{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T04:05:52Z","timestamp":1784261152562,"version":"3.55.0"},"reference-count":59,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/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":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Int Assoc Provid AIDS Care"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Despite global advances in HIV care, pediatric populations in Africa continue to experience suboptimal treatment outcomes. Dolutegravir (DTG)-based antiretroviral therapy (ART) offers improved efficacy and tolerability, however, its real-world impact on viral load suppression (VLS) and the uptake of DTG-based regimens from older ART to newly recommended DTG-based ART among children and adolescents in Africa has not been systematically quantified.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This systematic review and meta-analysis aimed to estimate the pooled viral load suppression after initiation of dolutegravir-based ART and the uptake of DTG-based regimens from older regimens to dolutegravir-based ART among children and adolescents living with HIV in Africa.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A systematic review and meta-analysis conducted in accordance with PRISMA 2020 guidelines. Comprehensive searches of PubMed, Google Scholar, ScienceDirect, Hinari, CORE, and DOAJ were performed from January 01-10, 2026. Studies reporting VLS after initiation of DTG-based ART and the uptake of DTG-based regimens among pediatric patients with HIV in Africa were included. Pooled estimates were computed using random-effect models. Heterogeneity was assessed using I\n                      <jats:sup>2<\/jats:sup>\n                      statistics, and subgroup, sensitivity, and publication bias analyses were performed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      out of 7,789 records screened, twenty-four studies comprising 119,292 participants were included. The overall pooled viral load suppression at six months after initiation of DTG-based ART was 82% (95% CI: 79-85%) and 70 (95% CI: 62-77%) among participants who were unsuppressed at baseline. The pooled uptake of DTG-based regimens was 77% (95% CI: 68-86%) based on 23 studies. Substantial heterogeneity was observed across outcomes (I\n                      <jats:sup>2<\/jats:sup>\n                      \u226598%). Subgroup analysis indicated regional and study-design variation in the uptake of DTG-based regimens but not in viral suppression. No substantial publication bias was detected among the included studies.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>DTG-based ART effectively suppressed viral load among pediatric patients in Africa, though adoption remains incomplete and below UNAIDS 95-95-95 targets. Significant heterogeneity highlights the influence of contextual and health system factors. Accelerated rollout, strengthened adherence support, and harmonized monitoring are needed to optimize pediatric HIV outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23259582261467826","type":"journal-article","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T09:44:36Z","timestamp":1784022276000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Dolutegravir-Based Antiretroviral Therapy on Viral Load Suppression and Uptake of DTG-Based Regimen Among Pediatric HIV Patients in Africa: A Systematic Review and Meta-Analysis"],"prefix":"10.1177","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-8087-9845","authenticated-orcid":false,"given":"Desalegn Mitiku","family":"Kidie","sequence":"first","affiliation":[{"name":"Debark University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abraham Dessie","family":"Gessesse","sequence":"additional","affiliation":[{"name":"Woldia University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenberu Mekurianew","family":"Kelkay","sequence":"additional","affiliation":[{"name":"Debark University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-0840-8707","authenticated-orcid":false,"given":"Tsegaamlak Kumelachew","family":"Derse","sequence":"additional","affiliation":[{"name":"Debark University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5438-8237","authenticated-orcid":false,"given":"Addisu Simachew","family":"Asgai","sequence":"additional","affiliation":[{"name":"Debark University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,14]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.12775\/JEHS.2020.10.08.022"},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0154893"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-024-20013-x"},{"key":"e_1_3_6_5_2","unstructured":"UNAIDS) JUNPoHA. Thematic Segment Background Note: Addressing inequalities in the HIV response at. 2024. https:\/\/www.unaids.org\/sites\/default\/files\/media_asset\/PCB55_Thematic_Segment_Background_Note.pdf"},{"key":"e_1_3_6_6_2","volume-title":"Mozambique","author":"Unaids A","unstructured":"Unaids A. Mozambique, People Living with HIV Available. https:\/\/aidsinfo.unaids.org\/?did=5581277ae9beccab3bd5a44e&r=world&t=null&tb=c&bt=undefined&ts=0, 0&cl= MOZ&cr= n&ct= 2010&cav= Population: All&aid= 5772878c9888f63937b6b1e5. Accessed; 2021."