{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T05:42:54Z","timestamp":1788327774441,"version":"build-2803163510"},"reference-count":46,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T00:00:00Z","timestamp":1769817600000},"content-version":"vor","delay-in-days":30,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["AIDS Research and Treatment"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Opportunistic infections (OIs) play a crucial role in the morbidity and mortality of HIV\u2010infected 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\u2010analysis aim to determine the pooled incidence and identify the predictors of OIs among people living with HIV in Ethiopia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>\n                      A systematic search was conducted across multiple electronic databases to identify relevant studies. The degree of heterogeneity across studies was assessed using the\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      statistic. Subgroup analyses were conducted to explore sources of heterogeneity. A funnel plot and Egger\u2019s test were used to assess publication bias. Adjusted hazard ratio with 95% CI was used to assess the relationship between predictors and OIs occurrence.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Result<\/jats:title>\n                    <jats:p>\n                      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\u2010years (95% CI: 5.14\u20138.78) based on a random\u2010effects model. The meta\u2010analysis identified predictors of OIs among people living with HIV, including poor adherence (pooled AHR 1.42, 95% CI: 1.12, 1.80), CD4 count &lt;\u2009200\u2009cells\/mm\n                      <jats:sup>3<\/jats:sup>\n                      (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).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/arat\/7249878","type":"journal-article","created":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T14:23:34Z","timestamp":1769869414000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Incidence and Predictors of Opportunistic Infection Among People Living With HIV in Ethiopia: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-5342-2450","authenticated-orcid":false,"given":"Beyene Zewdu","family":"Nigatu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amhasilasie Ewunetu","family":"Ageze","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,31]]},"reference":[{"key":"e_1_2_14_1_2","unstructured":"Joint United Nations Programme on HIV\/AIDS (UNAIDS) Fact Sheet 2024-Latest Global and Regional HIV Statistics on the Status of the AIDS Epidemic 2024 https:\/\/www.unaids.org\/en."},{"key":"e_1_2_14_2_2","doi-asserted-by":"crossref","unstructured":"WuduM. A. BeleteM. A. YosefS. T. andGelmoA. T. Incidence and Predictors of Common Opportunistic Infections Among Children Less Than 15 Years of Age on Antiretroviral Therapy in Ethiopia: A Systematic Review and Meta-Analysis 2025.","DOI":"10.1186\/s12879-025-10945-z"},{"key":"e_1_2_14_3_2","article-title":"Global Health Sector Strategy on HIV 2016\u20132021","author":"World Health Organization","year":"2016","journal-title":"Towards Ending AIDS"},{"key":"e_1_2_14_4_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0315599"},{"key":"e_1_2_14_5_2","first-page":"1","article-title":"Incidence and Predictors of Tuberculosis Among Adult Diabetic Patients, Debre Markos Referral Hospital, Northwest Ethiopia, 2018: A Retrospective Cohort Study","volume":"20","author":"Melkamu M. W.","year":"2020","journal-title":"BMC Infectious Diseases"},{"key":"e_1_2_14_6_2","doi-asserted-by":"publisher","DOI":"10.1080\/25787489.2023.2187013"},{"key":"e_1_2_14_7_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0229757"},{"key":"e_1_2_14_8_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2022.1064859"},{"key":"e_1_2_14_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw125"},{"key":"e_1_2_14_10_2","volume-title":"Guidelines for Managing Advanced HIV Disease and Rapid Initiation of Antiretroviral Therapy","author":"WHO","year":"2017"},{"key":"e_1_2_14_11_2","doi-asserted-by":"publisher","DOI":"10.5334\/aogh.4149"},{"key":"e_1_2_14_12_2","volume-title":"Consolidated Guidelines on HIV Prevention, Testing, Treatment, Service Delivery and Monitoring: Recommendations for a Public Health Approach","author":"WHO","year":"2021"},{"key":"e_1_2_14_13_2","volume-title":"Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents With HIV: Cryptococcosis","author":"HIV Gov","year":"2021"},{"key":"e_1_2_14_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(08)60345-1"},{"key":"e_1_2_14_15_2","doi-asserted-by":"publisher","DOI":"10.4314\/ejhs.v27i1.6s"},{"key":"e_1_2_14_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/md.0000000000029905"},{"key":"e_1_2_14_17_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0232426"},{"key":"e_1_2_14_18_2","volume-title":"HIV Prevention and Control Program: Annual Performance Report","author":"Ministry of Health","year":"2024"},{"key":"e_1_2_14_19_2","unstructured":"FMOH Ethiopia National Consolidated Guidelines for Comprehensive HIV Prevention Care and Treatment 2018 1\u2013238."