Southern African journal of HIV medicine最新文献

Incidence and risk factors of anaemia among people on antiretroviral therapy in Harare. 哈拉雷接受抗逆转录病毒治疗的人群中贫血的发生率和风险因素。

Southern African journal of HIV medicine Pub Date : 2024-08-30 eCollection Date: 2024-01-01 DOI: 10.4102/sajhivmed.v25i1.1605

Linda A Mandikiyana Chirimuta, Tinei Shamu, Cleophas Chimbetete, Chérie Part

{"title":"Incidence and risk factors of anaemia among people on antiretroviral therapy in Harare.","authors":"Linda A Mandikiyana Chirimuta, Tinei Shamu, Cleophas Chimbetete, Chérie Part","doi":"10.4102/sajhivmed.v25i1.1605","DOIUrl":"10.4102/sajhivmed.v25i1.1605","url":null,"abstract":"Background: Anaemia is associated with reduced quality of life and increased mortality risk among people living with HIV (PLHIV). Although antiretroviral therapy (ART) reduces the prevalence of anaemia, some patients remain at risk after commencing ART.Objectives: We estimated the incidence of anaemia after ART commencement and identified associated risk factors.Method: We analysed outpatient records at Newlands Clinic, Harare, Zimbabwe. Patients (≥ 5 years old) who were commenced on ART between January 2016 and December 2020 were included and were followed up for up to 2 years. Patients with anaemia at ART commencement and women who were pregnant at any time during follow-up were excluded. Cox proportional hazards regression was used to assess independent risk factors for anaemia.Results: During the study, 1110 patients ≥ 5 years old were commenced on ART with a prevalence of anaemia of 40.0%. Five hundred and twenty-nine patients met the inclusion criteria and were followed up for 823.7 person-years. The median age was 36.1 years and 290 (58.4%) were female. The incidence rate of anaemia after ART commencement was 176.1 per 1000 person-years (95% confidence interval [CI]: 149.6-207.2). Females (aHR: 2.09; 95% CI: 1.46-3.00, P < 0.001), zidovudine use (aHR: 3.50 96% CI: 2.14-5.71, P < 0.001), age 5-12 years or > 50 years, and the presence of World Health Organization stage III/IV disease (aHR: 2.19; 95% CI: 1.14-5.71, P = 0.019) had higher odds of developing anaemia.Conclusion: The incidence of anaemia after ART commencement was high. Female sex, zidovudine use, age and the presence of stage III/IV disease were independent risk factors for anaemia. Clinicians should screen PLHIV on ART regularly for anaemia.","PeriodicalId":94212,"journal":{"name":"Southern African journal of HIV medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11369551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Acceptability and performance of dual HIV/syphilis testing in male circumcision clients, 2021. 2021 年男性包皮环切术患者对艾滋病毒/梅毒双重检测的接受程度和效果。

Southern African journal of HIV medicine Pub Date : 2024-08-30 eCollection Date: 2024-01-01 DOI: 10.4102/sajhivmed.v25i1.1571

Tendesayi Kufa, Ocean Tobaiwa, Ewaldé Cutler, Beverley Singh, Zinhle Brukwe, Venessa Maseko, Erushka Pillay, Philip Dorrell, Khumbulani Moyo, Lindokuhle Zondi, Yogan Pillay, Sean Patrick, Adrian Puren

