Southern African journal of HIV medicine最新文献

{"title":"Adult vaccination in people living with HIV attending a tertiary centre infectious diseases clinic.","authors":"Mitchell T Muchichwa, Lyle W Murray, Sarah Stacey, Charles Feldman","doi":"10.4102/sajhivmed.v27i1.1819","DOIUrl":"https://doi.org/10.4102/sajhivmed.v27i1.1819","url":null,"abstract":"<p><strong>Background: </strong>People living with HIV (PLWH) are at increased risk of acquiring vaccine-preventable diseases and of developing severe illness because of their underlying immunodeficiency. Despite this risk, vaccination coverage remains low among these patients. International and local guidelines exist to address immunisation recommendations in PLWH, but evidence on adherence, knowledge, and attitudes toward vaccination in this population remain limited.</p><p><strong>Objectives: </strong>The aim of the study was to investigate vaccination uptake, knowledge, and acceptance among PLWH.</p><p><strong>Method: </strong>Interviews and retrospective file reviews were undertaken among PLWH attending the Charlotte Maxeke Johannesburg Academic Hospital Infectious Diseases Clinic from 01 June 2023 to 30 June 2023.</p><p><strong>Results: </strong>A total of 107 PLWH were interviewed, of whom 72 were women (67.3%), with a mean age of 47 years. Most (76.6%) had a prior history of tuberculosis. Overall, 24.3% had received at least one vaccine after their HIV diagnosis, of which influenza was the most common (76.9%). Only four vaccines, namely those against influenza, hepatitis B, herpes zoster and pneumococcus, were known to, or had been received by, the patients. While 65% believed vaccines could prevent disease, and 41.1% thought they could be harmful, notably 67.2% were willing to accept a vaccine if recommended by a healthcare provider.</p><p><strong>Conclusion: </strong>Our study revealed low vaccination rates amongst PLWH in Johannesburg, South Africa, specifically regarding guidelines from the South African HIV Clinicians Society. Increased awareness of the influenza vaccine and direct recommendations from healthcare providers were key factors linked to vaccine uptake.</p>","PeriodicalId":94212,"journal":{"name":"Southern African journal of HIV medicine","volume":"27 1","pages":"1819"},"PeriodicalIF":2.3,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13636416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149121117","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}

{"title":"Ethical considerations and the social context of HIV phylogenetic research in uMkhanyakude district, KwaZulu-Natal, South Africa.","authors":"Rujeko Samanthia Chimukuche, Thembelihle Zuma, Qinisile Shandu, Manono Luthuli, Dumisani Gumede, Janet Seeley","doi":"10.4102/sajhivmed.v27i1.1826","DOIUrl":"10.4102/sajhivmed.v27i1.1826","url":null,"abstract":"<p><strong>Background: </strong>HIV phylogenetic analyses provide insights into genetic relatedness and transmission patterns but cannot directly identify specific transmission events or the direction of transmission. However, if not well understood and handled carefully, phylogenetic results have the potential to harm individuals and groups.</p><p><strong>Objectives: </strong>The study aimed to explore the ethical considerations and the social context of HIV phylogenetic research.</p><p><strong>Method: </strong>A qualitative methods study on phylogenetics was embedded within a clinical trial on community-based biosocial HIV prevention and sexual reproductive health for youth in rural KwaZulu-Natal, South Africa. Data collection was conducted over an 8-week period using in-depth interviews. Data were audio-recorded and translated verbatim and transcribed into English in anonymised format. Data were later analysed thematically. Four themes were identified: perceived benefits of phylogenetics, informed consent, participant privacy and data security and social risks.</p><p><strong>Results: </strong>Participants acknowledged the benefits of using phylogenetics in HIV research highlighting the importance of identifying transmission pathways in high prevalence settings. However, consideration should be given to community members with informed consent required.</p><p><strong>Conclusion: </strong>Ethical care is necessary in HIV phylogenetic research. Strong ethical and rights-based frameworks that facilitate prevention strategies while respecting the rights and interests of individuals and minimising any risks are required.</p>","PeriodicalId":94212,"journal":{"name":"Southern African journal of HIV medicine","volume":"27 1","pages":"1826"},"PeriodicalIF":2.3,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13636421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149121170","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}

