# Incidence and Predictors of Opportunistic Infection Among People Living With HIV in Ethiopia: A Systematic Review and Meta‐Analysis

## TL;DR

This study summarizes the rate and risk factors for opportunistic infections in people with HIV in Ethiopia.

## Contribution

The study provides a pooled incidence rate and identifies key predictors of opportunistic infections in Ethiopia.

## Key findings

- The pooled incidence rate of opportunistic infections was 6.96 per 100 person-years.
- Low CD4 count, poor ART adherence, being bedridden, and advanced WHO stage were significant predictors.
- Opportunistic infections remain a major health issue for people living with HIV in Ethiopia.

## Abstract

Opportunistic infections (OIs) play a crucial role in the morbidity and mortality of HIV‐infected 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‐analysis aim to determine the pooled incidence and identify the predictors of OIs among people living with HIV in Ethiopia.

A systematic search was conducted across multiple electronic databases to identify relevant studies. The degree of heterogeneity across studies was assessed using the I
2 statistic. Subgroup analyses were conducted to explore sources of heterogeneity. A funnel plot and Egger’s test were used to assess publication bias. Adjusted hazard ratio with 95% CI was used to assess the relationship between predictors and OIs occurrence.

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‐years (95% CI: 5.14–8.78) based on a random‐effects model. The meta‐analysis identified predictors of OIs among people living with HIV, including poor adherence (pooled AHR 1.42, 95% CI: 1.12, 1.80), CD4 count < 200 cells/mm3 (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).

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.