{"title":"Acceptability and performance of dual HIV/syphilis testing in male circumcision clients, 2021.","authors":"Tendesayi Kufa, Ocean Tobaiwa, Ewaldé Cutler, Beverley Singh, Zinhle Brukwe, Venessa Maseko, Erushka Pillay, Philip Dorrell, Khumbulani Moyo, Lindokuhle Zondi, Yogan Pillay, Sean Patrick, Adrian Puren","doi":"10.4102/sajhivmed.v25i1.1571","DOIUrl":"10.4102/sajhivmed.v25i1.1571","url":null,"abstract":"Background: Dual HIV/syphilis testing may be an acceptable intervention to identify men with sexually transmitted infections (STIs) and at risk of HIV acquisition.Objectives: We sought to determine the acceptability, and performance of dual HIV/syphilis testing among men attending voluntary medical male circumcision (VMMC) services at six public sector facilities in Gauteng.Method: This was a cross-sectional study at VMMC facilities. Men ≥ 18 years were enrolled. The men had (1) a questionnaire administered, (2) on-site dual HIV/syphilis testing with First Response HIV1+2/Syphilis Combo Card Test by routine lay counsellors, and (3) a blood specimen collected for centralised laboratory testing for HIV and syphilis serology. We evaluated pre-test and post-test acceptability and performance compared to serological testing.Results: Of the 679 men analysed (median age 32.1 years), 96.7% of HIV-negative men preferred testing for HIV and syphilis simultaneously. Of the 675 men tested for syphilis, 28 (4.7%) tested positive (past or recent). In the laboratory, 43/609 (7.1%) had syphilis infection detected, with 9/609 (1.5%) having recent syphilis. There was sub-optimal sensitivity for HIV detection (90.9%; 95% confidence interval [CI]: 88.5% - 93.3%), and for past/recent syphilis (55.8%; 95% CI: 51.9% - 59.8%), improving to 88.9% (95% CI: 86.4% - 91.4%) for recent syphilis. Specificities were > 99% for HIV and syphilis (past or recent). Post-test acceptability was 96.6% and willingness to pay for future testing was 86.1%.Conclusion: Dual HIV/syphilis testing was acceptable but had sub-optimal sensitivity for HIV and syphilis. Syphilis detection was adequate for recent infection.","PeriodicalId":94212,"journal":{"name":"Southern African journal of HIV medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11369610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Reducing medication errors in HIV-positive patients: Influence of a clinical pharmacist. 减少 HIV 阳性患者的用药错误：临床药剂师的影响。

Southern African journal of HIV medicine Pub Date : 2024-08-01 eCollection Date: 2024-01-01 DOI: 10.4102/sajhivmed.v25i1.1594

Elmien Bronkhorst, Michè Joseph-Busby, Selente Bezuidenhout

{"title":"Reducing medication errors in HIV-positive patients: Influence of a clinical pharmacist.","authors":"Elmien Bronkhorst, Michè Joseph-Busby, Selente Bezuidenhout","doi":"10.4102/sajhivmed.v25i1.1594","DOIUrl":"10.4102/sajhivmed.v25i1.1594","url":null,"abstract":"Background: The roll-out of antiretroviral medicines has improved life expectancy in people living with HIV (PLHIV). This has resulted in more patients being hospitalised for non-communicable diseases, increasing risk for medication errors (MEs). Pharmacists, through medication reconciliation, may identify and reduce MEs in this population.Objectives: To describe the importance of a pharmacist's involvement in identifying and quantifying types of MEs.Method: A quantitative, prospective observational study was conducted over 14 weeks. A pharmacist reviewed HIV-positive, hospitalised patients' files, using a data collection instrument, to determine the prevalence of MEs in PLHIV. The study pharmacist recommended appropriate actions to the prescriber to resolve MEs and documented resolution of the MEs.Results: The study population of n = 180 patient files were reviewed 453 times, identifying 466 MEs. Medication errors included incorrect medication reconciliation from history (19; 4.1%), prescription omission (17; 3.7%), duplication of therapy (10; 2.2%), missed doses (265; 57.1%), incorrect dosing (103; 22.2%), incorrect administration frequency (2; 0.4%), incorrect duration of therapy (15; 3.2%) and drug-drug interactions (18; 3.9%). More than half (58.2%) of the MEs were resolved in less than 24 h, with involvement of the pharmacist.Conclusion: This study demonstrates the magnitude of MEs experienced in hospitalised PLHIV and highlights the role clinical pharmacists play in identifying and resolving MEs to improve patient outcomes.","PeriodicalId":94212,"journal":{"name":"Southern African journal of HIV medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11369597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The rollout of paediatric dolutegravir and virological outcomes among children living with HIV in Mozambique. 莫桑比克儿科多鲁特韦的推广和感染艾滋病毒儿童的病毒学结果。

Southern African journal of HIV medicine Pub Date : 2024-07-31 eCollection Date: 2024-01-01 DOI: 10.4102/sajhivmed.v25i1.1578