{"title":"Adherence thresholds of tenofovir diphosphate in dried blood spots for HIV treatment and pre-exposure prophylaxis: A scoping review.","authors":"Mohammed K Alghamdi, Mohammed W Ali, Anel Schoonees, Tamara Kredo, Eric Decloedt, Roland van Rensburg","doi":"10.4102/sajhivmed.v27i1.1829","DOIUrl":"https://doi.org/10.4102/sajhivmed.v27i1.1829","url":null,"abstract":"<p><strong>Background: </strong>Tenofovir (TFV) is a key antiretroviral used in HIV pre-exposure prophylaxis (PrEP) and treatment, with efficacy contingent on adherence. Quantifying TFV concentrations in dried blood spots (DBS) as tenofovir diphosphate (TFV-DP) is a robust method for determining long-term adherence. However, standardised TFV-DP adherence thresholds in DBS have not been established.</p><p><strong>Objectives: </strong>To map the existing literature on TFV-DP concentration thresholds in DBS for assessing adherence to TFV-based HIV prevention and treatment, and to identify evidence gaps.</p><p><strong>Method: </strong>We conducted a scoping review in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. Eight electronic databases were searched for studies reporting TFV-DP concentrations in DBS in relation to adherence thresholds or clinical outcomes for TFV-based PrEP or antiretroviral therapy (ART). Pharmacokinetic simulation or modelling studies used as reference benchmarks were included. Data were screened and extracted by two independent reviewers. We conducted descriptive analysis, tabulating findings.</p><p><strong>Results: </strong>Twenty-two studies were included. TFV-DP adherence thresholds for PrEP and treatment varied widely, from ≥ 650 fmol/punch to ≥ 1850 fmol/punch, reflecting differences in study design, populations and ART formulations. Reference studies defined adherence threshold as ≥ 700 fmol/punch for four doses/week. PrEP studies reported TFV-DP concentrations of 993-1173 fmol/punch for 4-7 doses/week, indicating that the reference threshold was conservative. In treatment studies, concentrations ≥ 1250 fmol/punch were associated with virological suppression, whereas concentrations < 800 fmol/punch were linked to an increased risk of viraemia.</p><p><strong>Conclusion: </strong>This review of TFV-DP in DBS for HIV PrEP and treatment supports purpose- and population-specific thresholds and highlights the need for further threshold validation to optimise PrEP and treatment strategies.</p>","PeriodicalId":94212,"journal":{"name":"Southern African journal of HIV medicine","volume":"27 1","pages":"1829"},"PeriodicalIF":2.3,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13636424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149121200","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}

