Southern African Journal of Hiv Medicine最新文献

{"title":"A case of a drug reaction to sulfasalazine in a patient infected with HIV.","authors":"Leanne Swart,&nbsp;Elise Schapkaitz,&nbsp;Anima Baiden","doi":"10.4102/sajhivmed.v19i1.829","DOIUrl":"https://doi.org/10.4102/sajhivmed.v19i1.829","url":null,"abstract":"<p><strong>Introduction: </strong>The diagnosis of drug reaction with eosinophilia and systemic symptoms (DRESS) in human immunodeficiency virus (HIV) patients on multiple drugs with concomitant disorders presents a diagnostic challenge.</p><p><strong>Patient presentation: </strong>We describe a case of a drug reaction to sulfasalazine in a 46 year old HIV-infected female with concurrent rheumatoid arthritis which presented atypically with a marked peripheral blood plasmacytosis mimicking a lymphoproliferative neoplasm.</p><p><strong>Management and outcome: </strong>A diagnosis of DRESS was made in conjunction with the laboratory and clinical presenting findings. Sulfasalazine was immediately discontinued. The mucocutaneous rash and systemic symptoms (which included fever, lymphadenopathy and multi-organ dysfunction) resolved with supportive treatment. This included topical and systemic corticosteroids.</p><p><strong>Conclusion: </strong>In conclusion, it is important to consider drug reactions when evaluating patients infected with HIV.</p>","PeriodicalId":49489,"journal":{"name":"Southern African Journal of Hiv Medicine","volume":"19 1","pages":"829"},"PeriodicalIF":1.7,"publicationDate":"2018-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6295965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36842125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Human immunodeficiency virus infection and older adults: A retrospective single-site cohort study from Johannesburg, South Africa.","authors":"India Butler,&nbsp;William MacLeod,&nbsp;Pappie P Majuba,&nbsp;Brent Tipping","doi":"10.4102/sajhivmed.v19i1.838","DOIUrl":"https://doi.org/10.4102/sajhivmed.v19i1.838","url":null,"abstract":"<p><strong>Introduction: </strong>HIV-infected adults aged over 50 years in South Africa are increasing. This study explored differences between baseline characteristics and 12-month outcomes of younger and older HIV-infected adults initiated on antiretroviral therapy (ART). Additionally, associations with outcomes within the older group were sought.</p><p><strong>Methods: </strong>We retrospectively reviewed treatment-naive HIV-infected adult patients at ART initiation. Patients aged 18.0-39.9 years were compared to patients aged over 50 years using log-binomial regression for baseline characteristics and 12-month outcomes. Within the older group, outcome associations were found using multivariate regression.</p><p><strong>Results: </strong>The older cohort (<i>n</i> = 1635) compared to the younger cohort (<i>n</i> = 10726) comprised more males (47.2% vs. 35.4%, PR 1.52, <i>p</i> < 0.05), smokers (12.9% vs. 9.7%, PR 1.32, <i>p</i> < 0.05) and overweight patients (26.0% vs. 20.0%, PR 1.32, <i>p</i> < 0.05). Fewer older patients had tuberculosis (10.2% vs. 15.3%, PR 0.67, <i>p</i> < 0.05), other opportunistic infections (16.9% vs. 23.3%, PR 0.70, <i>p</i> < 0.05), World Health Organization stage 3/4 disease (39.9% vs. 43.2%, PR 0.89, <i>p</i> < 0.05), anaemia (22.8% vs. 28.4%, PR 0.77, <i>p</i> < 0.05), liver dysfunction (17.1% vs. 21.3%, PR 0.83, <i>p</i> < 0.05) or low CD4+ count < 100 cells/mm³ (56.3% vs. 59.9%, PR 0.71, <i>p</i> < 0.05).Mortality was higher in the older cohort (11.3% vs. 7.5%, PR 1.48, <i>p</i> < 0.05). Virological suppression was greater in the older cohort (89.5% vs. 86.5%, PR 1.28, <i>p</i> < 0.05) but CD4+ restitution was lower (62.8% vs. 75.0%, PR 0.61, <i>p</i> < 0.05). There was no difference in treatment complications between the groups.Within the older cohort, associations with death were as follows: age > 55 years (PR 1.47, <i>p</i> < 0.05), an AIDS-defining condition (PR 2.28, <i>p</i> < 0.05), raised ALT (PR 1.53, <i>p</i> < 0.05) and CD4+ < 100 cells/mm³ (PR 2.15, <i>p</i> < 0.05). Associations with favourable treatment response at 12 months were unemployment (PR 1.18, <i>p</i> < 0.05) and raised ALT (PR 1.19, <i>p</i> < 0.05). Associations with a treatment complication at 12 months were unemployment (PR 1.12, <i>p</i> < 0.05), smoking (PR 1.20, <i>p</i> < 0.05) and nevirapine use (PR 1.36, <i>p</i> < 0.05) but secondary education was protective (PR 0.87, <i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>HIV-infected South African adults aged over 50 years differ in characteristics and outcomes compared to their younger counterparts and justify specialised management within HIV treatment facilities.