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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  <identifier identifierType="DOI">10.20372/nadre:17312</identifier>
  <creators>
    <creator>
      <creatorName>Tegene Atamenta kitaw1*, Biruk Beletew Abate1, Gizachew Yilak1, Befkad Derese Tilahun1, Abebe Merchaw Faris1, Getachew Tesfaw Walle1 and Ribka Nigatu Haile1</creatorName>
      <affiliation>1Department of Nursing, College of Health Science, Woldia University, Woldia, Ethiopia</affiliation>
    </creator>
  </creators>
  <titles>
    <title>Virological outcomes of third-line antiretroviral therapy in a global context: a systematic reviews and meta-analysis</title>
  </titles>
  <publisher>Zenodo</publisher>
  <publicationYear>2024</publicationYear>
  <dates>
    <date dateType="Issued">2024-06-26</date>
  </dates>
  <resourceType resourceTypeGeneral="JournalArticle"/>
  <alternateIdentifiers>
    <alternateIdentifier alternateIdentifierType="url">https://nadre.ethernet.edu.et/record/17312</alternateIdentifier>
  </alternateIdentifiers>
  <relatedIdentifiers>
    <relatedIdentifier relatedIdentifierType="DOI" relationType="IsVersionOf">10.20372/nadre:17311</relatedIdentifier>
  </relatedIdentifiers>
  <rightsList>
    <rights rightsURI="http://www.opendefinition.org/licenses/cc-by">Creative Commons Attribution</rights>
    <rights rightsURI="info:eu-repo/semantics/openAccess">Open Access</rights>
  </rightsList>
  <descriptions>
    <description descriptionType="Abstract">&lt;p&gt;Abstract&lt;br&gt;
Background Despite remarkable progress, HIV&amp;rsquo;s influence on global health remains firm, demanding continued&lt;br&gt;
attention. Understanding the effectiveness of third-line antiretroviral therapy in individuals who do not respond to&lt;br&gt;
second-line drugs is crucial for improving treatment strategies. The virological outcomes of third-line antiretroviral&lt;br&gt;
therapy vary from study to study, highlighting the need for robust global estimates.&lt;br&gt;
Methods A comprehensive search of databases including PubMed, MEDLINE, International Scientific Indexing, Web&lt;br&gt;
of 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&lt;br&gt;
sensitivity analysis were also performed. The prediction interval is computed to estimate the interval in which a future&lt;br&gt;
study will fall. The GRADE tool was also used to determine the quality of the evidence.&lt;br&gt;
Results In this systematic review and meta-analysis, 15 studies involving 1768 HIV patients receiving third-line&lt;br&gt;
antiretroviral therapy were included. The pooled viral suppression of third-line antiretroviral therapy was 76.6% (95%&lt;br&gt;
CI: 71.5- 81.7%). The viral suppression rates at 6 and 12 months were 75.5% and 78.6%, respectively. Furthermore,&lt;br&gt;
third-line therapy effectively suppressed viral RNA copy numbers to &amp;le; 50 copies/mL, &amp;le; 200 copies/mL, and &amp;le; 400&lt;br&gt;
copies/mL with rates of 70.7%, 85.4%, and 85.7%, respectively.&lt;br&gt;
Conclusion More than three-fourths of patients on third-line antiretroviral therapy achieve viral suppression.&lt;br&gt;
Consequently, improving access to and timely initiation of third-line therapy may positively impact the quality of life&lt;br&gt;
for those with second-line treatment failure.&lt;br&gt;
Key Summary Points&lt;br&gt;
&amp;bull; Understanding the effectiveness of third-line antiretroviral therapy in individuals who do not respond to secondline drugs is crucial for improving treatment strategies.&lt;br&gt;
&amp;bull; Currently, second-line treatment failure has been increasing, making progression to third-line therapy seemingly&lt;br&gt;
mandatory in many settings, making it apparent that recent evidence is crucial.&lt;br&gt;
&amp;bull; Viral suppression rate of third-line ART was 76.6% (95% CI: 71.5- 81.7%)&lt;br&gt;
&amp;nbsp;&lt;/p&gt;</description>
  </descriptions>
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