{"title":"Rapid review of gender-affirming healthcare for children and adolescents: Evidence synthesis (2021-2025) and recommendations for South Africa.","authors":"Ingrid Lynch, K L Dunkle, Chris McLachlan, Pierre Brouard, Landa Mabenge, Sakhile Msweli, Liberty Matthyse, Marion Stevens, Robin Dyers, Jenna-Lee de Beer-Procter, Kevin Adams, W D Francois Venter, Elma de Vries","doi":"10.4102/sajhivmed.v27i1.1800","DOIUrl":"10.4102/sajhivmed.v27i1.1800","url":null,"abstract":"<p><strong>Background: </strong>Since the publication of the Southern African HIV Clinicians Society Gender-Affirming Healthcare (GAHC) Guideline in 2021, global evidence on care for transgender and gender-diverse (TGD) youth has expanded. An updated, locally grounded, evidence-informed assessment of health outcomes can support South African stakeholders, particularly as both adolescents and TGD persons are populations of relevance to HIV prevention, sexual health, and integrated healthcare programmes in South Africa.</p><p><strong>Objectives: </strong>To synthesise global empirical evidence (2021-2025) across psychosocial, endocrine, surgical, policy, and non-medical gender-affirming interventions for TGD youth under 18, with attention to South Africa's social, legal, and health-system, and HIV-service delivery context.</p><p><strong>Method: </strong>A rapid review was conducted across 12 databases, supplemented by targeted searches for recent systematic reviews. Eligible sources comprised peer-reviewed empirical studies (<i>N</i> ≥ 5) reporting psychosocial or physical health outcomes of relevant interventions for TGD youth under 18 (or their families), and systematic or grey-literature reviews with reproducible methods. Findings were synthesised narratively by intervention domain.</p><p><strong>Results: </strong>The review included 200 primary studies, 29 academic systematic reviews, and four grey-literature reviews. Affirming psychosocial interventions were associated with reduced distress, anxiety and suicidality, and improved functioning and belonging. Puberty blockers and hormone therapy produced expected physiological outcomes under specialist care, with generally mild adverse events and stable or improved mental health. Restrictive policies were linked to poorer mental health, while protective policies improved outcomes. Most studies were small, observational, and Global North-focused.</p><p><strong>Conclusion: </strong>Evidence supports the safety and effectiveness of GAHC for TGD youth. Strengthening affirming care, timely clinical access, and protective policies in South Africa may improve healthcare engagement and support the delivery of integrated adolescent, sexual health, and HIV-related services for TGD youth.</p>","PeriodicalId":94212,"journal":{"name":"Southern African journal of HIV medicine","volume":"27 1","pages":"1800"},"PeriodicalIF":2.3,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148898358","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}

{"title":"Early outcomes of South African children with persistent viral non-suppression following switch to dolutegravir-based antiretroviral therapy.","authors":"Mila Guerrini, Minette Maré, Claire Hulsman, Leonore Greybe, Juanita Lishman, Clair Edson, Thania Hisham, Lisa Frigati, Helena Rabie","doi":"10.4102/sajhivmed.v27i1.1842","DOIUrl":"10.4102/sajhivmed.v27i1.1842","url":null,"abstract":"<p><strong>Background: </strong>Since 2019 dolutegravir-based antiretroviral therapy (ART) has been introduced for South African children and adolescents living with HIV (CALHIV), including those with persistent viral non-suppression. Current guidelines recommend the reuse of abacavir when switching CALHIV weighing < 30 kg with persistent viral non-suppression to dolutegravir-based ART.</p><p><strong>Objectives: </strong>We aimed to describe the viral suppression rates, clinical outcomes and risk factors for non-suppression in CALHIV switching to dolutegravir-based ART following persistent viral non-suppression.</p><p><strong>Method: </strong>We performed a retrospective cohort study at Tygerberg Hospital in Cape Town, South Africa.</p><p><strong>Results: </strong>We identified 39 children, 18 girls (46.2%). Median age at switch to a dolutegravir-based regimen was 7.2 years. Median duration on treatment pre-switch was 5.6 years. After switching to a dolutegravir-based regimen, 21 children (55.3%) achieved viral suppression. Abacavir was recycled with dolutegravir in 31 children (available viral load for 30/31) of whom 50.0% suppressed. Treatment interruptions were common, with 26 (66.7%) and 15 (38.5%) children experiencing at least one interruption in care before and after switching to a dolutegravir-based regimen, respectively.</p><p><strong>Conclusion: </strong>We provide evidence that recycling abacavir is safe in children with persistent viral non-suppression switching to dolutegravir. Supporting adherence and preventing therapy interruption is key to success.</p>","PeriodicalId":94212,"journal":{"name":"Southern African journal of HIV medicine","volume":"27 1","pages":"1842"},"PeriodicalIF":2.3,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148898352","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}

{"title":"Southern African HIV Clinicians Society guideline on doxycycline post-exposure prophylaxis to prevent bacterial sexually transmitted infections.","authors":"Katherine Gill, Sheetal Kassim, Adrian Brink, Sinead Delany-Moretlwe, Ahmad Haeri Mazanderani, Johan Hugo, Tendesayi Kufa-Chakezha, James McIntyre, Camilla Wattrus, Linda-Gail Bekker","doi":"10.4102/sajhivmed.v27i1.1844","DOIUrl":"10.4102/sajhivmed.v27i1.1844","url":null,"abstract":"","PeriodicalId":94212,"journal":{"name":"Southern African journal of HIV medicine","volume":"27 1","pages":"1844"},"PeriodicalIF":2.3,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148898361","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}

