School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
Health Research Development Directorate, Amhara Public Health Institute, Bahir Dar, Ethiopia.
Syst Rev. 2024 Jul 15;13(1):180. doi: 10.1186/s13643-024-02605-1.
The emergence of HIV drug resistance presents a substantial challenge. Current antiretroviral treatments, along with current classes, face the danger of becoming partially or entirely inactive. As a result, alternative treatment regimens are limited, and treatment choices are complicated. According to the recommendation of the WHO, nations should consider changing their first-line ART regimen if HIV drug resistance exceeds 10%. In spite of the fact that a number of primary studies have been performed on HIV drug resistance in Ethiopia, their pooled prevalence rate has not been determined in a systematic review and meta-analysis, which may provide stronger evidence. Therefore, the objective of this systematic review and meta-analysis will be to estimate the pooled prevalence rate of HIV1 drug resistance in patients with first-line treatment failure in Ethiopia.
Primary studies will be identified from PubMed/MEDLINE, Scopus, Embase, Web of Science Core Collection, and Google Scholar. The period of search will be from 01 April to 30 June 2024. Studies identified through the search strategies will first be screened by titles and abstracts. Included studies meeting established criteria will be evaluated for risk of bias using the JBI checklist. Data will be extracted, and the pooled prevalence rate of HIV drug resistance will be computed using STATA 14 software. Random effect models will be used when heterogeneity is suspected. The I statistic and its corresponding P value will be checked to distinguish heterogeneity. Additionally, publication bias and heterogeneity will be checked using visual funnel plots, Egger's test, trim-and-fill tests, meta-regression, and subgroup analysis. To present and synthesize the results, narrative synthesis will be performed to describe study characteristics and findings, and forest plots will be used to visually represent effect sizes and confidence intervals from individual studies.
Estimating the pooled prevalence rate of HIV drug resistance through a systematic review and meta-analysis improves the reliability of the evidence, the availability of effective HIV treatment options, and the ability to assist in making decisions for both clinical practice and public health policy in Ethiopia.
PROSPERO CRD42024533975.
HIV 耐药性的出现带来了巨大的挑战。目前的抗逆转录病毒治疗方法以及现有的药物类别都面临着部分或完全失效的风险。因此，可供选择的治疗方案有限，治疗选择也变得复杂。根据世界卫生组织的建议，如果 HIV 耐药性超过 10%，各国应考虑改变一线抗逆转录病毒治疗方案。尽管已经在埃塞俄比亚进行了许多关于 HIV 耐药性的初步研究，但这些研究的汇总流行率尚未在系统评价和荟萃分析中确定，这可能提供更强有力的证据。因此，本系统评价和荟萃分析的目的是估计在埃塞俄比亚一线治疗失败的患者中 HIV1 耐药性的汇总流行率。
将从 PubMed/MEDLINE、Scopus、Embase、Web of Science Core Collection 和 Google Scholar 中确定原始研究。搜索期为 2024 年 4 月 1 日至 6 月 30 日。通过搜索策略确定的研究将首先根据标题和摘要进行筛选。符合既定标准的纳入研究将使用 JBI 清单评估偏倚风险。将提取数据，并使用 STATA 14 软件计算 HIV 耐药性的汇总流行率。当怀疑存在异质性时，将使用随机效应模型。将检查 I 统计量及其相应的 P 值，以区分异质性。此外，还将使用可视化漏斗图、Egger 检验、修剪和填充检验、元回归和亚组分析来检查发表偏倚和异质性。为了呈现和综合结果，将进行叙述性综合，以描述研究特征和发现，并使用森林图直观地表示来自单个研究的效应大小和置信区间。
通过系统评价和荟萃分析估计 HIV 耐药性的汇总流行率，可以提高证据的可靠性、有效的 HIV 治疗方案的可获得性，并有助于为埃塞俄比亚的临床实践和公共卫生政策做出决策。
PROSPERO CRD42024533975。