</p>","PeriodicalId":49489,"journal":{"name":"Southern African Journal of Hiv Medicine","volume":"19 1","pages":"838"},"PeriodicalIF":1.7,"publicationDate":"2018-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6295827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36800543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sexual reproductive healthcare utilisation and HIV testing in an integrated adolescent youth centre clinic in Cape Town, South Africa.","authors":"Andrea S Mendelsohn,&nbsp;Katherine Gill,&nbsp;Rebecca Marcus,&nbsp;Dante Robbertze,&nbsp;Claudine van de Venter,&nbsp;Eve Mendel,&nbsp;Landisiwe Mzukwa,&nbsp;Linda-Gail Bekker","doi":"10.4102/sajhivmed.v19i1.826","DOIUrl":"https://doi.org/10.4102/sajhivmed.v19i1.826","url":null,"abstract":"<p><strong>Background: </strong>HIV prevalence is increasing among South African youth, but HIV counselling and testing (HCT) remains low. Adolescent pregnancy rates are also high.</p><p><strong>Objectives: </strong>Innovative strategies are needed to increase HIV and pregnancy screening and prevention among youth.</p><p><strong>Method: </strong>The Desmond Tutu HIV Foundation Youth Centre (DTHF-YC) offers integrated, incentivised sexual and reproductive health (SRH), educational and recreational programmes. We compared HCT and contraception rates between the DTHF-YC and a public clinic (PC) in Cape Town to estimate the impact of DTHF-YC on youth contraception and HCT utilisation.</p><p><strong>Results: </strong>In 2015, females < 18 years had 3.74 times (confidence interval [CI]: 3.37-4.15) more contraception visits at DTHF-YC versus PC. There were no differences in the contraception and adherence was suboptimal. DTHF-YC youth (aged 15-24 years) were 1.85 times (CI: 1.69-2.01) more likely to undergo HCT versus PC, while male youth were 3.83 times (CI: 3.04-4.81) more likely to test at DTHF-YC. Youth were a third less likely to test HIV-positive at DTHF-YC versus PC. Female sex, older age, clinic attendance for contraception and sexually transmitted infections (STIs), redeeming incentives and high DTHF-YC attendance were all independent factors associated with increased HCT.</p><p><strong>Conclusion: </strong>Youth were significantly more likely to access SRH services at DTHF-YC compared with the PC. The differences were greatest in contraception use by female adolescents < 18 years and HCT by male youth. Increased HCT did not increase youth HIV case detection. Data from DTHF-YC suggest that youth-friendly healthcare providers integrated into community youth spaces may increase youth HCT and contraception rates.</p>","PeriodicalId":49489,"journal":{"name":"Southern African Journal of Hiv Medicine","volume":"19 1","pages":"826"},"PeriodicalIF":1.7,"publicationDate":"2018-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4102/sajhivmed.v19i1.826","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36842123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and outcomes of central venous catheter-related bacteraemia in HIV-infected versus non-HIV-infected patients undergoing haemodialysis treatment for end-stage kidney disease.","authors":"Nuria Avila-Danguillecourt,&nbsp;Anand A Moodley,&nbsp;Polycarpe Makinga","doi":"10.4102/sajhivmed.v19i1.859","DOIUrl":"https://doi.org/10.4102/sajhivmed.v19i1.859","url":null,"abstract":"<p><strong>Background: </strong>Central venous catheter (CVC) haemodialysis (HD) to implement renal replacement therapy is the preferred choice in the urgent setting. Unfortunately, CVC placement is associated with multiple complications including nosocomial bloodstream infections. There is a paucity of data on the prevalence and pattern of pathogenic organisms in haemodialysed HIV-infected versus non-HIV-infected patients with end-stage kidney disease.