Southern African Journal of Hiv Medicine最新文献

{"title":"Cutaneous lesions in the setting of disseminated <i>Cryptococcus neoformans</i> infection.","authors":"Mithra John,&nbsp;Stacey Norsworthy,&nbsp;Lauren Richards","doi":"10.4102/sajhivmed.v22i1.1315","DOIUrl":"https://doi.org/10.4102/sajhivmed.v22i1.1315","url":null,"abstract":"No abstract available.","PeriodicalId":49489,"journal":{"name":"Southern African Journal of Hiv Medicine","volume":" ","pages":"1315"},"PeriodicalIF":1.7,"publicationDate":"2021-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8603087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39688180","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":"Five years after Treat All implementation: Botswana's HIV response and future directions in the era of COVID-19.","authors":"Keith Jefferis, Ava Avalos, Heston Phillips, Mpho Mmelesi, Dinah Ramaabya, Bornapate Nkomo, Charles Muthoga, Joseph N Jarvis, Siphiwe Ratladi, Robert Selato, John Stover","doi":"10.4102/sajhivmed.v22i1.1275","DOIUrl":"10.4102/sajhivmed.v22i1.1275","url":null,"abstract":"<p><strong>Background: </strong>As the relentless coronavirus disease-2019 (COVID-19) pandemic continues to spread across Africa, Botswana could face challenges maintaining the pathway towards control of its HIV epidemic.</p><p><strong>Objective: </strong>Utilising the Spectrum GOALS module (GOALS-2021), the 5-year outcomes from the implementation of the Treat All strategy were analysed and compared with the original 2016 Investment Case (2016-IC) projections. Future impact of adopting the new Joint United Nations Programme on HIV/AIDS (UNAIDS) Global AIDS Strategy (2021-2026) targets and macroeconomic analysis estimating how the financial constraints from the COVID-19 pandemic could impact the available resources for Botswana's National HIV Response through 2030 were also considered.</p><p><strong>Method: </strong>Programmatic costs, population demographics, prevention and treatment outputs were determined. Previous 2016-IC data were uploaded for comparison, and inputs for the GOALS, AIM, DemProj, Resource Needs and Family Planning modules were derived from published reports, strategic plans, programmatic data and expert opinion. The economic projections were recalibrated with consideration of the impact of the COVID-19 pandemic.</p><p><strong>Results: </strong>Decreases in HIV infections, incidence and mortality rates were achieved. Increases in laboratory costs were offset by estimated decreases in the population of people living with HIV (PLWH). Moving forward, young women and others at high risk must be targeted in HIV prevention efforts, as Botswana transitions from a generalised to a more concentrated epidemic.</p><p><strong>Conclusion: </strong>The Treat All strategy contributed positively to decreases in new HIV infections, mortality and costs. If significant improvements in differentiated service delivery, increases in human resources and HIV prevention can be realised, Botswana could become one of the first countries with a previously high-burdened generalised HIV epidemic to gain epidemic control, despite the demands of the COVID-19 pandemic.</p>","PeriodicalId":49489,"journal":{"name":"Southern African Journal of Hiv Medicine","volume":" ","pages":"1275"},"PeriodicalIF":1.6,"publicationDate":"2021-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8602965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39684285","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":"Celebrating 21 years and introducing the 21st anniversary issue.","authors":"Yunus Moosa,&nbsp;Lauren Jankelowitz","doi":"10.4102/sajhivmed.v22i1.1317","DOIUrl":"https://doi.org/10.4102/sajhivmed.v22i1.1317","url":null,"abstract":"No abstract available.","PeriodicalId":49489,"journal":{"name":"Southern African Journal of Hiv Medicine","volume":" ","pages":"1317"},"PeriodicalIF":1.7,"publicationDate":"2021-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8603062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39688181","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":"Earlier antiretroviral initiation is independently associated with better arterial stiffness in children living with perinatally acquired HIV with sustained viral suppression in Mozambique.","authors":"Igor S Dobe, Ana O Mocumbi, Noorjean Majid, Birhanu Ayele, Sara H Browne, Steve Innes","doi":"10.4102/sajhivmed.v22i1.1282","DOIUrl":"10.4102/sajhivmed.v22i1.1282","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular disease is a major driver of morbidity and mortality in adults living with HIV. The drivers of cardiovascular disease in children living with perinatally acquired HIV (PHIV) with sustained HIV viral suppression are unclear.