{"title":"Ten years on: Ongoing challenges in screening for cryptococcal antigenaemia in people with advanced HIV disease in South Africa.","authors":"Rhys Wenlock, Emily Prendergast, Kyla Murphy, Tshiamo Mmotsa, David Lawrence, Rudzani Mashau, Joseph Jarvis, Thomas Harrison, Síle Molloy, Nelesh Govender","doi":"10.4102/sajhivmed.v27i1.1788","DOIUrl":"10.4102/sajhivmed.v27i1.1788","url":null,"abstract":"<p><p>Screening for early asymptomatic cryptococcal antigenaemia is a crucial step in preventing symptomatic cryptococcal meningitis and reducing mortality among people with advanced HIV disease. However, even when early cryptococcal disease is detected, a significant number of people with advanced HIV disease still develop meningitis and die, suggesting barriers to care following a positive serum cryptococcal antigen result. Ten years after the initiation of a national screening programme in South Africa, we discuss progress and implementation challenges and highlight potential solutions identified through a clinical trial to reduce barriers to care for people with early cryptococcal disease. Analysing systems that care for individuals with early cryptococcal disease and creating interventions to optimise available resources are key steps in reducing HIV-associated cryptococcal disease mortality worldwide.</p>","PeriodicalId":94212,"journal":{"name":"Southern African journal of HIV medicine","volume":"27 1","pages":"1788"},"PeriodicalIF":2.3,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13444131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148687406","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}

{"title":"Not your usual drug-induced liver injury: Dolutegravir-associated granulomatous hepatitis.","authors":"Muhammed Vally, Muhammad Ayob, Adam Mahomed, Kairoonisha Mahomed, Washington Mudini, Vikash Lala","doi":"10.4102/sajhivmed.v27i1.1817","DOIUrl":"10.4102/sajhivmed.v27i1.1817","url":null,"abstract":"<p><p>Dolutegravir is an integrase inhibitor in first-line antiretroviral therapy in South Africa. We describe a patient who developed severe drug-induced liver injury on dolutegravir-containing antiretroviral treatment, in whom liver biopsy demonstrated subacute hepatic necrosis, non-necrotising granulomatous inflammation, and bile duct injury: an uncommon histological pattern in dolutegravir-associated hepatotoxicity.</p>","PeriodicalId":94212,"journal":{"name":"Southern African journal of HIV medicine","volume":"27 1","pages":"1817"},"PeriodicalIF":2.3,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13348393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148427670","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}

{"title":"The SAHCS gender-affirming healthcare guideline and the <i>Southern African Journal of HIV Medicine</i>: Scientific, ethical and editorial concerns.","authors":"Mark E Patrick","doi":"10.4102/sajhivmed.v27i1.1830","DOIUrl":"10.4102/sajhivmed.v27i1.1830","url":null,"abstract":"","PeriodicalId":94212,"journal":{"name":"Southern African journal of HIV medicine","volume":"27 1","pages":"1830"},"PeriodicalIF":2.3,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13347688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148427656","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}

{"title":"Southern African HIV Clinicians Society clinical guideline for the management of older people with HIV.","authors":"Evan Shoul, Nomathemba Chandiwana, Sathya Jogulu, Rene Krause, Coceka Mnyani, Zainab Mohamed, Jeremy S Nel, Sam Nightingale, Catherine Orrell, W D Francois Venter, Camilla Wattrus, Linda-Gail Bekker","doi":"10.4102/sajhivmed.v27i1.1809","DOIUrl":"10.4102/sajhivmed.v27i1.1809","url":null,"abstract":"","PeriodicalId":94212,"journal":{"name":"Southern African journal of HIV medicine","volume":"27 1","pages":"1809"},"PeriodicalIF":2.3,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13347707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148427603","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}