Adetokunboh Olatunji O, Schoonees Anel, Wiysonge Charles S
Centre for Evidence-based Health Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town 7505, South Africa.
Syst Rev. 2014 Aug 12;3:87. doi: 10.1186/2046-4053-3-87.
Abacavir is one of the recommended nucleoside reverse transcriptase inhibitors (NRTIs) for the treatment of HIV infections among children and adolescents. However, there are concerns that the antiviral efficacy of abacavir might be low when compared to other NRTIs especially among children. There are also concerns that abacavir use may lead to serious adverse events such as hypersensitivity reactions and has potential predisposition to developing cardiovascular diseases.
We plan to do a systematic review to evaluate the antiviral efficacy and safety of abacavir-containing combination antiretroviral therapy as first-line treatment of HIV-infected children aged between 3 months and 18 years, compared with other NRTIs. We will search Scopus, Cochrane Central Register of Controlled Trials, MEDLINE, and Web of Science databases for eligible studies regardless of language or publication status. We will check the reference lists of included studies, search relevant conference proceedings, email the authors of included studies and also look for unpublished and ongoing trials in prospective clinical trial registries. Two authors will independently screen search outputs, select studies, extract data and assess the risk of bias in included studies. All disagreements will be resolved by discussion and consensus. Where data allow, we will conduct meta-analysis for similar types of participants, study designs, interventions, and outcome measures. If the results are statistically homogeneous, we will use the fixed-effect model; otherwise, we will use the random-effects model and explore the reasons for heterogeneity using subgroup analyses. Heterogeneity will be assessed with the Chi-squared test and quantified with the I-squared statistic.
The findings will be useful to policy makers and programme managers to inform treatment and management of HIV in children and adolescents and to point out research gaps for future research.
This review is registered with PROSPERO, registration number CRD42014009157.
阿巴卡韦是治疗儿童和青少年人类免疫缺陷病毒（HIV）感染推荐使用的核苷类逆转录酶抑制剂（NRTIs）之一。然而，有人担心与其他NRTIs相比，尤其是在儿童中，阿巴卡韦的抗病毒疗效可能较低。也有人担心使用阿巴卡韦可能会导致严重不良事件，如过敏反应，并且有发展为心血管疾病的潜在倾向。
我们计划进行一项系统评价，以评估含阿巴卡韦的联合抗逆转录病毒疗法作为3个月至18岁HIV感染儿童一线治疗的抗病毒疗效和安全性，并与其他NRTIs进行比较。我们将检索Scopus、Cochrane对照试验中心注册库、MEDLINE和Web of Science数据库，以查找符合条件的研究，无论其语言或发表状态如何。我们将检查纳入研究的参考文献列表，检索相关会议论文集，给纳入研究的作者发电子邮件，并在前瞻性临床试验注册库中查找未发表和正在进行的试验。两位作者将独立筛选检索结果、选择研究、提取数据并评估纳入研究的偏倚风险。所有分歧将通过讨论和达成共识来解决。如果数据允许，我们将对类似类型的参与者、研究设计、干预措施和结局指标进行荟萃分析。如果结果在统计学上具有同质性，我们将使用固定效应模型；否则，我们将使用随机效应模型，并通过亚组分析探索异质性的原因。异质性将通过卡方检验进行评估，并用I²统计量进行量化。
研究结果将有助于政策制定者和项目管理者为儿童和青少年HIV的治疗和管理提供信息，并指出未来研究的空白。
本评价已在PROSPERO注册，注册号为CRD42014009157。