</p><p><strong>Method and results: </strong>We undertook a retrospective study of 228 patients who were dialysed using a CVC at a tertiary referral hospital in KwaZulu-Natal, South Africa. Seventy-eight patients (34.2%) complicated with bacteraemia and sepsis requiring antibiotics. Removal of the catheter was necessary in 58 patients (74.0%). The most common organisms isolated were <i>Staphylococcus aureus</i> (30.8%), <i>Staphylococcus epidermidis</i> (24.4%) and <i>Klebsiella pneumoniae</i> (15.4%). There was no statistically significant difference between HIV-infected and non-infected patients with regards to infection rate, time interval from insertion of CVC to infection and final outcome. However, HIV-infected patients took longer to recover; 54.3% of non-infected patients versus 10.3% HIV-infected patients had their sepsis controlled within one week. Acidosis, hypotension, line malfunction and line discharge were infrequent signs of sepsis. Fever, rigors and raised white cell count occurred in over 80.0% of patients.</p><p><strong>Conclusion: </strong>The infection rate in CVC HD is not more frequent in HIV-infected patients, provided that CD4+ count is ≥ 200 cells/µL and the patient is virologically suppressed. Outcomes following intravenous antibiotic and removal of the CVC are similar in HIV-infected and non-infected patients but response to treatment is slower in HIV-infected patients. A high index of suspicion is needed in detecting CVC-related bacteraemia.</p>","PeriodicalId":49489,"journal":{"name":"Southern African Journal of Hiv Medicine","volume":"19 1","pages":"859"},"PeriodicalIF":1.7,"publicationDate":"2018-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4102/sajhivmed.v19i1.859","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36800988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"B-cell and T-cell activation in South African HIV-1-positive non-Hodgkin's lymphoma patients.","authors":"Brian T Flepisi,&nbsp;Patrick Bouic,&nbsp;Gerhard Sissolak,&nbsp;Bernd Rosenkranz","doi":"10.4102/sajhivmed.v19i1.809","DOIUrl":"https://doi.org/10.4102/sajhivmed.v19i1.809","url":null,"abstract":"<p><strong>Background: </strong>Altered immune mechanisms play a critical role in the pathogenesis of non-Hodgkin's lymphoma (NHL). HIV-1 (HIV) infection is associated with a state of excessive T-cell activation, which can lead to increased T-cell turnover and lymph node fibrosis.</p><p><strong>Objectives: </strong>This study aimed to determine the serum levels of circulating B-cell activation markers, and the expression of T-cell activation and regulatory markers in HIV-positive NHL patients.</p><p><strong>Method: </strong>The serum levels of circulating soluble(s) sCD20, sCD23, sCD27, sCD30 and sCD44 molecules, all of which are biomarkers of B-cell activation, were determined by enzyme-linked immunosorbent assays (ELISA), while biomarkers of T-cell activation (CD8+CD38+) and regulation (FoxP3) were determined by flow cytometry in 141 subjects who were divided into five groups: Combination antiretroviral therapy (ART)-naïve HIV-positive patients; ART-treated HIV-positive patients; HIV-negative NHL patients; HIV-positive NHL patients on ART; and healthy controls.</p><p><strong>Results: </strong>HIV-positive NHL patients had significantly higher serum levels of sCD20, sCD23, sCD30 and sCD44 than HIV-negative NHL patients, while all five biomarkers were significantly elevated in HIV-positive NHL patients when compared with ART-treated HIV-positive patients. HIV-positive NHL patients had higher CD8+CD38+ and lower FoxP3 expression than HIV-negative NHL and ART-treated HIV-positive patients.</p><p><strong>Conclusion: </strong>B-cell activation is increased in HIV-positive NHL patients and is associated with reduced regulatory T-cell populations and increased CD8+ T-cell activation.</p>","PeriodicalId":49489,"journal":{"name":"Southern African Journal of Hiv Medicine","volume":"19 1","pages":"809"},"PeriodicalIF":1.7,"publicationDate":"2018-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6244198/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36715244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guidelines to support HIV-affected individuals and couples to achieve pregnancy safely: Update 2018.","authors":"Natasha E C G Davies,&nbsp;Gail Ashford,&nbsp;Linda-Gail Bekker,&nbsp;Nomathemba Chandiwana,&nbsp;Diane Cooper,&nbsp;Silker J Dyer,&nbsp;Lauren Jankelowitz,&nbsp;Otty Mhlongo,&nbsp;Coceka N Mnyani,&nbsp;Muhangwi B Mulaudzi,&nbsp;Michelle Moorhouse,&nbsp;Landon Myer,&nbsp;Malika Patel,&nbsp;Melanie Pleaner,&nbsp;Tatiana Ramos,&nbsp;Helen Rees,&nbsp;Sheree Schwartz,&nbsp;Jenni Smit,&nbsp;Doreen S van