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  11. The Prevalence Of Adverse Drug Reactions To Antiretroviral Therapy And Associated Factors Among Pediatric Patients Living With Hiv In Sub-saharan African Countries: A Systematic Review And Meta-analysis

The prevalence of adverse drug reactions to antiretroviral therapy and associated factors among pediatric patients living with HIV in sub-Saharan African countries: a systematic review and meta-analysis

Bukola R Omotoso1, Anthony A Olashore2, Joseph B Sempa3

  • 1Department of Internal Medicine, Faculty of Health Sciences, University of the Free State, Bloemfontein, 9300, South Africa. Omotoso.br@ufs.ac.za.

BMC Infectious Diseases
|December 30, 2025

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View abstract on PubMed

Summary
This summary is machine-generated.

Adverse drug reactions (ADRs) affect 26% of children with HIV on antiretroviral therapy (ART) in sub-Saharan Africa. Identifying ADRs and risk factors is crucial for improving treatment adherence and retention in care for pediatric HIV patients.

Area of Science:

  • Pediatric infectious diseases
  • Pharmacovigilance
  • Public health in sub-Saharan Africa

Background:

  • Sub-Saharan Africa (SSA) bears a significant burden of pediatric HIV.
  • Treatment failure in children with HIV is high due to factors including delayed diagnosis, low adherence, and adverse drug reactions (ADRs).
  • Understanding ADRs is critical for improving treatment outcomes in this population.

Purpose of the Study:

  • To estimate the pooled prevalence of ADRs in HIV-positive pediatric patients on antiretroviral therapy (ART) in SSA.
  • To identify the types of ADRs experienced by these children.
  • To examine factors associated with the occurrence of ADRs.

Main Methods:

  • Systematic literature search across major databases (PubMed, Scopus, CINAHL, Web of Science, EBSCOHost).
Keywords:
Adverse drug reactionsAntiretroviral drugsAntiretroviral therapyPediatric

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  • Data extraction using a standardized form.
  • Meta-analysis conducted using R statistics (version 4.3.2).

    • Main Results:

    • Nine studies were included in the review.
    • The pooled prevalence of ADRs among children on ART was 26% (95% CI 0.15, 0.36), with significant heterogeneity.
    • Common ADRs included gastrointestinal, dermatological, and central nervous system effects. Associated factors included treatment duration, ART combination, sex, age, malnutrition, and compliance.
    • Pooled prevalence of mortality was also significant with high heterogeneity.

    Conclusions:

    • ADRs are prevalent in HIV-positive children on ART in SSA, impacting treatment adherence and patient retention.
    • Findings can inform policies for integrating ADR reporting and pharmacovigilance into pediatric ART services.
    • Strengthening pharmacovigilance is essential for achieving UNAIDS 95-95-95 targets in pediatric HIV care.
    Sub-Saharan Africa