Magnitude and predictors of HIV-Drug resistance in Africa: A protocol for systematic review and meta-analysis

Abstract

Introduction Human Immunodeficiency Virus (HIV) is continued to be a major public health problem in low-income countries and more importantly in Africa. For the last decade, access to Antiretroviral Therapy (ART) and its impact in improving quality of life and reducing HIV-related morbidity and mortality has significantly been improved in Africa. Nevertheless, the emergency of HIV drug resistance (HIVDR) has posed challenges in achieving optimal ART treatment outcomes and is alarmingly increasing globally in general and in Africa in particular. Comprehensive epidemiological data on the magnitude of HIVDR and HIVDR mutations, and predictors of HIVDR are, however, limited in Africa. Objective The main objective of this systematic review will be to estimate the pooled proportion of HIVDR and HIVDR mutations, and identify factors associated with HIVDR among people living with HIV/AIDS (PLWH) in Africa. Method Published Literature from 2000 until 30 October 2021 will be searched in PubMed/Medline Ovid, HINARI, SCOPUS, EMBASE, CINAHL, Web of Sciences, and Cochrane electronic databases. Initially, the literature will be screened based on title/abstract and followed by full-text appraisal for methodological quality using JBI critical appraisal tools. Data will be extracted from eligible articles after the full-text appraisal. Heterogeneity will be qualitatively assessed by a visual Funnel plot and quantitatively measured by an index of heterogeneity (I2 statistics). Random-effects model will be fitted to estimate the proportion of HIVDR and each HIVDR mutations. Sub-group and sensitivity analyses will be conducted to reduce heterogeneity. Meta-regression will be done by median year of sampling per study to observe the pattern of changes over time. Publication bias will be assessed by egger’s statistics. In case of publication bias, Trim and Fill analysis will be conducted to overcome small-study effect. Data analysis will be performed using Stata version 14. Ethics and dissemination As the data sources are published papers, the protocol will not require an ethical approval letter. The final report of the review will be published in a peer-reviewed journal.

HIV-1 diversity and pre-treatment drug resistance in the era of integrase inhibitor among newly diagnosed ART-naïve adult patients in Luanda, Angola

“…2 ) with INSTIs in ART regimens 25 . On the other hand, the PDR against NRTIs and PIs although low, was notable and corresponds with the findings observed in other regions of Africa 39 , observed in the PharmAccess African Studies to Evaluate Resistance Monitoring among ART-naive individuals which reported 2.5% for NRTIs, 3.3% for NNRTIs, 1.3% for PIs and 1.2% for dual-class resistance to NRTIs and NNRTIs 40 , which justifies continued surveillance of DRMs against NRTIs administered alongside DTG in Angola. For the NRTI drug class, we detected the M41L mutation associated with reduced susceptibility to zidovudine-AZT, abacavir-ABC, and tenofovir-TDF 35 .…”

Strengthening and enhancing national antiretroviral drug resistance surveillance in Zimbabwe—A country that has reached UNAIDS 95-95-95 amongst adults

“…The prevalence of HIVDR is a growing concern globally, particularly in regions with widespread access to antiretroviral therapy (ART). Africa has witnessed a significant increase in ART availability, accompanied by a rise in HIVDR cases (9)(10)(11). This is particularly concerning in newly infected individuals and those starting ART in sub-Saharan Africa, as it impacts the effectiveness of first-line treatment regimens and threatens the overall success of HIV control programs.…”

Determinants of virological failure among HIV clients on second-line antiretroviral treatment at Felege-hiwot and University of Gondar comprehensive specialized hospitals in the Amhara Region, Northwest Ethiopia: A case-control study

“…Even though HIV infection prevention, diagnosis, treatment and care has increased, the disease remains a major public health threat worldwide due to the emergence of drug-resistant HIV [ 1 , 2 ]. All current antiretroviral drugs (ARVD), including newer classes, are at risk of becoming partly or fully inactive [ 3 , 4 ]. This results an increase in mortality, morbidity, HIV incidence and health care costs [ 5 ].…”