},{"key":"e_1_2_14_20_2","unstructured":"Sch\u00fcnemannH.andOxmanJ. B. G. G. A. Introduction to GRADE Handbook 2013."},{"key":"e_1_2_14_21_2","doi-asserted-by":"publisher","DOI":"10.2147\/HIV.S346182"},{"key":"e_1_2_14_22_2","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2023.1107321"},{"key":"e_1_2_14_23_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12887-024-05117-y"},{"key":"e_1_2_14_24_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-72404-0"},{"key":"e_1_2_14_25_2","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/307810"},{"key":"e_1_2_14_26_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0152941"},{"key":"e_1_2_14_27_2","doi-asserted-by":"publisher","DOI":"10.5588\/ijtld.16.0105"},{"key":"e_1_2_14_28_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13104-018-3846-z"},{"key":"e_1_2_14_29_2","doi-asserted-by":"crossref","unstructured":"BeshirM. T. BeyeneA. H. TlayeK. G. andDemelewT. M. Incidence and Predictors of Tuberculosis Among HIV-Positive children at Adama Referral Hospital and Medical College Oromia Ethiopia: A retrospective follow-Up study 2019.","DOI":"10.4178\/epih.e2019028"},{"key":"e_1_2_14_30_2","doi-asserted-by":"publisher","DOI":"10.17485\/IJST\/v15i34.1073"},{"key":"e_1_2_14_31_2","doi-asserted-by":"crossref","unstructured":"KebedeF. TarekegnH. MollaM. JaraD. andAbateA. Incidence and Predictors of Pulmonary Tuberculosis Among Children Who Received Antiretroviral Therapy (ART) Northwest Ethiopia: A Multicenter Historical Cohorts Study 2009\u20132019 2022.","DOI":"10.1155\/2022\/9925693"},{"key":"e_1_2_14_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amsu.2022.104910"},{"key":"e_1_2_14_33_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13052-024-01695-w"},{"key":"e_1_2_14_34_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0291502"},{"key":"e_1_2_14_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.heliyon.2021.e06745"},{"key":"e_1_2_14_36_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0298021"},{"key":"e_1_2_14_37_2","doi-asserted-by":"publisher","DOI":"10.11591\/ijphs.v6i3.9294"},{"key":"e_1_2_14_38_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-016961"},{"key":"e_1_2_14_39_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-019-7912-9"},{"key":"e_1_2_14_40_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-020-04959-y"},{"key":"e_1_2_14_41_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12887-022-03168-7"},{"key":"e_1_2_14_42_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0170893"},{"key":"e_1_2_14_43_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2008.03.029"},{"key":"e_1_2_14_44_2","unstructured":"Panel on Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents With HIV\u2014A Working Group of the NIH Office of AIDS Research Advisory Council (OARAC) How to Cite the Adult and Adolescent Opportunistic Infection Gu 2025 https:\/\/clinicalinfo.hiv.gov\/en\/guidelines\/adult-and-adolescent-opportunistic-infection\/cryptococcosis."},{"key":"e_1_2_14_45_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-13-292"},{"key":"e_1_2_14_46_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.aids.0000194808.20035.c1"}],"container-title":["AIDS Research and Treatment"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/arat\/7249878","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/arat\/7249878","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/arat\/7249878","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T09:27:46Z","timestamp":1785058066000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/arat\/7249878"}},"subtitle":[],"editor":[{"given":"Malik","family":"Suliman Mohamed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":46,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1155\/arat\/7249878"],"URL":"https:\/\/doi.org\/10.1155\/arat\/7249878","archive":["Portico"],"relation":{},"ISSN":["2090-1240","2090-1259"],"issn-type":[{"value":"2090-1240","type":"print"},{"value":"2090-1259","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2025-06-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-31","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"7249878"}}