Abstract / Summary
Abstract Introduction: Traditionally, antiretroviral treatment monitoring was measured by different laboratory indexes, which was not reliable. Currently, the treatment progress of children on antiretroviral therapy is commonly evaluated by monitoring the viral load. Methods: The 2020 PRISMA guideline was used as the study selection tool. Databases like EBSCOhost, ScienceDirect, EMBASE, Web of Science, Scopus, and PubMed were searched. EndNote 8 was used for citation and to remove duplicated studies. The 95% confidence interval and relative risk of identified factors were retrieved. To conduct meta-analysis, the random effects model and R statistics version 4.4.3 software were used. Result: The total of 5253 children on antiretroviral therapy were selected from 16 studies. The pooled virological failure was 19% [95% CI: 15, 23]. Subgroup analysis was performed at I² = 93.1% and p = 0.0001. Factors frequently associated with virological failure were poor ART adherence, poor nutritional status, advanced clinical stage at initiation, and regimen change, with the risk ratios [95% CI: 4.74 (1.59, 14.13)] and [95% CI 4.59 (2.08; 10.14]), respectively. Conclusion: Associated factors with virological failure identified by this meta-analysis: poor adherence, undernutrition, advanced clinical stage at initiation, and intolerance to regimen change significantly affected antiretroviral treatments among infected pediatrics.