Ivete Meque, Nicole Herrera, Amâncio Nhangave, Dórcia Mandlate, Rui Guilaze, Ana Tambo, Abdul Mussa, Nilesh Bhatt, Michelle M Gill

{"title":"The rollout of paediatric dolutegravir and virological outcomes among children living with HIV in Mozambique.","authors":"Ivete Meque, Nicole Herrera, Amâncio Nhangave, Dórcia Mandlate, Rui Guilaze, Ana Tambo, Abdul Mussa, Nilesh Bhatt, Michelle M Gill","doi":"10.4102/sajhivmed.v25i1.1578","DOIUrl":"10.4102/sajhivmed.v25i1.1578","url":null,"abstract":"Background: In 2022, Mozambique introduced Dolutegravir 10mg (pDTG), as part of paediatric antiretroviral therapy for children weighing < 20 kg. Understanding real-world challenges during national rollout can strengthen health systems in resource-limited settings.Objectives: We described the transition rate to, and new initiation of, pDTG, viral load suppression (VLS) post-pDTG, and factors associated with VLS among children living with HIV.Method: We conducted a retrospective cohort study involving children aged < 9 years and abstracted data from clinical sources. We used logistic regression to assess VLS and pDTG initiation predictors.Results: Of 1353 children, 1146 initiated pDTG; 196 (14.5%) had no recorded weight. Post-pDTG switch, 98.9% (950/961) of children maintained the same nucleoside reverse transcriptase inhibitor backbone. After initiating Abacavir/Lamivudine+pDTG, 834 (72.8%) children remained on the regimen, 156 (13.6%) switched off (majority to Dolutegravir 50mg), 22 (1.9%) had ≥ 2 anchor drug switches; 134 (11.7%) had no documented follow-up regimen. Factors associated with pDTG initiation or switch were younger age (adjusted odds ratio [AOR] = 0.71 [0.63-0.80]) and a recorded weight (AOR = 55.58 [33.88-91.18]). VLS among the 294 children with a viral load (VL) test after ≥ 5 months post-pDTG was 75.5% (n = 222/294). Pre-pDTG VLS rate among treatment-experienced children was 56.5% (n = 130/230). Factors associated with VLS were older age (AOR = 1.18 [1.03-1.34]) and previous VLS (AOR = 2.27 [1.27-4.06]).Conclusion: Most eligible children initiated pDTG per guidelines, improving post-pDTG VLS. Challenges included unexplained switches off pDTG after initiation, low VL coverage and inadequate documentation in clinic records.","PeriodicalId":94212,"journal":{"name":"Southern African journal of HIV medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11304402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141904094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A multidisciplinary approach for people with HIV failing antiretroviral therapy in South Africa 为南非抗逆转录病毒疗法失败的艾滋病毒感染者提供多学科方法

Southern African journal of HIV medicine Pub Date : 2024-07-22 DOI: 10.4102/sajhivmed.v25i1.1579

Parisha M. Juta, Juan M. Jansen van Vuuren, Kabamba J. Mbaya

{"title":"A multidisciplinary approach for people with HIV failing antiretroviral therapy in South Africa","authors":"Parisha M. Juta, Juan M. Jansen van Vuuren, Kabamba J. Mbaya","doi":"10.4102/sajhivmed.v25i1.1579","DOIUrl":"https://doi.org/10.4102/sajhivmed.v25i1.1579","url":null,"abstract":"Background: South Africa (SA) has the largest antiretroviral therapy (ART) programme worldwide. Multiple factors contribute to virological failure (VF), including poor adherence and viral resistance mutations. A multidisciplinary team (MDT) clinic dedicated to those with VF may be of benefit; however, very little data from SA exist.Objectives: To assess whether an MDT approach achieved virological suppression (VS) in patients failing second-line-ART (2LART); assess the number of MDT sessions required to achieve VS; assess local resistance mutation patterns and whether the MDT reduced the number of genotypic resistance testing (GRT) required.Method: An observational, retrospective, cross-sectional chart review study was conducted between January 2018 and December 2019 at a Target High Viral Load (VL) MDT clinic in KwaZulu-Natal, SA.Results: Ninety-seven medical records were eligible. Women accounted for 63% of patients, with a mean age of 37 years. A significant reduction in the first VL measurement following the MDT was seen (median reduction 2374 c/mL; P 0.001). This was maintained at the second VL measurement post-MDT (median reduction 2957 c/mL; P 0.001). Patients attended a mean of 2.71 MDT sessions and 73.2% achieved VS, resulting in 61.86% fewer GRTs required. Of the GRTs performed, nucleoside reverse transcriptase inhibitors and non-nucleoside reverse transcriptase inhibitor-related mutations were noted most frequently.Conclusion: The MDT approach resulted in a significant reduction in VL, with most participants achieving VS. The MDT was successful in reducing the need for GRT. Resistance mutations were similar to those found in other studies conducted across SA.","PeriodicalId":94212,"journal":{"name":"Southern African journal of HIV medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141816796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Knowledge and attitudes in the prevention of vertical transmission of HIV in referral hospitals. 转诊医院在预防艾滋病毒垂直传播方面的知识和态度。

