Current ART, determinants for virologic failure and implications for HIV drug resistance: an umbrella review
Abstract Objective The purpose of this study is to investigate the incidence of determinants for virologic failure and to identify predisposing factors to enhance treatment efficacy. Tackling this global public health issue is the key to reducing the rate of virological failure and increasing the su...
| Main Authors: | , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-10-01
|
| Series: | AIDS Research and Therapy |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12981-023-00572-6 |
| _version_ | 1797647198120312832 |
|---|---|
| author | SeyedAhmad SeyedAlinaghi Amir Masoud Afsahi Ali Moradi Zohal Parmoon Pedram Habibi Pegah Mirzapour Mohsen Dashti Afsaneh Ghasemzadeh Elaheh Karimi Foziye Sanaati Zahra Hamedi Ayoob Molla Esmaeil Mehraeen Omid Dadras |
| author_facet | SeyedAhmad SeyedAlinaghi Amir Masoud Afsahi Ali Moradi Zohal Parmoon Pedram Habibi Pegah Mirzapour Mohsen Dashti Afsaneh Ghasemzadeh Elaheh Karimi Foziye Sanaati Zahra Hamedi Ayoob Molla Esmaeil Mehraeen Omid Dadras |
| author_sort | SeyedAhmad SeyedAlinaghi |
| collection | DOAJ |
| description | Abstract Objective The purpose of this study is to investigate the incidence of determinants for virologic failure and to identify predisposing factors to enhance treatment efficacy. Tackling this global public health issue is the key to reducing the rate of virological failure and increasing the success of treatment for those living with HIV. Methods This umbrella review delves into various aspects of current anti-retroviral therapy (ART) which is the primary treatment for human immunodeficiency virus (HIV) infection. Comprehensive searches were conducted in online databases including PubMed, Embase, Scopus, and Web of Science, up to May 26, 2023. Following the screening and selection of relevant articles, eligible articles were included in the data extraction. This study adhered to the PRISMA guideline to report the results and employed the NIH quality and bias risk assessment tool to ensure the quality of included studies. Results In total, 40 review studies published from 2015 to 2023 were included. The bulk of these studies concurred on several major factors contributing to HIV drug resistance and virological failure. Key among these were medication adherence, baseline and therapeutic CD4 levels, the presence of co-infections, and the advanced clinical stage of the infection. Conclusion The resistance to HIV drugs and instances of determinants for virologic failure have a profound impact on the life quality of those infected with HIV. Primary contributors to this scenario include insufficient adherence to treatment, decreased CD4 T-cell count, elevated viral levels, and certain treatment regimens. Implementing appropriate interventions could address these issues. Sub-Saharan Africa exhibits elevated rates of determinants for virologic failure, attributed to the delay in HIV testing and diagnosis, and late initiation of antiretroviral therapy (ART). It is essential to undertake further research aimed at enhancing the detection of resistance in HIV patients and mitigating viral failure by addressing these underlying causes. |
| first_indexed | 2024-03-11T15:12:49Z |
| format | Article |
| id | doaj.art-79b3e297fc5046cface4b54d84076293 |
| institution | Directory Open Access Journal |
| issn | 1742-6405 |
| language | English |
| last_indexed | 2024-03-11T15:12:49Z |
| publishDate | 2023-10-01 |
| publisher | BMC |
| record_format | Article |
| series | AIDS Research and Therapy |
| spelling | doaj.art-79b3e297fc5046cface4b54d840762932023-10-29T12:37:04ZengBMCAIDS Research and Therapy1742-64052023-10-0120112210.1186/s12981-023-00572-6Current ART, determinants for virologic failure and implications for HIV drug resistance: an umbrella reviewSeyedAhmad SeyedAlinaghi0Amir Masoud Afsahi1Ali Moradi2Zohal Parmoon3Pedram Habibi4Pegah Mirzapour5Mohsen Dashti6Afsaneh Ghasemzadeh7Elaheh Karimi8Foziye Sanaati9Zahra Hamedi10Ayoob Molla11Esmaeil Mehraeen12Omid Dadras13Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical SciencesDepartment of Radiology, School of Medicine, University of California, San Diego (UCSD)School of Medicine, Tehran University of Medical SciencesIranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical SciencesIranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical SciencesIranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical SciencesDepartment of Radiology, Tabriz University of Medical SciencesDepartment of Radiology, Tabriz University of Medical SciencesSchool of Medicine, Tehran University of Medical SciencesSchool of Nursing and Allied Medical Sciences, Maragheh University of Medical SciencesShahid Beheshti University of Medical SciencesSchool of Medicine, Bushehr University of Medical SciencesDepartment of Health Information Technology, Khalkhal University of Medical SciencesBergen Addiction Research, Department of Addiction Medicine, Haukland