},{"key":"e_1_3_6_7_2","unstructured":"UNICEF. Adolescent HIV Prevention. Available at. https:\/\/data.unicef.org\/topic\/hivaids\/adolescents-young-people\/#:\u223c:text=HIVinadolescents ofnewadultHIVinfections. Accessed June 16 2021. 2021."},{"key":"e_1_3_6_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000001747"},{"key":"e_1_3_6_9_2","doi-asserted-by":"publisher","DOI":"10.1080\/09540121.2016.1176684"},{"key":"e_1_3_6_10_2","first-page":"S213","volume-title":"Global, regional and country-level 90\u201390\u201390 estimates for 2018: assessing progress towards the 2020 target","author":"Marsh K","year":"2019","unstructured":"Marsh K, Eaton JW, Mahy M, et al. Global, regional and country-level 90\u201390\u201390 estimates for 2018: assessing progress towards the 2020 target. LWW; 2019:S213\u2013S226."},{"key":"e_1_3_6_11_2","volume-title":"HIV treatment coverage among children and adolescents","author":"UNICEF. UNICEF","year":"2024","unstructured":"UNICEF. UNICEF. HIV treatment coverage among children and adolescents. UNICEF Data; 2024. Available from. https:\/\/data.unicef.org\/topic\/hivaids\/.2024"},{"key":"e_1_3_6_12_2","volume-title":"Report on UNICEF follow-up to the recommendations and decisions of the fifty-first and fifty-second meetings of the Joint United Nations Programme on HIV\/AIDS Programme Coordinating Board","author":"UNICEF","year":"2024","unstructured":"UNICEF. Report on UNICEF follow-up to the recommendations and decisions of the fifty-first and fifty-second meetings of the Joint United Nations Programme on HIV\/AIDS Programme Coordinating Board. UNICEF; 2024."},{"key":"e_1_3_6_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(21)00265-4"},{"key":"e_1_3_6_14_2","unstructured":"UNICEF). UNCsF. Global Snapshot on HIV and AIDS. 2024. Available at. https:\/\/www.childrenandaids.org\/documents\/global-snapshot-hiv-and-aids-2024.2024"},{"key":"e_1_3_6_15_2","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000000239"},{"key":"e_1_3_6_16_2","volume-title":"Update of recommendations on first-and second-line antiretroviral regimens","author":"Who W","year":"2019","unstructured":"Who W. Update of recommendations on first-and second-line antiretroviral regimens. Geneva World Health Organization; 2019."},{"key":"e_1_3_6_17_2","volume-title":"Consolidated guidelines on HIV prevention, testing, treatment, service delivery and monitoring: recommendations for a public health approach","author":"Organization WH","year":"2021","unstructured":"Organization WH. Consolidated guidelines on HIV prevention, testing, treatment, service delivery and monitoring: recommendations for a public health approach. World Health Organization; 2021."},{"key":"e_1_3_6_18_2","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000002951"},{"key":"e_1_3_6_19_2","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000001845"},{"key":"e_1_3_6_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(18)30710-2"},{"key":"e_1_3_6_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2020.100573"},{"key":"e_1_3_6_22_2","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000003835"},{"key":"e_1_3_6_23_2","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0000000000003878"},{"key":"e_1_3_6_24_2","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0000000000004037"},{"key":"e_1_3_6_25_2","unstructured":"Bacha J Dlamini S Anabwani F Gwimile J Kanywa J Elyanu P et al. editors. The fast and the continuous: dolutegravir-based antiretroviral therapy achieves impressive viral load suppression in CALHIV in the short-and long-term. JOURNAL OF THE INTERNATIONAL AIDS SOCIETY; 2022: JOHN WILEY & SONS LTD THE ATRIUM SOUTHERN GATE CHICHESTER PO19 8SQ W."},{"key":"e_1_3_6_26_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0164619"},{"key":"e_1_3_6_27_2","doi-asserted-by":"publisher","DOI":"10.4102\/SAJHIVMED.v25i1.1578"},{"key":"e_1_3_6_28_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-025-11647-2"},{"key":"e_1_3_6_29_2","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"Page MJ","year":"2021","unstructured":"Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. bmj. 2021;372.","journal-title":"bmj"},{"key":"e_1_3_6_30_2","volume-title":"Update on the transition to dolutegravir-based antiretroviral therapy: report of a WHO meeting, 29\u201330 March 2022","author":"Organization WH","year":"2022","unstructured":"Organization WH. Update on the transition to dolutegravir-based antiretroviral therapy: report of a WHO meeting, 29\u201330 March 2022. World Health Organization; 2022."