Southern African journal of HIV medicine Pub Date : 2024-06-11 eCollection Date: 2024-01-01 DOI: 10.4102/sajhivmed.v25i1.1553

Patience D Magugu, Melissa A Lawler, Kimesh L Naidoo

{"title":"Knowledge and attitudes in the prevention of vertical transmission of HIV in referral hospitals.","authors":"Patience D Magugu, Melissa A Lawler, Kimesh L Naidoo","doi":"10.4102/sajhivmed.v25i1.1553","DOIUrl":"10.4102/sajhivmed.v25i1.1553","url":null,"abstract":"Background: Prevention of HIV vertical transmission programmes (VTPs) in South Africa has decreased paediatric HIV. These programmes require integration in referral hospitals.Objectives: To determine knowledge of and attitudes to the national VTP guidelines in staff from Obstetric and Paediatric disciplines at two referral hospitals.Method: Using a cross-sectional design, a questionnaire to assess knowledge of the guidelines and attitudes (awareness, ease-of-use and non-silo practice, measuring integrated practice) was developed and validated locally. Using standard statistical analyses, data from these questionnaires were used to draw comparisons and determine factors associated with knowledge and attitudes.Results: Of the 249 participants, 138 (55.4%) were in obstetrics, 125 (50.2%) were nurses, and 168 (67.5%) self-identified as junior staff. Knowledge scores were good, median score (Q1-Q3) was 91.7% (79.1-95.8), and higher in those who had discipline-specific training (P = 0.003). Junior staff (P = 0.002) had higher knowledge levels than senior staff. Most (80%) found the guidelines easy to use and had good awareness, which correlated with knowledge and training. Gaps included understanding of antenatal testing of HIV-negative women and timelines for neonatal HIV testing. Staff scored poorly on integrated practice; the median score (Q1-Q3) was 50% (33.3-58.3), which was inversely correlated with knowledge (r= -0.146, n = 249, P = 0.022).Conclusion: Staff in referral hospitals appear to be practising within silos when implementing VTPs, and this may result in failures to ensure integrated practice. Regularised interdisciplinary and interprofessional training may be important to ensure the integrated implementation of VTPs in referral hospitals.","PeriodicalId":94212,"journal":{"name":"Southern African journal of HIV medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11220426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141500058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Lived experience of people with cryptococcal meningitis: A qualitative study. 隐球菌脑膜炎患者的生活经历：定性研究。

Southern African journal of HIV medicine Pub Date : 2024-05-29 eCollection Date: 2024-01-01 DOI: 10.4102/sajhivmed.v25i1.1560