</p><p><strong>Objectives: </strong>We explored the contribution of HIV-specific risk factors to arterial stiffness independently of traditional risk factors (metabolic syndrome [MetS]) in prepubertal children with PHIV with sustained viral suppression in a low-income country in Africa.</p><p><strong>Method: </strong>For this cross-sectional analysis, arterial stiffness was assessed by pulse wave velocity <i>z</i>-score (PWVz), measured using a Vicorder device. Metabolic syndrome components were measured. We retrospectively collected the antiretroviral therapy (ART) exposures, HIV stage, CD4 count and HIV viral load. A multivariate linear regression model was constructed for MetS components, retaining age and gender as obligatory variables. We then added HIV-related metrics to assess whether these had an independent or additive effect.</p><p><strong>Results: </strong>We studied 77 virally suppressed children with PHIV without evidence of cardiovascular disease (from medical history and physical examination). In the initial model, the PWVz was independently associated with each MetS component. The PWVz was higher in participants with proportionally greater visceral fat (waist/height ratio), elevated lipids (triglyceride/high-density lipoprotein ratio) and insulin resistance (log homeostatic model assessment [HOMA]). The addition of age at ART initiation increased the model <i>R</i> ² value from 0.36 to 0.43. In the resulting model, younger age at ART initiation was independently associated with a better PWVz (<i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>Earlier ART initiation was independently associated with lower large artery stiffness. This effect was independent of the effect of elevated lipids, visceral fat and insulin resistance.</p>","PeriodicalId":49489,"journal":{"name":"Southern African Journal of Hiv Medicine","volume":"22 1","pages":"1282"},"PeriodicalIF":1.6,"publicationDate":"2021-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8603154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9850381","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 gender-affirming healthcare guideline for South Africa.","authors":"Anastacia Tomson,&nbsp;Chris/Tine McLachlan,&nbsp;Camilla Wattrus,&nbsp;Kevin Adams,&nbsp;Ronald Addinall,&nbsp;Rutendo Bothma,&nbsp;Lauren Jankelowitz,&nbsp;Elliott Kotze,&nbsp;Zamasomi Luvuno,&nbsp;Nkanyiso Madlala,&nbsp;Savuka Matyila,&nbsp;Anil Padavatan,&nbsp;Mershen Pillay,&nbsp;Mmamontsheng D Rakumakoe,&nbsp;Mathilde Tomson-Myburgh,&nbsp;Willem D F Venter,&nbsp;Elma de Vries","doi":"10.4102/sajhivmed.v22i1.1299","DOIUrl":"https://doi.org/10.4102/sajhivmed.v22i1.1299","url":null,"abstract":"No abstract available.","PeriodicalId":49489,"journal":{"name":"Southern African Journal of Hiv Medicine","volume":" ","pages":"1299"},"PeriodicalIF":1.7,"publicationDate":"2021-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8517808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39554143","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":"Looking back at paediatric HIV treatment in South Africa. My, how we have grown!","authors":"Leon J Levin,&nbsp;Juliet L Horak,&nbsp;James Nuttall","doi":"10.4102/sajhivmed.v22i1.1283","DOIUrl":"https://doi.org/10.4102/sajhivmed.v22i1.1283","url":null,"abstract":"<p><p>Antiretroviral treatment has undergone major changes in the last 20 years, from monotherapy, to dual therapy and finally to triple therapy. Lately, more focus has been placed on better, more well-tolerated combinations and formulations. As in most other disciplines in medicine, the development of paediatric HIV dosages and formulations always tends to lag behind adult research. Twenty years ago, it could take several years before data were available to enable the use of life-saving antiretrovirals in children. Paediatricians, being ever resourceful, were not prepared to let their paediatric patients suffer despite the lack of data or formulations and so made a plan. This article describes some of the trials and tribulations that we went through trying to make sure that our paediatric HIV patients not only survived but thrived. Clinicians treating paediatric patients today have it so much easier because of what our colleagues and their patients went through in those early days.