University HospitalAbstract Objective The purpose of this study is to investigate the incidence of determinants for virologic failure and to identify predisposing factors to enhance treatment efficacy. Tackling this global public health issue is the key to reducing the rate of virological failure and increasing the success of treatment for those living with HIV. Methods This umbrella review delves into various aspects of current anti-retroviral therapy (ART) which is the primary treatment for human immunodeficiency virus (HIV) infection. Comprehensive searches were conducted in online databases including PubMed, Embase, Scopus, and Web of Science, up to May 26, 2023. Following the screening and selection of relevant articles, eligible articles were included in the data extraction. This study adhered to the PRISMA guideline to report the results and employed the NIH quality and bias risk assessment tool to ensure the quality of included studies. Results In total, 40 review studies published from 2015 to 2023 were included. The bulk of these studies concurred on several major factors contributing to HIV drug resistance and virological failure. Key among these were medication adherence, baseline and therapeutic CD4 levels, the presence of co-infections, and the advanced clinical stage of the infection. Conclusion The resistance to HIV drugs and instances of determinants for virologic failure have a profound impact on the life quality of those infected with HIV. Primary contributors to this scenario include insufficient adherence to treatment, decreased CD4 T-cell count, elevated viral levels, and certain treatment regimens. Implementing appropriate interventions could address these issues. Sub-Saharan Africa exhibits elevated rates of determinants for virologic failure, attributed to the delay in HIV testing and diagnosis, and late initiation of antiretroviral therapy (ART). It is essential to undertake further research aimed at enhancing the detection of resistance in HIV patients and mitigating viral failure by addressing these underlying causes.https://doi.org/10.1186/s12981-023-00572-6Antiretroviral therapyARTVirologic failureHIVAIDS |
| spellingShingle | SeyedAhmad SeyedAlinaghi Amir Masoud Afsahi Ali Moradi Zohal Parmoon Pedram Habibi Pegah Mirzapour Mohsen Dashti Afsaneh Ghasemzadeh Elaheh Karimi Foziye Sanaati Zahra Hamedi Ayoob Molla Esmaeil Mehraeen Omid Dadras Current ART, determinants for virologic failure and implications for HIV drug resistance: an umbrella review AIDS Research and Therapy Antiretroviral therapy ART Virologic failure HIV AIDS |
| title | Current ART, determinants for virologic failure and implications for HIV drug resistance: an umbrella review |
| title_full | Current ART, determinants for virologic failure and implications for HIV drug resistance: an umbrella review |
| title_fullStr | Current ART, determinants for virologic failure and implications for HIV drug resistance: an umbrella review |
| title_full_unstemmed | Current ART, determinants for virologic failure and implications for HIV drug resistance: an umbrella review |
| title_short | Current ART, determinants for virologic failure and implications for HIV drug resistance: an umbrella review |
| title_sort | current art determinants for virologic failure and implications for hiv drug resistance an umbrella review |
| topic | Antiretroviral therapy ART Virologic failure HIV AIDS |
| url | https://doi.org/10.1186/s12981-023-00572-6 |
| work_keys_str_mv | AT seyedahmadseyedalinaghi currentartdeterminantsforvirologicfailureandimplicationsforhivdrugresistanceanumbrellareview AT amirmasoudafsahi currentartdeterminantsforvirologicfailureandimplicationsforhivdrugresistanceanumbrellareview AT alimoradi currentartdeterminantsforvirologicfailureandimplicationsforhivdrugresistanceanumbrellareview AT zohalparmoon currentartdeterminantsforvirologicfailureandimplicationsforhivdrugresistanceanumbrellareview AT pedramhabibi currentartdeterminantsforvirologicfailureandimplicationsforhivdrugresistanceanumbrellareview AT pegahmirzapour currentartdeterminantsforvirologicfailureandimplicationsforhivdrugresistanceanumbrellareview AT mohsendashti currentartdeterminantsforvirologicfailureandimplicationsforhivdrugresistanceanumbrellareview AT afsanehghasemzadeh currentartdeterminantsforvirologicfailureandimplicationsforhivdrugresistanceanumbrellareview AT elahehkarimi currentartdeterminantsforvirologicfailureandimplicationsforhivdrugresistanceanumbrellareview AT foziyesanaati currentartdeterminantsforvirologicfailureandimplicationsforhivdrugresistanceanumbrellareview AT zahrahamedi currentartdeterminantsforvirologicfailureandimplicationsforhivdrugresistanceanumbrellareview AT ayoobmolla currentartdeterminantsforvirologicfailureandimplicationsforhivdrugresistanceanumbrellareview AT esmaeilmehraeen currentartdeterminantsforvirologicfailureandimplicationsforhivdrugresistanceanumbrellareview AT omiddadras currentartdeterminantsforvirologicfailureandimplicationsforhivdrugresistanceanumbrellareview |