Southern African journal of HIV medicine最新文献

{"title":"Social support experiences of adolescents living with perinatal HIV in rural Limpopo, South Africa","authors":"R. A. Mabasa, L. Skaal, T. Mothiba","doi":"10.4102/sajhivmed.v25i1.1521","DOIUrl":"https://doi.org/10.4102/sajhivmed.v25i1.1521","url":null,"abstract":"","PeriodicalId":94212,"journal":{"name":"Southern African journal of HIV medicine","volume":" 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140210017","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}

{"title":"Effects of the COVID-19 pandemic on early infant diagnosis of HIV in Cape Town, South Africa","authors":"Hendrike Van Vollenhoven, E. Kalk, Stuart M. Kroon, Tafadzwa Maseko, F. Phelanyane, J. Euvrard, Lezanne Fourie, Nicolene Le Roux, P. Nongena","doi":"10.4102/sajhivmed.v25i1.1542","DOIUrl":"https://doi.org/10.4102/sajhivmed.v25i1.1542","url":null,"abstract":"Background: In South Africa, infants who are HIV-exposed are tested for HIV at birth and 10 weeks of age. The COVID-19 pandemic lockdown restrictions resulted in reduced access to healthcare services and uncertain impact on early infant HIV testing.Objectives: To describe the effects of the COVID-19 pandemic lockdown restrictions on early infant HIV testing and diagnosis in Cape Town, South Africa.Method: This retrospective cohort study compares HIV-exposed infants born during the first COVID-19 pandemic lockdown (2020) to those born in the same period the year before (2019). Laboratory and other data were abstracted from the Provincial Health Data Centre.Results: A total of 2888 infants were included: 1474 born in 2020 and 1413 in 2019. Compared to 2019, there was an increase in the 10-week HIV polymerase chain reaction (PCR) uptake in 2020 (71% vs. 60%, P 0.001). There was also an increase in the proportion of infants who demised without 10-week testing or were lost to follow-up in 2020 compared to 2019 (8% vs. 5%, P = 0.017). Differences detected in birth HIV PCR positivity rates between the two groups (1.1% vs. 0.5%, P = 0.17) did not reach statistical significance; however, a significant increase in vertical transmission of HIV by 10 weeks old was found in the 2020 cohort (1.2% vs. 0.5%. P = 0.046).Conclusion: Vertical transmission of HIV at 10 weeks increased in the Cape Town Metropolitan during the initial COVID-19 lockdown. There was also an increase in the proportion of deaths without testing by 10 weeks in the 2020 group.","PeriodicalId":94212,"journal":{"name":"Southern African journal of HIV medicine","volume":"269 10‐13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140233527","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}

{"title":"Retrospective review of maternal HIV viral load electronic gatekeeping codes in South Africa.","authors":"Siphesihle K Mahanjana, Tladi Ledibane, Gayle G Sherman, Tanya Y Murray, Ahmad F Haeri Mazanderani","doi":"10.4102/sajhivmed.v25i1.1539","DOIUrl":"10.4102/sajhivmed.v25i1.1539","url":null,"abstract":"<p><strong>Background: </strong>Maternal electronic gatekeeping (eGK) codes for HIV viral load (VL) testing of pregnant and breastfeeding women were developed to permit increased frequency of maternal HIV VL testing without automated gatekeeping cancellation, and to enable virological surveillance.</p><p><strong>Objectives: </strong>This study describes the national uptake of maternal eGK codes and VL suppression (VLS) rates disaggregated by age during antenatal, delivery and postnatal periods in South Africa during 2022.</p><p><strong>Method: </strong>HIV VL tests associated with C#PMTCT (used for antenatal and postnatal testing) and C#DELIVERY (used at delivery) eGK codes between 01 January and 31 December 2022, were extracted from the National Institute for Communicable Diseases Data Warehouse. Uptake of eGK codes was calculated using indicators from the District Health Information System as denominators while HIV VLS rates (< 1000 copies/mL) were calculated as monthly and annual percentages.