</p>","PeriodicalId":49489,"journal":{"name":"Southern African Journal of Hiv Medicine","volume":" ","pages":"1283"},"PeriodicalIF":1.7,"publicationDate":"2021-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8517800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39556107","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":"Impact of a delayed diagnosis of vulvar cancer and its association with HIV infection: A 4-year review at a tertiary hospital in KwaZulu-Natal, South Africa.","authors":"Ramakhosana S Hlapane,&nbsp;Thandekile L Khumalo,&nbsp;Bongumusa S Makhathini,&nbsp;Jagidesa Moodley","doi":"10.4102/sajhivmed.v22i1.1272","DOIUrl":"https://doi.org/10.4102/sajhivmed.v22i1.1272","url":null,"abstract":"<p><strong>Background: </strong>Vulvar cancer is becoming more common in young women owing to the increased prevalence of co-infection with human papillomavirus and HIV.</p><p><strong>Objectives: </strong>The aim of this study was to determine the impact of the time interval from the diagnosis of vulvar cancer at the referring institution to the tertiary hospital and to evaluate the impact of HIV infection in the study population.</p><p><strong>Method: </strong>This was a retrospective descriptive chart review.</p><p><strong>Results: </strong>A total of 86 cases of vulvar cancer were analysed. The mean age was 48.2 ± 12.5. Sixty (69.8%) patients were under 50 years of age and eight (9.3%) under 30 years. The interval from the onset of symptoms to the diagnosis of cancer was > 12 months in 63 (73.3%) patients. Eighty-one (94.8%) had had symptoms treated multiple times prior to diagnosis. Seventy (81.4%) were referred to the tertiary institution within 3 months of the diagnosis of cancer. Seventy (81.4%) had concomitant HIV infection. Of those with CD4 counts of > 200 cells/mm³, 61.7% had early-stage vulvar cancer, while 38.3% had late-stage disease (<i>P</i> = 0.048). There was no association between the viral load and the Federation of Gynaecology and Obstetrics stage (<i>P</i> = 0.401). The primary treatment was surgery in 50%.</p><p><strong>Conclusion: </strong>Although the study was retrospective, we found that vulvar cancer was prevalent in younger patients with HIV infection. Higher CD4 counts were associated with early-stage disease. Early sampling of suspicious lesions can ensure early diagnosis of vulvar cancer and the initiation of therapeutic interventions, particularly in HIV-infected patients.</p>","PeriodicalId":49489,"journal":{"name":"Southern African Journal of Hiv Medicine","volume":" ","pages":"1272"},"PeriodicalIF":1.7,"publicationDate":"2021-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8517792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39555678","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":"Optimised paediatric antiretroviral treatment to achieve the 95-95-95 goals.","authors":"Moherndran Archary,&nbsp;Riana van Zyl,&nbsp;Nosisa Sipambo,&nbsp;Gillian Sorour","doi":"10.4102/sajhivmed.v22i1.1278","DOIUrl":"https://doi.org/10.4102/sajhivmed.v22i1.1278","url":null,"abstract":"<p><p>While the progress towards reaching the UNAIDS 95-95-95 targets in South African adults seems promising, the progress in the paediatric population is lagging far behind; only 79% percent of children living with HIV know their status. Of these, only 47% are on treatment, and a mere 34% of those are virally suppressed. Thus, virological suppression has been attained in only 13% of children living with HIV in South Africa. Multiple factors contribute to the high treatment failure rate, one of them being a lack of paediatric-friendly antiretroviral treatment (ART) formulations. For example, the Lopinavir/ritonavir syrup, which is the current mainstay of ART for young children, has an extremely unpleasant taste, contributing to the poor tolerability and lack of adherence by children using the formulation. Furthermore, the lack of appropriate formulations limits the optimisation of regimens, especially for young children and those who cannot swallow tablets. Switching from syrups to dispersible tablets will improve ease of administration and adherence and result in cost-saving. Despite the approval of simplified paediatric-friendly formulations internationally, including other sub-Saharan African countries, unnecessary delays are experienced in South Africa. Clinician groups and community organisations must speak up and demand that approvals be expedited to ensure the delivery of life-changing and life-saving formulations to our patients as a matter of urgency.