Title : Prevalence, pattern, and genetic diversity of human immunodeficiency virus in children under 10 years of age with acquired immunodeficiency syndrome in South Africa: A systematic review and meta-analysis
The human immunodeficiency virus (HIV), the causative agent of acquired immune deficiency syndrome, poses major challenges to healthcare worldwide, especially in children under the age of 10. Sub-Saharan Africa is overwhelmingly suffering unprecedented deaths due to this pandemic. A meta-analysis was performed on 58 published studies between 1985 and 2021 to assess the pooled prevalence of HIV/AIDS infection and drug resistance mutations in the genetic diversities of HIV1 and 2 occurring before and after the introduction of antiretroviral treatment (ART) in children occurred age 10 years in South Africa. The pooled national prevalence of HIV/AIDS infection was estimated at 23% (95% CI: 1927%) before ART and decreased to 19% (95% CI: 1236%) after the ART period. However, an increased number of cases after ART was observed in the provinces of KwaZulu-Natal (3247%) and Western Cape (2838%). The most dominant genotype combinations in the pre-ARTera were HIV 1, while HIV 2 was 9. Greater drug resistance, mutations and genetic diversity of HIV 1 in ART compared to HIV2 with 5 were observed after ART introduction. The introduction of ART has been associated with a reduction in HIV/AIDS stigma in South Africa, although not without regional variations. The observed changing patterns of genotype distribution underscore the need for ongoing surveillance to monitor disease trend and identify possible implications related to the dynamics of genotype changes on ART and its failure. Efforts also need to be intensified to ensure that information about HIV reaches vulnerable subgroups, as outlined in this study, by mobilizing all available resources to reach the less educated and poor parents, particularly rural residents.