6.3% (95% confidence interval: 4.6–8.0%), respectively. The pooled effects of World Health Organization clinical stage III/IV (Adjusted Odd Ratio = 1.9; 95% CI: 1.3–2.6), presence of opportunistic infections (Adjusted Odd Ratio = 1.8; 95% CI: 1.2–2.4), and poor adherence to highly active antiretroviral therapy (Adjusted Odd Ratio = 8.1; 95% CI: 4.3–11.8) on HIV treatment failure were estimated.ConclusionsHuman immunodeficiency virus treatment failure in Ethiopia found to be high. Being on advanced clinical stage, presence of opportunistic infections, and poor adherence to highly active antiretroviral therapy were the contributing factors of human immunodeficiency virus treatment failure. Human immunodeficiency virus intervention programs need to address the specified contributing factors of human immunodeficiency virus treatment failure. Behavioral intervention to prevent treatment interruption is required to sustain human immunodeficiency virus treatment adherence.Protocol registrationIt has been registered in the PROSPERO database with a registration number of CRD42018100254.
Highlights
The national burden of human immunodeficiency virus treatment failure and associated factors in the Ethiopian context is required to provide evidence towards a renewed ambitious future goal
The search strategy made in PubMed was: [(“Human Immunodeficiency virus”[MeSH Terms] OR Human Immunodeficiency Virus (HIV) OR Acquired Immunodeficiency Syndrome (AIDS) OR “Acquired Immunodeficiency syndrome” AND (“antiretroviral therapy”[MeSH Terms] OR “highly antiretroviral therapy” OR highly active antiretroviral therapy (HAART) OR ART OR “ARV Therapy” OR “antiretroviral therapy”) AND AND (Ethiopia)]
Immunological and Virological definition of HIV treatment failure A total of 5899 study participants in 13 studies were involved to determine HIV treatment failure based on the immunological definition
Summary
The national burden of human immunodeficiency virus treatment failure and associated factors in the Ethiopian context is required to provide evidence towards a renewed ambitious future goal. There were approximately 37.9 million Human Immunodeficiency Virus (HIV) infected people and around 770,000 people died from AIDS-related illnesses worldwide in 2018. In this year, there were 20.6 million people with HIV in eastern and southern Africa, and 5.0 million in western and central Africa [1]. In Ethiopia, 690,000 people were living with HIV in 2018 [2]. In 2018, 23.3 million people with HIV were accessing antiretroviral therapy (ART) worldwide [1]. 65% of people living with HIV were on treatment in Ethiopia [2]. A review of the HIV situation in Addis Ababa Ethiopia revealed that weak monitoring of the quality of interventions, limited linkage of HIV-positive clients, lost to follow-up, financial shortage, limited man-power, and gaps in the use of program data were the challenges of HIV/AIDS treatment [3]
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