{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T04:40:15Z","timestamp":1763959215902,"version":"3.45.0"},"reference-count":30,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T00:00:00Z","timestamp":1761523200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["ascpt.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clin Pharma and Therapeutics"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:p>HIV remains a major public health challenge, with Africa bearing over two\u2010thirds of the global burden. While three\u2010drug antiretroviral therapy (ART) is the standard of care, emerging evidence suggests that two\u2010drug regimens (2DRs) may offer comparable efficacy with reduced toxicity and cost. However, data on their use in African populations are limited. This systematic review assessed outcomes of 2DRs compared to other ART regimens among adults in Africa, following PRISMA guidelines. A comprehensive search of PubMed, Scopus, Web of Science, Embase, and African Journals Online was conducted for English\u2010language studies published from 2015 onwards. Eligible studies included adult HIV patients in Africa comparing 2DRs with other ART regimens, reporting outcomes such as viral suppression, drug resistance, adherence, safety, and toxicity. Five randomized, open\u2010label phase III trials were included, all conducted across multiple countries with African sites. Four (80%) were non\u2010inferiority trials involving virologically suppressed or ART\u2010na\u00efve adults. Regimens included dolutegravir\u2010based (40%) and long\u2010acting injectable cabotegravir+rilpivirine (CAB+RPV) (60%). Virological suppression (&lt;50 copies\/mL) was achieved in 80% of studies over 24\u2013144\u2009weeks, with stable or improved CD4+ counts in 60%. Injection\u2010site reactions occurred in 40% of trials; adverse effects with dolutegravir ranged from 6 to 20%, while CAB\u2009+\u2009RPV showed high adherence (97\u201398%) but injection\u2010site reactions (75\u201386%). Non\u2010inferiority was confirmed in 60% of studies, with strong patient preference for injectables reported in 40%. Limitations included short follow\u2010up, lack of blinding (80%), and potential selection bias (40%). Two\u2010drug ART regimens appear effective and well\u2010tolerated in African settings, warranting further high\u2010quality, long\u2010term studies.<\/jats:p>","DOI":"10.1002\/cpt.70106","type":"journal-article","created":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T13:07:37Z","timestamp":1761656857000},"page":"1422-1429","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["High Virologic Suppression and Favorable Profiles of Two\u2010Drug Antiretroviral Regimens in Africa: A Systematic Review of Current Evidence"],"prefix":"10.1002","volume":"118","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6305-0545","authenticated-orcid":false,"given":"Paul Achile","family":"Akpa","sequence":"first","affiliation":[{"name":"Department of Pharmaceutics University of Nigeria  Nsukka Enugu Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1349-6434","authenticated-orcid":false,"given":"AbdulMuminu","family":"Isah","sequence":"additional","affiliation":[{"name":"Person\u2010Centred HIV Research Team University of Nigeria  Nsukka Enugu Nigeria"},{"name":"Department of Clinical Pharmacy and Pharmacy Management University of Nigeria  Nsukka Enugu Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4003-1939","authenticated-orcid":false,"given":"Jennifer","family":"Cocohoba","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy University of California, San Francisco  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8041-5430","authenticated-orcid":false,"given":"Kathleen M.","family":"Giacomini","sequence":"additional","affiliation":[{"name":"Department of Bioengineering and Therapeutic Sciences University of California, San Francisco  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5897-5543","authenticated-orcid":false,"given":"Akinyemi","family":"Oni\u2010Orisan","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy University of California, San Francisco  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7195-2880","authenticated-orcid":false,"given":"Ezinwanne Jane","family":"Ugochukwu","sequence":"additional","affiliation":[{"name":"Person\u2010Centred HIV Research Team University of Nigeria  Nsukka Enugu Nigeria"},{"name":"Department of Clinical Pharmacy and Pharmacy Management University of Nigeria  Nsukka Enugu Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-0729-6972","authenticated-orcid":false,"given":"Amauche Pearl","family":"Ngige","sequence":"additional","affiliation":[{"name":"Person\u2010Centred HIV Research Team University of Nigeria  Nsukka Enugu Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3744-3038","authenticated-orcid":false,"given":"Chinonyelum","family":"Agbo","sequence":"additional","affiliation":[{"name":"Person\u2010Centred HIV Research Team University of Nigeria  Nsukka Enugu Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1346-9946","authenticated-orcid":false,"given":"Chukwuemeka Augustine","family":"Nwachuya","sequence":"additional","affiliation":[{"name":"Person\u2010Centred HIV Research Team University of Nigeria  Nsukka Enugu Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,10,27]]},"reference":[{"key":"e_1_2_10_1_1","unstructured":"WHO<https:\/\/www.who.int\/data\/gho\/data\/themes\/hiv\u2010aids> (2025). 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