International Journal of STD & AIDS > Volume 19, Number 5 > Pp. 291-296

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Hammond, R. Articles by Harry, T. C Search for Related Content PubMed PubMed Citation Social Bookmarking                      What's this?

Reviews

Efficacy of antiretroviral therapy in Africa: effect on immunological and virological outcome measures – a meta-analysis^a

Rebecca Hammond MBBS ^* and Tubonye C Harry MRCOG  

^* Norfolk & Norwich University Hospital NHS Trust, Norwich NR4 7UY; Bure Clinic, James Paget University Hospital NHS Trust, Great Yarmouth, Norfolk NR31 6LA, UK

Correspondence to: Dr Tubonye C Harry Email: tcharry{at}bureclinic.com

This study is a systematic literature review exploring the efficacy of antiretroviral therapy (ART) in Africa through a meta-analysis 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.

Key Words: meta-analysis • antiretroviral drugs • sub-Saharan Africa • viral load • CD4 count

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?