Zyl","doi":"10.4102/sajhivmed.v19i1.915","DOIUrl":"https://doi.org/10.4102/sajhivmed.v19i1.915","url":null,"abstract":"Read online: Scan this QR code with your smart phone or mobile device to read online. Authors: Natasha E.C.G. Davies1 Gail Ashford2 Linda-Gail Bekker3,4 Nomathemba Chandiwana1 Diane Cooper5 Silker J. Dyer6 Lauren Jankelowitz7 Otty Mhlongo8 Coceka N. Mnyani9 Muhangwi B. Mulaudzi7 Michelle Moorhouse1 Landon Myer10 Malika Patel6 Melanie Pleaner1 Tatiana Ramos7 Helen Rees1 Sheree Schwartz1,11 Jenni Smit9 Doreen S. van Zyl12","PeriodicalId":49489,"journal":{"name":"Southern African Journal of Hiv Medicine","volume":"19 1","pages":"915"},"PeriodicalIF":1.7,"publicationDate":"2018-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6244351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36715246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Appropriate clinical use of darunavir 800 mg.","authors":"Michelle A Moorhouse,&nbsp;Sergio Carmona,&nbsp;Natasha Davies,&nbsp;Sipho Dlamini,&nbsp;Cloete van Vuuren,&nbsp;Thandekile Manzini,&nbsp;Moeketsi Mathe,&nbsp;Yunus Moosa,&nbsp;Jennifer Nash,&nbsp;Jeremy Nel,&nbsp;Yoliswa Pakade,&nbsp;Joana Woods,&nbsp;Gert van Zyl,&nbsp;Francesca Conradie,&nbsp;Francois Venter,&nbsp;Graeme Meintjes","doi":"10.4102/sajhivmed.v19i1.918","DOIUrl":"https://doi.org/10.4102/sajhivmed.v19i1.918","url":null,"abstract":"PREZISTA, in combination with low dose ritonavir (DRV/r) and with other antiretroviral medicines, is indicated for the treatment of human immunodeficiency virus (HIV) infection in antiretroviral treatment experienced adult patients who are protease-inhibitor-naïve or after exclusion of darunavir resistance associated mutations (DRV-RAMs: V11I, V32I, L33F, I47V, I50V, I54M, I54L, T74P, L76V, I84V and L89V). Genotypic or phenotypic testing should guide the use of DRV/r. (Prezista package insert)","PeriodicalId":49489,"journal":{"name":"Southern African Journal of Hiv Medicine","volume":"19 1","pages":"918"},"PeriodicalIF":1.7,"publicationDate":"2018-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6244068/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36715247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Southern African HIV Clinicians Society Guidance on the use of dolutegravir in first-line antiretroviral therapy.","authors":"Michelle A Moorhouse,&nbsp;Sergio Carmona,&nbsp;Natasha Davies,&nbsp;Sipho Dlamini,&nbsp;Cloete van Vuuren,&nbsp;Thandekile Manzini,&nbsp;Moeketsi Mathe,&nbsp;Yunus Moosa,&nbsp;Jennifer Nash,&nbsp;Jeremy Nel,&nbsp;Yoliswa Pakade,&nbsp;Joana Woods,&nbsp;Gert van Zyl,&nbsp;Francesca Conradie,&nbsp;Francois Venter,&nbsp;Graeme Meintjes","doi":"10.4102/sajhivmed.v19i1.917","DOIUrl":"https://doi.org/10.4102/sajhivmed.v19i1.917","url":null,"abstract":"In preliminary data from the Tsepamo study in Botswana, it was found that 0.94% (95% confidence interval [CI]: 0.37 – 2.4) of babies (4/426) born to women who were taking dolutegravir periconception had neural tube defects (NTDs), compared with 0.1% of babies (14/11 173) of women taking other antiretroviral drugs (ARVs) in the periconception period.1 No NTDs were observed in pregnancies where dolutegravir was initiated later in pregnancy. Further data from the Tsepamo study were presented at AIDS 2018: the updated number of NTDs with periconception dolutegravir exposure in the Tsepamo cohort is 4/596, 0.67% (95% CI: 0.26 to 1.7). The next formal analysis will occur after 31 March 2019 and will include women exposed to dolutegravir from conception before the recent change in guidance. Tsepamo plans to expand the number of study sites, increasing the coverage from 45% to 72% of births in Botswana with a projected denominator of over 1200 by March 2019.1","PeriodicalId":49489,"journal":{"name":"Southern African Journal of Hiv Medicine","volume":"19 1","pages":"917"},"PeriodicalIF":1.7,"publicationDate":"2018-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6244149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36715245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Will the current National Strategic Plan enable South Africa to end AIDS, Tuberculosis and Sexually Transmitted Infections by 2022?","authors":"Kathryn L Hopkins,&nbsp;Tanya Doherty,&nbsp;Glenda E Gray","doi":"10.4102/sajhivmed.v19i1.796","DOIUrl":"https://doi.org/10.4102/sajhivmed.v19i1.796","url":null,"abstract":"<p><strong>Background: </strong>In May 2017, the South African National AIDS Council released the fourth National Strategic Plan (NSP) for HIV, tuberculosis and sexually transmitted infections. This five-year plan (2017-2022), which aims to track the progress towards transitioning these epidemics to no longer being public health threats by the year 2030, is built on the successes and barriers of the previous NSP (2012-2016). However, the NSP does not address some critical components, which may contribute to a future failure in achieving its hefty goals.