What is the best first-line art for adolescents with HIV infection?
· In a retrospective multi-site study evaluating long-term outcomes of patients receiving ART in a treatment program in Nigeria, authors indicated that older age, ART regimen, lower CD4 count, higher VL and inadequate adherence were predictors of virologic failure, while female sex and lower baseline CD4 were predictive of immunologic failure . Our findings in …
What are the new ARV drug guidelines for first-line treatment?
Background: Globally, 49% of the estimated 1.8 million children living with HIV are accessing antiretroviral therapy (ART). There are limited data concerning long-term durability of first-line ART regimens and time to transition to second-line. Methods: Children initiating their first ART regimen between 2 and 14 years of age and enrolled in one of 208 sites in 30 Asia-Pacific and …
What is the preferred monitoring approach to diagnose treatment failure?
· From 18 articles reviewed; the pooled proportion of first line treatment failure among ART users in Ethiopia was 15.3% (95% CI: 12, 18.6) with (I2 = 97.9%, p < 0.001). The subgroup analysis by World Health Organization (WHO) treatment failure assessment criteria were carried out, accordingly the highest prevalence (11.5%) was noted on immunological and …
When were the who guidelines on antiretroviral therapy (ART) published?
Background: First-line antiretroviral treatment failure has become a public health concern in high, low and middle-income countries with high mortality and morbidity In Ethiopia, around 710,000 peoples were living with HIV and 420,000 of them were receiving ART in 2017. Little is known about the magnitude of first-line ART treatment failure and its associated factors in Ethiopia, …
Why are some articles excluded from the first line of treatment?
Exclusion of these articles is because of the inability to assess the quality of articles in the absence of full text.
What is treatment failure?
Treatment failure is one of the causes of mortality and development of drug resistant viral strains potentiating a significant challenge globally [ 10, 11 ]. To the best of our knowledge, this meta-analysis is the first of its kind to estimate the pooled prevalence of treatment failure in Ethiopia.
What is MAA in research?
MAA: Conception of research protocol, study design, literature review, data extraction, data analysis, interpretation and drafting the manuscript. MA and DBK contribute on data extraction, quality assessment, data analysis and manuscript review and SM edition & validation. All authors have read and approved the manuscript.
What is ART therapy?
Antiretroviral therapy (ART) restores immune function and reduces human immunodeficiency virus (HIV) related adverse outcomes. The results of previous studies in Ethiopia were replete with inconsistent findings; nonexistence of national representative figures and determinant factors are found as significant gap. The aim of this systematic review and meta-analysis was to assess the existing evidence on ART treatment failure and associated factors in Ethiopia.
Is Ethiopia included in the systematic review?
All studies conducted in Ethiopia were included in the systematic review and a combination of two and above studies used in the meta-analysis to produce single estimate of common effect.
Abstract
Globally, 49% of the estimated 1.8 million children living with HIV are accessing antiretroviral therapy (ART). There are limited data concerning long-term durability of first-line ART regimens and time to transition to second-line.
BACKGROUND
As of 2015, globally, 1.8 million children were living with HIV, most of whom resided in low- and middle-income countries (LMIC). 1 Of these children (ages 0–14), 49% were accessing treatment, ranging from 20% in West and Central Africa to >95% in Europe and North America.
METHODS
This retrospective cohort study used deidentified patient-level and site-level data drawn from the IeDEA Pediatric Cohort. The IeDEA consortium is composed of 7 regional data centers that collect, harmonize, and analyze data drawn from HIV care and treatment programs within their region.
RESULTS
Data were contributed by 208 clinical sites from 30 countries.
DISCUSSION
This 5-region analysis of data from Sub-Saharan Africa and Asia demonstrated a high rate of first-line failure (25.9%) among children at 5 years after ART initiation.
ACKNOWLEDGMENTS
The authors acknowledge the clinics and investigators within each program who contributed data to this analysis:
REFERENCES
1. UNICEF. Pediatric treatment and care. Available at: http://data.unicef.org/hiv-aids/paediatric.html. Accessed January 18, 2017.
What are the additional recommendations in the guidelines?
Additional recommendations in the guidelines aim to help programmes deliver services
When was HIV prophylaxis published?
prophylaxis for HIV: Early Release” Published in September 2015
Does ART keep people awake?
of recent findings from clinical trials confirming that the early use of ART keeps people
Why is early detection of ART failure important?
Early detection of treatment failure is crucial to ensure the effectiveness of the first-line therapy [ 6 ].
How is treatment failure measured?
Treatment failure is typically measured in three ways in poor-resource settings: (i) clinically, as evidenced by disease progression; (ii) immunologically, as evidenced by trends in CD4 counts over time; and (iii) virologically, as evidenced by measurement of HIV RNA levels.
Who contributed to the conceptualization of the project?
YL, MK, and PN contributed to the conceptualization of the project. YL, MK, SJ, OA, and PN designed the search strategy, study selection process, and drafting of the manuscript. YL, MK, SJ, OA, and PN contributed to critically reviewing the manuscript. PN is the guarantor. The authors gave the final approval of the manuscript for publication.
Does PLHIV increase with prolonged use of ART?
Furthermore, an increase in the coverage of ART use among PLHIV, which has resulted in an increase in the number of individuals failing first-line ART, and therefore, the magnitude increases with prolonged use of ART .
What is the registration number for systematic review?
The systematic review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO), registration number: 2019 CRD42019136538.
What is a viral failure?
Virological failure is defined as a plasma viral load above 1000 copies/ml based on two consecutive viral load measurements after 3 months , with adherence support. A viral load test is a measurement of the amount of HIV in a sample of the blood. This is usually reported as the number of copies per milliliter (copies/mm 3) [ 17 ].
Is there any data regarding HIV treatment failure?
Despite the increase in the number of people accessing antiretroviral therapy (ART), there is limited data regarding treatment failure and its related factors among HIV-positive individuals enrolled in HIV care in resource-poor settings. This review aimed to identify factors associated with antiretroviral treatment failure among individuals living with HIV on ART in resource-poor settings.