Neo A Legare, Vanessa C Quan, Nelesh P Govender, Jane W Muchiri

{"title":"Lived experience of people with cryptococcal meningitis: A qualitative study.","authors":"Neo A Legare, Vanessa C Quan, Nelesh P Govender, Jane W Muchiri","doi":"10.4102/sajhivmed.v25i1.1560","DOIUrl":"10.4102/sajhivmed.v25i1.1560","url":null,"abstract":"Background: The high burden of cryptococcal meningitis (CM) among people living with HIV persists despite widespread access to antiretroviral therapy. Efforts to prevent CM among people living with HIV could be hindered by a limited understanding of their lived experiences of CM and its diagnosis.Objectives: To explore and describe the experiences of people diagnosed with HIV-associated CM in routine care. Two public healthcare facilities in Johannesburg, South Africa.Method: This was a qualitative-methods exploratory, descriptive, phenomenological study. We conducted semi-structured, individual in-depth interviews with nine purposively sampled participants (comprising 5 men and 4 women). Data were analysed using the Moustakas phenomenological approach.Results: Five themes and several sub-themes emerged from the data. Participants described their experiences of being diagnosed, which were marked by intense headaches. Diagnosis of CM led to reduced quality of life, fear of death, and loss of income. Participants described their CM treatment experience and health-seeking behaviour including self-medication, seeking help from traditional healers and general practitioners and utilising public health facilities as a last resort. Barriers to care included negative healthcare workers' attitudes, unhealthy lifestyles, and poor knowledge of CM.Conclusion: People with HIV-associated CM face negative impacts prior to and after diagnosis. These patients struggled to access timely quality healthcare. Patients starting or restarting antiretroviral therapy, and thus at risk for CM, should receive CM education as part of HIV counselling.","PeriodicalId":94212,"journal":{"name":"Southern African journal of HIV medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11151364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141263689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Exploring factors hindering the uptake of HIV pre-exposure prophylaxis by potential users in Namibia 探索阻碍纳米比亚潜在用户接受艾滋病毒暴露前预防的因素

Southern African journal of HIV medicine Pub Date : 2024-05-21 DOI: 10.4102/sajhivmed.v25i1.1561

D. O. Ashipala

{"title":"Exploring factors hindering the uptake of HIV pre-exposure prophylaxis by potential users in Namibia","authors":"D. O. Ashipala","doi":"10.4102/sajhivmed.v25i1.1561","DOIUrl":"https://doi.org/10.4102/sajhivmed.v25i1.1561","url":null,"abstract":"Background: Pre-exposure prophylaxis (PrEP) is recommended for people who are at substantial risk of HIV infection, in conjunction with other HIV prevention tools and strategies. Unfortunately, the uptake of PrEP among potential users in Namibia’s Okongo district is low.Objectives: The objective of this study was to explore and describe the factors that hinder the uptake of HIV PrEP by potential users at the Okongo District Hospital in Namibia.Method: A qualitative exploratory, descriptive and contextual design was used. The study sought to understand the factors hindering uptake of HIV PrEP by potential users in the peri-urban setting of Okongo District Hospital, Namibia. Purposive sampling was used to select participants for this study, with qualitative data being gathered from semi-structured interviews with 20 potential PrEP users. The data were analysed using qualitative thematic analysis.Results: Participants reported numerous factors hindering uptake, including level of understanding, non-compliance on the part of the health department, distances, and attitudes. Additionally, participants maintained that health workers do not put enough effort into educating patients in the different hospital departments about PrEP, and sometimes there is insufficient stock of the medicine, both of which hinder PrEP uptake.Conclusion: Despite the PrEP rollout, multiple obstacles continue to hinder PrEP uptake, especially in the outskirts of Okongo district. This study recognises that there is a need to work hand in hand with the support systems of both potential users.","PeriodicalId":94212,"journal":{"name":"Southern African journal of HIV medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141114802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

How paediatric HIV services weathered the COVID-19 storm in Tshwane District, South Africa 南非茨瓦内地区的儿科艾滋病服务如何经受 COVID-19 风暴的考验

Southern African journal of HIV medicine Pub Date : 2024-05-20 DOI: 10.4102/sajhivmed.v25i1.1557