</p><p><strong>Results: </strong>Overall, national maternal eGK code uptake was 41.8%, 24.5% and 0.12% for the antenatal, delivery and postnatal periods, respectively. The monthly antenatal eGK uptake increased from 27.5% to 58.5% while delivery uptake increased from 17.3% to 30.0%. The overall annual maternal HIV VLS rate was 86.7% antenatally and 87.2% during delivery. The monthly average HIV VLS for adolescent girls and young women (AGYW) was 76.1% antenatally and 79.6% during delivery.</p><p><strong>Conclusion: </strong>Although overall national uptake of maternal HIV VL eGK codes was low, antenatal and delivery uptake improved over time, thereby facilitating use of eGK codes for programmatic monitoring of maternal VLS rates for the first time. Quality of care among pregnant AGYW requires urgent attention.</p>","PeriodicalId":94212,"journal":{"name":"Southern African journal of HIV medicine","volume":"25 1","pages":"1539"},"PeriodicalIF":0.0,"publicationDate":"2024-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10913175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140041248","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":"Very low HIV positivity on paediatric surgical wards in Mozambique: Implications for inpatient provider-initiated testing programmes","authors":"Henriques Viola, Angela Bi, Dalva Khosa, Zacarias Mateus, Massada da Rocha, V. Amado, Atanásio Taela, Daniel A. DeUgarte, Andreas Schindele, W. Chris Buck","doi":"10.4102/sajhivmed.v25i1.1544","DOIUrl":"https://doi.org/10.4102/sajhivmed.v25i1.1544","url":null,"abstract":"","PeriodicalId":94212,"journal":{"name":"Southern African journal of HIV medicine","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139380057","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}

{"title":"Country ownership and sustainable programming of the HIV response in South Africa: A scoping review.","authors":"Refilwe N Phaswana-Mafuya, Edith Phalane, Haley Sisel, Lifutso Motsieloa, Katherine Journeay, Vuyiseka Dubula, Jabulile Sibeko, Pholokgolo Ramothwala","doi":"10.4102/sajhivmed.v24i1.1511","DOIUrl":"10.4102/sajhivmed.v24i1.1511","url":null,"abstract":"<p><strong>Background: </strong>Concerns have arisen regarding the extent to which South Africa's HIV response can be country-owned and sustainable given substantial foreign investment and technical support.</p><p><strong>Objectives: </strong>To assess the extent to which South Africa's national HIV response is country-owned.</p><p><strong>Method: </strong>We conducted a scoping review of South African literature using the Global Health Initiative Framework for country ownership.</p><p><strong>Results: </strong>South Africa has clear aspirations for what should be accomplished and strategies are aligned with national and international priorities. Although South Africa has leveraged community-based strategies to reach key populations (KPs), most are supported by international donors, which poses a sustainability challenge. Despite robust capacity strengthening and training programmes, South Africa continues to face healthcare worker shortages. While it is commendable that South Africa funds nearly 70% of the national HIV response, the funds mainly support HIV treatment. This may create dependency on international partners.</p><p><strong>Conclusion: </strong>South Africa appears to be progressing well along the spectrum of country ownership, but sustained efforts are required to combat HIV. Greater ownership over KP programming and prevention services are especially needed to achieve greater impact.</p>","PeriodicalId":94212,"journal":{"name":"Southern African journal of HIV medicine","volume":"24 1","pages":"1511"},"PeriodicalIF":0.0,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10696614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138500622","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":"Dolutegravir resistance in three pregnant and breastfeeding women in South Africa.","authors":"Ninke Fourie, Kate Rees, Denis Mali, Bridget Mugisa, Cara O'Connor, Natasha Davies","doi":"10.4102/sajhivmed.v24i1.1531","DOIUrl":"10.4102/sajhivmed.v24i1.1531","url":null,"abstract":"","PeriodicalId":94212,"journal":{"name":"Southern African journal of HIV medicine","volume":"24 