},{"key":"e_1_3_6_31_2","volume-title":"The role of HIV viral suppression in improving individual health and reducing transmission: policy brief","author":"Organization WH","year":"2023","unstructured":"Organization WH. The role of HIV viral suppression in improving individual health and reducing transmission: policy brief. World Health Organization; 2023."},{"key":"e_1_3_6_32_2","doi-asserted-by":"publisher","DOI":"10.15171\/ijhpm.2014.71"},{"key":"e_1_3_6_33_2","doi-asserted-by":"publisher","DOI":"10.11124\/JBIES-22-00125"},{"key":"e_1_3_6_34_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.g5630"},{"key":"e_1_3_6_35_2","doi-asserted-by":"publisher","DOI":"10.1186\/2046-4053-3-82"},{"key":"e_1_3_6_36_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13643-022-02102-3"},{"key":"e_1_3_6_37_2","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000033737"},{"key":"e_1_3_6_38_2","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000042555"},{"key":"e_1_3_6_39_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.idnow.2025.105185"},{"issue":"4","key":"e_1_3_6_40_2","first-page":"274","article-title":"Antiretroviral therapy regimens associated with viral suppression in adolescents on HIV treatment in Kenya","volume":"24","author":"Koske VC","year":"2025","unstructured":"Koske VC, Kuria SN, Okonjo EO, Otieno MO. Antiretroviral therapy regimens associated with viral suppression in adolescents on HIV treatment in Kenya. HIV & AIDS Review. 2025;24(4):274\u2013280.","journal-title":"HIV & AIDS Review"},{"key":"e_1_3_6_41_2","doi-asserted-by":"publisher","DOI":"10.4102\/sajhivmed.v26i1.1692"},{"key":"e_1_3_6_42_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-024-04312-3"},{"key":"e_1_3_6_43_2","volume-title":"Closing the Gaps in Pediatric and Adolescent HIV Care: Viral Suppression and Adverse Events after 2018 Antiretroviral Optimization in Uganda","author":"Ankunda C","year":"2025","unstructured":"Ankunda C, Namasambi S, Kyomuhangi B, Emunyu J, Sserunjogi C, Nakaweesi J. Closing the Gaps in Pediatric and Adolescent HIV Care: Viral Suppression and Adverse Events after 2018 Antiretroviral Optimization in Uganda; 2025."},{"key":"e_1_3_6_44_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0305129"},{"key":"e_1_3_6_45_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0331835"},{"key":"e_1_3_6_46_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0288619"},{"key":"e_1_3_6_47_2","doi-asserted-by":"publisher","DOI":"10.9734\/jsrr\/2020\/v26i230224"},{"key":"e_1_3_6_48_2","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000003190"},{"key":"e_1_3_6_49_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0315866"},{"key":"e_1_3_6_50_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12981-025-00780-2"},{"key":"e_1_3_6_51_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12981-024-00622-7"},{"key":"e_1_3_6_52_2","doi-asserted-by":"publisher","DOI":"10.1177\/23259582221109613"},{"key":"e_1_3_6_53_2","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2025.1442215"},{"key":"e_1_3_6_54_2","doi-asserted-by":"publisher","DOI":"10.1089\/aid.2021.0140"},{"key":"e_1_3_6_55_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0296293"},{"key":"e_1_3_6_56_2","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.25970"},{"key":"e_1_3_6_57_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaf191"},{"key":"e_1_3_6_58_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(24)00155-3"},{"key":"e_1_3_6_59_2","unstructured":"World Health Organization (WHO). New findings from the ODYSSEY trial confirm superiority of dolutegravir-based ART in young children at. 2021. https:\/\/www.who.int\/news\/item\/16-07-2021-new-findings-from-the-odyssey-trial-confirm-superiority-of-dolutegravir-based-art-in-young-children"},{"key":"e_1_3_6_60_2","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.25227"}],"container-title":["Journal of the International Association of Providers of AIDS Care (JIAPAC)"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/23259582261467826","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/23259582261467826","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/23259582261467826","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T03:47:38Z","timestamp":1784260058000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/23259582261467826"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":59,"alternative-id":["10.1177\/23259582261467826"],"URL":"https:\/\/doi.org\/10.1177\/23259582261467826","relation":{},"ISSN":["2325-9582","2325-9582"],"issn-type":[{"value":"2325-9582","type":"print"},{"value":"2325-9582","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"article-number":"23259582261467826"}}