Michael Christie, A. H. Haeri Mazanderani, G. Sherman, U. Feucht

{"title":"How paediatric HIV services weathered the COVID-19 storm in Tshwane District, South Africa","authors":"Michael Christie, A. H. Haeri Mazanderani, G. Sherman, U. Feucht","doi":"10.4102/sajhivmed.v25i1.1557","DOIUrl":"https://doi.org/10.4102/sajhivmed.v25i1.1557","url":null,"abstract":"Background: The coronavirus disease 2019 (COVID-19) pandemic disrupted paediatric HIV services across South Africa. Shortly before COVID-19, updated national HIV guidelines were released.Objectives: This study describes COVID-19’s impact on paediatric HIV services in Tshwane District, South Africa.Method: A retrospective review of National Institute for Communicable Diseases and District Health Information System data for Tshwane District from April 2019 to March 2022. Data included: Early Infant Diagnosis (EID), HIV viral load (VL) and CD4 monitoring and HIV management among children ( 15 years) living with HIV (CLHIV). Pre-pandemic (2019/2020) and pandemic periods (2020/2021, 2021/2022) were compared.Results: Year-on-year, HIV testing improved at 10 weeks, 6 months, and 18 months, whereas birth testing decreased. HIV EID case rates were 485 (2019/2020), 410 (2020/2021) and 454 (2021/2022). HIV EID test positivity was 0.77% – 1.2%. Antiretroviral treatment initiation declined from 2019/2020 to 2020/2021, but improved in 2021/2022.Initial HIV VL and CD4 testing declined, with HIV VL testing increasing in 2021/2022, and CD4 testing further declining. HIV VL suppression rate among CLHIV ranged from 69% to 73%.Conclusion: Initially, COVID-19 resulted in reduced paediatric HIV services as children disengaged from care. Indicators eventually recovered to proximate pre-pandemic levels; however, compensatory increases did not occur. Thus, some children may not have returned to care.","PeriodicalId":94212,"journal":{"name":"Southern African journal of HIV medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141118880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Effect of dolutegravir on ferritin, iron, and C-reactive protein among people living with HIV and co-infections. 多罗替拉韦对艾滋病毒感染者和合并感染者铁蛋白、铁和 C 反应蛋白的影响。

Southern African journal of HIV medicine Pub Date : 2024-04-30 eCollection Date: 2024-01-01 DOI: 10.4102/sajhivmed.v25i1.1543

Bridget Kamurai, Raylton P Chikwati, Donald Vhanda, Terrence Nyamayaro, Justen Manasa, Vinie Kouamou

{"title":"Effect of dolutegravir on ferritin, iron, and C-reactive protein among people living with HIV and co-infections.","authors":"Bridget Kamurai, Raylton P Chikwati, Donald Vhanda, Terrence Nyamayaro, Justen Manasa, Vinie Kouamou","doi":"10.4102/sajhivmed.v25i1.1543","DOIUrl":"10.4102/sajhivmed.v25i1.1543","url":null,"abstract":"Background: Dolutegravir-based antiretroviral therapy (ART) is currently recommended as the preferred first-line ART in many resource-limited settings. However, little is known about the clinical experience of dolutegravir within a context of prevalent co-infections.Objectives: To assess virological outcomes, and iron, ferritin and C-reactive protein (CRP) levels among people living with HIV (PLWH) and co-infections after initiating or re-initiating dolutegravir-based ART.Method: This prospective study was conducted between August 2022 and August 2023. Study participants were recruited from an HIV opportunistic infection clinic. Screening for co-infections (syphilis, hepatitis B virus, cytomegalovirus and herpes simplex virus) was performed at baseline, prior to ART initiation. Plasma HIV viral load (VL), CRP, ferritin and iron levels were measured at baseline and at the 6-month follow-up period.Results: A total of 100 participants (51 women and 49 men) were enrolled in this study. The median age of the participants was 39 years. The prevalence of co-infections was 30%. Prior to ART initiation, participants with co-infections had higher VL, CRP and ferritin, and lower iron levels, compared to those without co-infections (P < 0.001). Following 6 months of ART, CRP and ferritin levels decreased while iron levels increased, regardless of co-infection status. However, CRP and ferritin remained significantly higher in those with co-infections despite similar and high rates of virologic suppression in both groups.Conclusion: The presence of co-infections in PLWH is associated with higher VL and with chronic inflammation. Ferritin and CRP decreased on dolutegravir-based ART but remained higher in people with co-infections despite similar rates of virologic suppression.","PeriodicalId":94212,"journal":{"name":"Southern African journal of HIV medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11079419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140900782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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