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- Title
Efficacy of antiretroviral therapy in Africa: effect on immunological and virological outcome measures -a meta-analysis.
- Authors
Hammond, Rebecca; Harry, Tubonye C.
- Abstract
This study is a systematic literature review exploring the efficacy of antiretroviral therapy (ART) in Africa through a metaanalysis of immunological and virological outcome measures at baseline and six subsequent time points. A literature search was conducted through two databases and references of relevant papers searched. The inclusion criteria were papers with data from the African continent with predominantly an adult population, who were ART naïve and human immunodefieciency virus-1-positive, data on the CD4 count and/or percentage undetectable viral load (UDVL) at a subsequent time-point following ART initiation. The search identified 368 papers. Of these 320 were excluded by title and abstract, 48 papers were accessed with a further 19 papers then excluded. Twenty-nine papers from 12 countries were included in the meta-analysis. All papers showed evidences of Grade III or IV. The mean CD4 count (cells/mm3) at baseline was 141.0 and viral load was 5.2 log10. The mean CD4 count was 243.8, 248.9, 277.1, 274.1, 298.4, 374 at 3, 6, 12, 18, 24 and .24 months, respectively. The mean percentage with UDVL was 73.3, 74.7, 66.9, 68.1, 64.6, 73.5 at 3, 6, 12, 18, 24 and .24 months, respectively. In conclusion, the meta-analysis provides evidence that ART increases the CD4 count from three months until three years, and the majority of subjects had an UDVL (,400 copies/mL) at each analysed time-point. Though the grade of evidence is low, this analysis suggests that ART can be provided successfully within the continent of Africa even with the limitations of a resource-poor setting.
- Subjects
AFRICA; HIGHLY active antiretroviral therapy; META-analysis; HEALTH outcome assessment; VIRAL load; MEDICAL quality control; CD4 antigen; IMMUNE system
- Publication
International Journal of STD & AIDS, 2008, Vol 19, Issue 5, p291
- ISSN
0956-4624
- Publication type
Article
- DOI
10.1258/ijsa.2007.007248