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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  <dc:creator>Tegene Atamenta kitaw1*, Biruk Beletew Abate1, Gizachew Yilak1, Befkad Derese Tilahun1, Abebe Merchaw Faris1, Getachew Tesfaw Walle1 and Ribka Nigatu Haile1</dc:creator>
  <dc:date>2024-06-26</dc:date>
  <dc:description>Abstract
Background Despite remarkable progress, HIV’s influence on global health remains firm, demanding continued
attention. Understanding the effectiveness of third-line antiretroviral therapy in individuals who do not respond to
second-line drugs is crucial for improving treatment strategies. The virological outcomes of third-line antiretroviral
therapy vary from study to study, highlighting the need for robust global estimates.
Methods A comprehensive search of databases including PubMed, MEDLINE, International Scientific Indexing, Web
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
sensitivity analysis were also performed. The prediction interval is computed to estimate the interval in which a future
study will fall. The GRADE tool was also used to determine the quality of the evidence.
Results In this systematic review and meta-analysis, 15 studies involving 1768 HIV patients receiving third-line
antiretroviral therapy were included. The pooled viral suppression of third-line antiretroviral therapy was 76.6% (95%
CI: 71.5- 81.7%). The viral suppression rates at 6 and 12 months were 75.5% and 78.6%, respectively. Furthermore,
third-line therapy effectively suppressed viral RNA copy numbers to ≤ 50 copies/mL, ≤ 200 copies/mL, and ≤ 400
copies/mL with rates of 70.7%, 85.4%, and 85.7%, respectively.
Conclusion More than three-fourths of patients on third-line antiretroviral therapy achieve viral suppression.
Consequently, improving access to and timely initiation of third-line therapy may positively impact the quality of life
for those with second-line treatment failure.
Key Summary Points
• Understanding the effectiveness of third-line antiretroviral therapy in individuals who do not respond to secondline drugs is crucial for improving treatment strategies.
• Currently, second-line treatment failure has been increasing, making progression to third-line therapy seemingly
mandatory in many settings, making it apparent that recent evidence is crucial.
• Viral suppression rate of third-line ART was 76.6% (95% CI: 71.5- 81.7%)
 </dc:description>
  <dc:identifier>https://zenodo.org/record/17312</dc:identifier>
  <dc:identifier>10.20372/nadre:17312</dc:identifier>
  <dc:identifier>oai:zenodo.org:17312</dc:identifier>
  <dc:relation>doi:10.20372/nadre:17311</dc:relation>
  <dc:rights>info:eu-repo/semantics/openAccess</dc:rights>
  <dc:rights>http://www.opendefinition.org/licenses/cc-by</dc:rights>
  <dc:title>Virological outcomes of third-line antiretroviral therapy in a global context: a systematic reviews and meta-analysis</dc:title>
  <dc:type>info:eu-repo/semantics/article</dc:type>
  <dc:type>publication-article</dc:type>
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