Evidence that poor HAART adherence has a great impact on HIV/AIDS treatment failure more than severity of illness and opportunity of infection in Ethiopia: Systematic review and meta-analysis
BackgroundThe pooled burden of HIV treatment failure and its associated factors in Ethiopian context is required to provide evidence towards renewed ambitious future goal.\n\nMethodsPubMed, Web of Science, Scopus, Google Scholar, and Ethiopian Universities (University of Gondar and Addis Ababa University) online repository library were used to get the research articles. I-squared statistics was used to see heterogeneity. Publication bias was checked by Eggers regression test. A meta-analysis using the DerSimonian-Laird random-effects model was employed to estimate the overall prevalence of treatment failure. Subgroup analyses based on the geographical location of the study, age of study population, type of treatment failure, and study design were conducted to see variation in outcomes. The sensitivity analysis was also employed to see whether an outlier result found in the included studies.\n\nResultsOverall HIV treatment failure found to be 15.9% (95% CI: 11.6%-20.1%). HIV treatment failure was 10.2% (6.9%-13.6%) using immunological definition, 5.6% (95% CI: 2.9%-8.3%) using virological definition, and 6.3% (4.6%-8.0%) using clinical definition. Poor HAART adherence (AOR= 8.5; 95% CI: 4.1-12.8), severity of illness (as measured by WHO clinical stage III/IV (AOR=1.9; 95% CI: 1.3-2.6), and presence of opportunistic infections (AOR=1.8; 95% CI: 1.2-2.4) were significantly associated with HIV treatment failure.\n\nConclusionsHIV treatment failure in Ethiopia found to be high and differed by adherence level, severity of illness, and presence of opportunistic infection. HIV intervention programs, such as behavioral intervention is required to sustain HIV treatment adherence and improve treatment success as a result.\n\nProtocol RegistrationIt has been registered in the PROSPERO database (CRD42018100254).