</p>","PeriodicalId":49489,"journal":{"name":"Southern African Journal of Hiv Medicine","volume":" ","pages":"1278"},"PeriodicalIF":1.7,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8517773/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39555679","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":"Importance of global communication to combat global pandemics: Lessons from the HIV Online Provider Education programme.","authors":"Efeose A Airewele,&nbsp;Henry Sunpath,&nbsp;Mahomed-Yunus S Moosa,&nbsp;Rajesh T Gandhi","doi":"10.4102/sajhivmed.v22i1.1281","DOIUrl":"https://doi.org/10.4102/sajhivmed.v22i1.1281","url":null,"abstract":"<p><p>In many ways, the coronavirus disease 2019 (COVID-19) pandemic mirrors the challenges, lessons and opportunities of the HIV pandemic. In this article, we argue that global pandemics such as COVID-19 and HIV require a global response. We highlight the HIV Online Provider Education (HOPE) programme as an example of the importance of global communication when combating a pandemic. From both the COVID-19 and HIV pandemics, we have learned that to optimise health worldwide, it is necessary to have effective and efficient means of swiftly sharing experiences, expertise, best practices and guidelines. To prepare for the next public health emergency, clinicians and researchers must put in place and promote effective programmes for global communication.</p>","PeriodicalId":49489,"journal":{"name":"Southern African Journal of Hiv Medicine","volume":" ","pages":"1281"},"PeriodicalIF":1.7,"publicationDate":"2021-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8424751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39418714","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":"Geographical variation in HIV testing in South Africa: Evidence from the 2017 national household HIV survey.","authors":"Sean Jooste,&nbsp;Musawenkosi Mabaso,&nbsp;Myra Taylor,&nbsp;Alicia North,&nbsp;Yolande Shean,&nbsp;Leickness C Simbayi,&nbsp;Tarylee Reddy,&nbsp;Leonard Mwandingi,&nbsp;Tenielle Schmidt,&nbsp;Portia Nevhungoni,&nbsp;Samuel Manda,&nbsp;Khangelani Zuma","doi":"10.4102/sajhivmed.v22i1.1273","DOIUrl":"https://doi.org/10.4102/sajhivmed.v22i1.1273","url":null,"abstract":"<p><strong>Background: </strong>Identification of the geographical areas with low uptake of HIV testing could assist in spatial targeting of interventions to improve the uptake of HIV testing.</p><p><strong>Objectives: </strong>The objective of this research study was to map the uptake of HIV testing at the district level in South Africa.</p><p><strong>Method: </strong>The secondary analysis used data from the Human Sciences Research Council's 2017 National HIV Prevalence, Incidence, Behaviour and Communication Survey, where data were collected using a multistage stratified random cluster sampling approach. Descriptive spatial methods were used to assess disparities in the proportion of those ever tested for HIV at the district level in South Africa.</p><p><strong>Results: </strong>The districts with the highest overall coverage of people ever having tested for HIV (> 85%) include West Rand in Gauteng, Lejweleputswa and Thabo Mofutsanyane in Free State, and Ngaka Modiri Molema in North-West. These provinces also had the least variation in HIV testing coverage between their districts. Districts in KwaZulu-Natal had the widest variation in coverage of HIV testing. The districts with the lowest uptake of HIV testing were uMkhanyakude (54.7%) and Ugu (61.4%) in KwaZulu-Natal and Vhembe (61.0%) in Limpopo. Most districts had a higher uptake of HIV testing amongst female than male participants.</p><p><strong>Conclusion: </strong>The uptake of HIV testing across various districts in South Africa seems to be unequal. Intervention programmes must improve the overall uptake of HIV testing, especially in uMkhanyakude and Ugu in KwaZulu-Natal and Vhembe in Limpopo. Interventions must also focus on enhancing uptake of HIV testing amongst male participants in most districts. Strategies that would improve the uptake of HIV testing include HIV self-testing and community HIV testing, specifically home-based testing.</p>","PeriodicalId":49489,"journal":{"name":"Southern African Journal of Hiv Medicine","volume":" ","pages":"1273"},"PeriodicalIF":1.7,"publicationDate":"2021-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8424727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39418713","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}