paper · doi:10.20372/nadre:17312
Abstract<br> Background Despite remarkable progress, HIV’s influence on global health remains firm, demanding continued<br> attention. Understanding the effectiveness of third-line antiretroviral therapy in individuals who do not respond to<br> second-line drugs is crucial for improving treatment strategies. The virological outcomes of third-line antiretroviral<br> therapy vary from study to study, highlighting the need for robust global estimates.<br> Methods A comprehensive search of databases including PubMed, MEDLINE, International Scientific Indexing, Web<br> of Science, and Google Scholar, was conducted. STATA version 17 statistical software was used for analysis. A randomeffects model was applied to compute the pooled estimates. Subgroup analysis, heterogeneity, publication bias, and<br> sensitivity analysis were also performed. The prediction interval is computed to estimate the interval in which a future<br> study will fall. The GRADE tool was also used to determine the quality of the evidence.<br> Results In this systematic review and meta-analysis, 15 studies involving 1768 HIV patients receiving third-line<br> antiretroviral therapy were included. The pooled viral suppression of third-line antiretroviral therapy was 76.6% (95%<br> CI: 71.5- 81.7%). The viral suppression rates at 6 and 12 months were 75.5% and 78.6%, respectively. Furthermore,<br> third-line therapy effectively suppressed viral RNA copy numbers to ≤ 50 copies/mL, ≤ 200 copies/mL, and ≤ 400<br> copies/mL with rates of 70.7%, 85.4%, and 85.7%, respectively.<br> Conclusion More than three-fourths of patients on third-line antiretroviral therapy achieve viral suppression.<br> Consequently, improving access to and timely initiation of third-line therapy may positively impact the quality of life<br> for those with second-line treatment failure.<br> Key Summary Points<br> • Understanding the effectiveness of third-line antiretroviral therapy in individuals who do not respond to secondline drugs is crucial for improving treatment strategies.<br> • Currently, second-line treatment failure has been increasing, making progression to third-line therapy seemingly<br> mandatory in many settings, making it apparent that recent evidence is crucial.<br> • Viral suppression rate of third-line ART was 76.6% (95% CI: 71.5- 81.7%)<br>