1","pages":"1531"},"PeriodicalIF":0.0,"publicationDate":"2023-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10696620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138500623","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":"Confronting the human papillomavirus-HIV intersection: Cervical cytology implications for Kenyan women living with HIV.","authors":"James M Kangethe, Stephen Gichuhi, Eddy Odari, Jillian Pintye, Kenneth Mutai, Leila Abdullahi, Alex Maiyo, Marianne W Mureithi","doi":"10.4102/sajhivmed.v24i1.1508","DOIUrl":"10.4102/sajhivmed.v24i1.1508","url":null,"abstract":"<p><strong>Background: </strong>High-risk human papillomavirus (HR-HPV) is the primary cause of cervical cancer, leading to over 311 000 global deaths, mainly in low- and middle-income countries. Kenyan women living with HIV (WLHIV) face a disproportionate burden of HR-HPV.</p><p><strong>Objectives: </strong>We determined the prevalence of HR-HPV infections and their association with cervical cytology findings among Kenyan WLHIV.</p><p><strong>Method: </strong>We conducted a cross-sectional study among WLHIV attending the HIV care and treatment clinic at the Kenyatta National Hospital (KNH), Kenya's national referral hospital. Study nurses collected a cervical sample with a cytobrush for HR-HPV genotyping using Gene Xpert^® assays and HPV Genotypes 14 Real-TM Quant V67-100FRT. Bivariate analysis explored the associations.</p><p><strong>Results: </strong>We enrolled 647 WLHIV (mean age of 42.8 years), with 97.2% on antiretroviral therapy (ART) and 79% with a suppressed viral load (< 50 copies/mL plasma). The prevalence of any and vaccine-preventable HR-HPV was 34.6% and 29.4%, respectively, with HPV 52 being the most common genotype (13.4%). Among WLHIV with HR-HPV infections, 21.4% had abnormal cervical cytology. Women with multiple HR-HPV infections were more likely to have abnormal cytology compared to those with single HR-HPV infections (34.9 vs 9.3%, adjusted odds ratio [aOR] = 6.2, 95% confidence interval [CI]: 2.7-14.1, <i>P</i> = 0.001). Women with HR-HPV infection (single or multiple) were more likely to be on the second-line ART regimen compared to those without HR-HPV infections (53.1% vs 46.7%, aOR = 2.3, 95% CI: 1.3-4.1, <i>P</i> = 0.005).</p><p><strong>Conclusion: </strong>Among WLHIV at KNH, abnormal cytology was common and more frequent among women with multiple HR-HPV infections.</p>","PeriodicalId":94212,"journal":{"name":"Southern African journal of HIV medicine","volume":"24 1","pages":"1508"},"PeriodicalIF":0.0,"publicationDate":"2023-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10623654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71490681","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":"Thrombotic thrombocytopaenic purpura in the era of HIV: A single-centre experience.","authors":"Yusuf Moola,&nbsp;Zaheera Cassimjee,&nbsp;Chandni Dayal,&nbsp;Sheetal Chiba,&nbsp;Adekunle Ajayi,&nbsp;Malcolm Davies","doi":"10.4102/sajhivmed.v24i1.1504","DOIUrl":"https://doi.org/10.4102/sajhivmed.v24i1.1504","url":null,"abstract":"<p><strong>Background: </strong>Thrombotic thrombocytopaenia purpura (TTP) is a rare disorder which carries a high mortality. HIV is an important cause of TTP.</p><p><strong>Objectives: </strong>We assessed the presentation and response to plasma exchange (PEX) by HIV status.</p><p><strong>Method: </strong>A single-centre retrospective review of all patients receiving PEX for TTP between 01 January 2010 and 31 December 2019 was undertaken. Demographics and presenting parameters were compared between HIV-associated TTP and other aetiologies using Mann-Whitney <i>U</i> and Kruskal Wallis analysis of variance testing, as appropriate. The effect of aetiology and presenting parameters on PEX duration was modelled using Cox proportional hazards; effect of these variables on mortality and residual renal dysfunction in survivors was analysed using stepwise multivariate regression.</p><p><strong>Results: </strong>Uncontrolled HIV infection was the commonest cause (81.9%) of TTP in the 83 patients identified. Thrombocytopaenia was more severe and neurological deficit more frequent in HIV-associated TTP; but renal dysfunction was milder in this group. Aetiology did not influence mortality risk. Aetiological category and presenting parameters did not predict PEX duration. Residual renal dysfunction was less frequent in survivors of HIV-associated TTP.