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

Background 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. Method 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. Result 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/mm 3 (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). Conclusion 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.