Ndlazi Lindokuhle, Mokgatle Mathildah M, Cele Lindiwe P, Seretlo Raikane J
Department of Public Health, School of Healthcare Sciences, Sefako Makgatho Health Sciences University, Tshwane, South Africa.
J Public Health Afr. 2025 Aug 15;16(1):1324. doi: 10.4102/jphia.v16i1.1324. eCollection 2025.
Viral rebound (VR), the resurgence of detectable human immunodeficiency virus (HIV) viral loads (> 50 copies/mL) after suppression, remains a challenge for individuals on antiretroviral therapy (ART) in South Africa, despite free access to treatment.
This systematic review aimed to determine the prevalence of HIV VR and its contributing factors among individuals on ART.
This is a systematic review study, it relies primarily on secondary data, and it does not have a physical setting.
This study is conducted in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the Cochrane methodology, and the study was registered with PROSPERO (ID: CRD42024524121). Data were sourced from PubMed, EBSCOhost and Scopus, yielding 89 684 articles. After screening in Rayyan, 23 articles met the inclusion criteria. The risk of bias was assessed using the Joanna Briggs Institute's (JBI's) appraisal tool.
Viral rebound varies across different populations. Contributing factors included biological, genetic, demographic, socio-economic and structural elements, as well as incarceration, missed appointments, lifestyle behaviours, travel, multiple sexual partners, ART regimen, age and clinical management. Poor ART adherence emerged as a key driver.
Human immunodeficiency virus viral rebound results from a combination of biological, social and treatment-related factors, with non-adherence to ART being a major contributor. The study highlights the need for improved adherence strategies to reduce VR.
This review enhances the understanding of HIV VR prevalence and its contributing factors, while also providing recommendations to mitigate these factors.
病毒反弹（VR），即人类免疫缺陷病毒（HIV）病毒载量在被抑制后重新出现可检测水平（>50拷贝/毫升），尽管南非可免费获得抗逆转录病毒疗法（ART），但对于接受ART治疗的个体而言，仍然是一个挑战。
本系统评价旨在确定接受ART治疗的个体中HIV病毒反弹的患病率及其影响因素。
这是一项系统评价研究，主要依赖二手数据，没有实际的研究场所。
本研究按照系统评价和Meta分析的首选报告项目（PRISMA）指南及Cochrane方法进行，该研究已在国际前瞻性系统评价注册库（PROSPERO）注册（ID：CRD42024524121）。数据来源于PubMed、EBSCOhost和Scopus，共检索到89684篇文章。在Rayyan软件中进行筛选后，有23篇文章符合纳入标准。使用乔安娜·布里格斯研究所（JBI）的评估工具评估偏倚风险。
病毒反弹在不同人群中有所不同。影响因素包括生物学、遗传学、人口统计学、社会经济和结构因素，以及监禁、错过预约、生活方式行为、旅行、多个性伴侣、ART方案、年龄和临床管理。ART依从性差是一个关键驱动因素。
人类免疫缺陷病毒病毒反弹是由生物学、社会和治疗相关因素共同导致的，其中不坚持ART治疗是主要因素。该研究强调需要改进依从性策略以减少病毒反弹。
本综述增进了对HIV病毒反弹患病率及其影响因素的理解，同时还提供了减轻这些因素的建议。