</p><p><strong>Conclusion: </strong>HIV is an important cause of TTP in the local context. Haematological and neurological involvement are more severe in HIV-associated TTP. Acceptable survival rates are achievable with PEX even in advanced HIV infection; renal sequalae are less common in this group.</p>","PeriodicalId":94212,"journal":{"name":"Southern African journal of HIV medicine","volume":"24 1","pages":"1504"},"PeriodicalIF":0.0,"publicationDate":"2023-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10623642/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71490683","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":"No increased in utero and peripartum HIV acquisition risk in HIV-exposed preterm infants.","authors":"Gbolahan Ajibola, Charlotte Mdluli, Kara Bennett, Maureen Sakoi, Oganne Batlang, Joseph Makhema, Shahin Lockman, Roger Shapiro, Landon Myer, Kathleen Powis","doi":"10.4102/sajhivmed.v24i1.1509","DOIUrl":"10.4102/sajhivmed.v24i1.1509","url":null,"abstract":"<p><strong>Background: </strong>Limited data exist on the differential risk of HIV acquisition between infants born preterm versus those born at term to women living with HIV (WLHIV). With a reported increase in preterm delivery among pregnant WLHIV, understanding the risk of vertical transmission of HIV in preterm infants can inform strategies to optimise the timing of diagnostic testing, antiretroviral prophylaxis, and infant feeding.</p><p><strong>Objectives: </strong>To describe the prevalence and timing of HIV acquisition, in utero versus perinatal, among infants with perinatal HIV exposure born prior to 37 weeks completed gestation age compared to those born at term in the Botswana-based Mpepu study and explore predictors of infant HIV acquisition.</p><p><strong>Method: </strong>Using data extracted from the Mpepu study, we describe the prevalence, timing and risk factors for HIV acquisition in infants born preterm versus those born at term. Fisher exact testing was used to test for differences in prevalence and timing of HIV and a multivariable logistic regression model was used to assess risk factors for infant HIV acquisition.</p><p><strong>Results: </strong>2866 infants born to WLHIV were included in this secondary analysis. 532 (19%) were born preterm. There was no observed difference in the prevalence of HIV acquisition among infants born preterm versus at term overall (0.8% vs 0.6%, <i>P</i> = 0.54), at birth (0.2% vs 0.3%, <i>P</i> = 1.00) or between 14 and 34 days post-delivery (0.6% vs 0.3%, <i>P</i> = 0.41). The absence of maternal antiretroviral use during pregnancy significantly predicted infant HIV acquisition, with the risk of HIV acquisition reduced by 96% among infants whose mothers were taking antiretroviral treatment (ART) during pregnancy (adjusted odds ratio: 0.003, confidence interval: 0.01-0.02, <i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>There was no observed increase of in utero and peripartum HIV acquisition among infants born preterm following foetal exposure to HIV compared to those born at term.</p>","PeriodicalId":94212,"journal":{"name":"Southern African journal of HIV medicine","volume":"24 1","pages":"1509"},"PeriodicalIF":0.0,"publicationDate":"2023-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10623649/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71490682","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":"2023 Southern African HIV Clinicians Society Adult Antiretroviral Therapy Guidelines: What's new?","authors":"Jeremy Nel, Camilla Wattrus, Regina Osih, Graeme Meintjes","doi":"10.4102/sajhivmed.v24i1.1528","DOIUrl":"10.4102/sajhivmed.v24i1.1528","url":null,"abstract":"","PeriodicalId":94212,"journal":{"name":"Southern African journal of HIV medicine","volume":"24 1","pages":"1528"},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10546902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41151672","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}