</p><p><strong>Objectives: </strong>This article outlines the gaps within the new NSP, as well as highlighting aspects requiring careful focus, which are critical to address in order for South Africa to make progress towards the set targets.</p><p><strong>Method: </strong>This commentary included an in depth review of the NSP, other South African National Strategic Plans and documents, and scientific literature.</p><p><strong>Results: </strong>The NSP does not address gaps in funding, oversights in prevention and treatment strategies, human resource shortages and lacking health system requirements.</p><p><strong>Conclusion: </strong>To realistically achieve the NSP targets and goals, a robust, client-centred strategy addressing the NSP gaps needs to be implemented. The strategy must be cost-effective; provide active linkage to care; and address health system weaknesses that inhibit its successful implementation, including human resources, service delivery and supply chain management, accountability and monitoring and evaluation (M&E).</p>","PeriodicalId":49489,"journal":{"name":"Southern African Journal of Hiv Medicine","volume":"19 1","pages":"796"},"PeriodicalIF":1.7,"publicationDate":"2018-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6191675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36608793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The metabolic syndrome and renal function in an African cohort infected with human immunodeficiency virus.","authors":"Edith Phalane,&nbsp;Carla M T Fourie,&nbsp;Aletta E Schutte","doi":"10.4102/sajhivmed.v19i1.813","DOIUrl":"10.4102/sajhivmed.v19i1.813","url":null,"abstract":"<p><strong>Introduction: </strong>The human immunodeficiency virus (HIV) is often accompanied by renal dysfunction. It is expected that metabolic syndrome (MetS) may exacerbate renal impairment.</p><p><strong>Objective: </strong>We therefore determined the prevalence of MetS and the association thereof with renal function in a South African cohort infected with HIV.</p><p><strong>Methods: </strong>We matched 114 HIV-infected (77.3% on antiretroviral therapy [ART] and 22.7% ART-naïve) and 114 HIV-uninfected individuals according to age, sex and locality. We examined cardiovascular, anthropometric and metabolic measurements and determined the MetS. Renal function was assessed using standardised procedures.</p><p><strong>Results: </strong>The prevalence of MetS was lower in the HIV-infected individuals as compared to the uninfected individuals (28% vs. 44%, <i>p</i> = 0.013). The HIV-infected group presented with a lower body mass index (BMI) and waist circumference (WC) (all <i>p</i> < 0.001), as well as blood pressure (BP) (<i>p</i> ≤ 0.0021). The results were confirmed when comparing the HIV-infected group using ART (<i>N</i> = 85) and the HIV-uninfected group. When comparing the HIV-infected individuals with MetS to the HIV-uninfected individuals with MetS, no differences in BP were seen. With regard to renal function, the HIV-infected individuals with MetS (<i>n</i> = 32) had 43% higher urinary albumin-creatinine ratio (uACR) compared to the HIV-uninfected individuals with MetS, after adjusting for age, sex and WC (<i>p</i> = 0.032). None of the other renal function markers differed after adjustments for WC or BMI.</p><p><strong>Conclusion: </strong>The HIV-infected Africans with MetS had almost twofold higher uACR, despite the low prevalence of MetS, compared to their uninfected counterparts. The combination of HIV and MetS seemed to increase the risk for renal impairment.</p>","PeriodicalId":49489,"journal":{"name":"Southern African Journal of Hiv Medicine","volume":"19 1","pages":"813"},"PeriodicalIF":1.7,"publicationDate":"2018-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6191676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36609180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}