June 26, 2024 Journal article Open Access

Tegene Atamenta kitaw1*, Biruk Beletew Abate1, Gizachew Yilak1, Befkad Derese Tilahun1, Abebe Merchaw Faris1, Getachew Tesfaw Walle1 and Ribka Nigatu Haile1

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{
  "DOI": "10.20372/nadre:17312", 
  "author": [
    {
      "family": "Tegene Atamenta kitaw1*, Biruk Beletew Abate1, Gizachew Yilak1, Befkad Derese Tilahun1, Abebe Merchaw Faris1, Getachew Tesfaw Walle1 and Ribka Nigatu Haile1"
    }
  ], 
  "issued": {
    "date-parts": [
      [
        2024, 
        6, 
        26
      ]
    ]
  }, 
  "abstract": "<p>Abstract<br>\nBackground Despite remarkable progress, HIV&rsquo;s influence on global health remains firm, demanding continued<br>\nattention. Understanding the effectiveness of third-line antiretroviral therapy in individuals who do not respond to<br>\nsecond-line drugs is crucial for improving treatment strategies. The virological outcomes of third-line antiretroviral<br>\ntherapy vary from study to study, highlighting the need for robust global estimates.<br>\nMethods A comprehensive search of databases including PubMed, MEDLINE, International Scientific Indexing, Web<br>\nof Science, and Google Scholar, was conducted. STATA version 17 statistical software was used for analysis. A randomeffects model was applied to compute the pooled estimates. Subgroup analysis, heterogeneity, publication bias, and<br>\nsensitivity analysis were also performed. The prediction interval is computed to estimate the interval in which a future<br>\nstudy will fall. The GRADE tool was also used to determine the quality of the evidence.<br>\nResults In this systematic review and meta-analysis, 15 studies involving 1768 HIV patients receiving third-line<br>\nantiretroviral therapy were included. The pooled viral suppression of third-line antiretroviral therapy was 76.6% (95%<br>\nCI: 71.5- 81.7%). The viral suppression rates at 6 and 12 months were 75.5% and 78.6%, respectively. Furthermore,<br>\nthird-line therapy effectively suppressed viral RNA copy numbers to &le; 50 copies/mL, &le; 200 copies/mL, and &le; 400<br>\ncopies/mL with rates of 70.7%, 85.4%, and 85.7%, respectively.<br>\nConclusion More than three-fourths of patients on third-line antiretroviral therapy achieve viral suppression.<br>\nConsequently, improving access to and timely initiation of third-line therapy may positively impact the quality of life<br>\nfor those with second-line treatment failure.<br>\nKey Summary Points<br>\n&bull; Understanding the effectiveness of third-line antiretroviral therapy in individuals who do not respond to secondline drugs is crucial for improving treatment strategies.<br>\n&bull; Currently, second-line treatment failure has been increasing, making progression to third-line therapy seemingly<br>\nmandatory in many settings, making it apparent that recent evidence is crucial.<br>\n&bull; Viral suppression rate of third-line ART was 76.6% (95% CI: 71.5- 81.7%)<br>\n&nbsp;</p>", 
  "title": "Virological outcomes of third-line antiretroviral therapy in a global context: a systematic reviews and meta-analysis", 
  "type": "article-journal", 
  "id": "17312"
}