Incidence and Predictors of Opportunistic Infection Among People Living With HIV in Ethiopia: A Systematic Review and Meta-Analysis.

Abstract

<h4>Background</h4>Opportunistic infections (OIs) play a crucial role in the morbidity and mortality of HIV-infected individuals. Despite the increasing use of antiretroviral therapy, there remains a lack of comprehensive data on the incidence of OIs to provide a clearer national picture. Therefore, this systematic review and meta-analysis aim to determine the pooled incidence and identify the predictors of OIs among people living with HIV in Ethiopia.<h4>Method</h4>A systematic search was conducted across multiple electronic databases to identify relevant studies. The degree of heterogeneity across studies was assessed using the <i>I</i> ² statistic. Subgroup analyses were conducted to explore sources of heterogeneity. A funnel plot and Egger's test were used to assess publication bias. Adjusted hazard ratio with 95% CI was used to assess the relationship between predictors and OIs occurrence.<h4>Result</h4>In total, 24 studies met the inclusion criteria and were analyzed. The pooled incidence rate of OIs among people living with HIV in Ethiopia was found to be 6.96 per 100 person-years (95% CI: 5.14-8.78) based on a random-effects model. The meta-analysis identified predictors of OIs among people living with HIV, including poor adherence (pooled AHR 1.42, 95% CI: 1.12, 1.80), CD4 count < 200 cells/mm³ (AHR 1.49, 95% CI: 1.25, 1.78), being bedridden (AHR 1.45, 95% CI: 1.10, 1.90), and advanced WHO clinical stage (AHR 1.57, 95% CI: 1.24, 1.98).<h4>Conclusion</h4>The burden of OIs continues to be a major health concern among people living with HIV/AIDS. Low CD4 count, poor adherence to ART, being bedridden, and advanced clinical stage were significantly associated with the occurrence of OIs.