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- Volume 2, Issue 3, 2001
Southern African Journal of HIV Medicine - Volume 2, Issue 3, 2001
Volumes & issues
Volume 2, Issue 3, 2001
Author Des MartinSource: Southern African Journal of HIV Medicine 2 (2001)More Less
Clinicians working in the field of HIV medicine welcome the accelerated treatment access programmes that are providing standard of care to HIV-infected individuals. This has occurred as a result of the dramatic price reduction of antiretroviral therapies. A vast amount of education is required to bring health care professionals in our country up to speed regarding the toxicities, drug interactions and other complexities inherent in the wider use of antiretroviral drugs.
Author Linda-Gail BekkerSource: Southern African Journal of HIV Medicine 2, pp 6 –7 (2001)More Less
News out of Africa is often bad, and certainly the HIV pandemic at present ravaging this continent must rate as one of the worst disasters of all time. However, even in the face of this disaster there have been glimmers of hope emanating out of this continent and other developing countries.
The right of access to information - some ramifications for the health sector : legal and ethical issuesAuthor Elsabe KlinckSource: Southern African Journal of HIV Medicine 2, pp 8 –9 (2001)More Less
The Promotion of Access to Information Act of 2000 (the Act) came into operation in March this year. The Act purports to give effect to the human right of access to information. It contains very detailed prescriptions on procedure, forms and types of access. It also sets time frames within which the person or institution holding information has to respond to a request for access to information. The Department of Justice administers the Act The Act overrides any other Act that provides for more restrictive access to information. In this regard concern has been expressed in relation to its suitability for the health sector and its relationship with the proposed National Health Bill.
Informed consent and HIV : a review of the topic with reference to the particular problems posed by the HIV pandemic : legal and ethical issuesAuthor Steve AndrewsSource: Southern African Journal of HIV Medicine 2, pp 10 –12 (2001)More Less
'Both the low and morality require that a health professional obtain a patient's voluntary, informed consent before providing medical treatment.'The above statement would seem to be a fairly uncontroversial one. Few health care professionals would argue with the need to obtain informed consent before intervening in any patient's life. The extent and meaning of the terms 'informed', and 'consent', however, cause significant debate. This paper will address a concept and definition of informed consent, and illustrate that schema with particular aspects of HIV-related problems in the application of the principle in day-to-day clinical practice. It is hoped that the arguments presented will alter the perception of informed consent as being a signature on a piece of paper legally indemnifying the professional from litigation, to one of a dynamic process vital in the strengthening of the ongoing doctor-patient relationship. Further, it should be seen as one of the tools for the breaking down of the terrible secrecy that surrounds this illness, and which hampers the effective use of available methodologies for prevention and treatment of HIV and AIDS.
Author Pierre SchoemanSource: Southern African Journal of HIV Medicine 2, pp 13 –18 (2001)More Less
The mutation rate in the HN genome is high because the HIV reverse transcriptase (Rn does not possess DNA 'proofreading' activity and is consequently highly error prone. During the synthesis of double-stranded DNA from the RNA template, mutations may appear owing to substitution of one nucleotide base for another, giving rise to amino acid substitutions in the viral protein for which the gene encodes. Insertions and deletions occur less commonly.
Diagnosis of perinatal HIV-1 infection in South Africa : recommendations for best practice under ideal and resource-constrained conditions : clinical guidelineSource: Southern African Journal of HIV Medicine 2, pp 21 –26 (2001)More Less
These guidelines for best practice under both ideal and resource-constrained conditions are intended to provide guidance for health care professionals on the laboratory diagnosis of HIV-1-infected and non-infected infants and young children. Resources, circumstances and decisions will differ across the wide range of clinical settings in South Africa.
Author Christopher C. RachanisSource: Southern African Journal of HIV Medicine 2, pp 27 –31 (2001)More Less
Very early on in the AIDS epidemic publications indicated that HIV infection is associated with a variety of oral lesions that often occur early in the course of the disease, and tend to increase in prevalence with the decline of the infected individual's immune function. In order to carry out proper epidemiological studies on the occurrence of these lesions a sound classification had to be constructed. In September 1992 members of the EC Clearinghouse on Oral Problems Related to HIV Infection met in London, together with members of the US Workshop on Oral Manifestations of HIV Infection, to review the previously published classification of the oral manifestations of HIV infection and their diagnostic criteria. A consensus was reached; the classification incorporated a group of oral lesions based on their frequency of occurrence.
Author Shabir A. MadhiSource: Southern African Journal of HIV Medicine 2, pp 32 –39 (2001)More Less
Lower respiratory tract infections (LRTI) are the leading cause of childhood morbidity and mortality in developing countries. The human immunodeficiency virus type 1 (HIV) epidemic has worsened the global burden of LRTI. Statistics from one South African hospital confirm the strong association between the two. Almost half [46%) of all children requiring hospitalisation for severe LRTI were HIV-infected, while these children accounted for 84% of all deaths from LRTI. There are also differences in the spectrum of pathogens causing LRTI in HIV-infected and uninfected children. This review describes the burden of severe LRTI in South African children and appraises the existing data on the potential for interventions to reduce both disease and mortality in these children.
Source: Southern African Journal of HIV Medicine 2, pp 40 –42 (2001)More Less
The current status of HIV/AIDS statistics for southern Africa highlights and elevates the plight of health care students, already burdened by the specific nature of their training under the peculiar circumstances now prevailing in South African hospitals and training centres. The everyday and repetitive encounter with the tragedy of HIV/AIDS may well evoke a dangerous and complacent attitude on the part of health care students and a possible non-coring ethos akin to HIV fatigue : Health educators and all members of this profession need to rise to this challenge and ensure health core quality in the age of a changing infectious disease status.
Source: Southern African Journal of HIV Medicine 2, pp 43 –45 (2001)More Less
The Foundation for Professional Development (FPD), the educational division of the South African Medical Association (SAMA), in association with the South African HIV Clinicians Society, a SAMA Special Interest Group, is offering a course in the management of HIV/AIDS conditions with the support of an educational grant.
Author Grant NapierSource: Southern African Journal of HIV Medicine 2 (2001)More Less
I would like to comment on the use of HIV tests with reference to the guideline published in this issue of the Journal (Diagnosis of perinatal HIV-1 infection in South Africa). While it is valid that the HIV-1 DNA PCR is considered the established test of choice for the diagnosis of perinatally acquired HIV infection, there are considerable differences in performance (sensitivity, specificity and reliability) between different HIV-1 DNA PCR assays. Commonly used 'home-brew' PCR assays are developed 'inhouse' by different laboratories and have different sensitivities, specificities and reliabilities. Performance may also vary from test to test as different reagent components are used.
Author D.H. WangSource: Southern African Journal of HIV Medicine 2 (2001)More Less
Source: Southern African Journal of HIV Medicine 2 (2001)More Less
Dr Steven Miller is a consultant in clinical microbiology and infectious disease in private practice in Johannesburg. He is medical director of Innovir Institute, an organisation providing state-of-the-art laboratory diagnostics, clinical trial opportunities and patient care services far persons with HIV/AIDS. Dr Miller is a graduate of the Witwatersrand University Medical School. Following a period of postgraduate training overseas in cardiothoracic surgery, he returned to Johannesburg and joined the South African Institute for Medical Research where he qualified as a clinical microbiologist. He was appointed associate professor of clinical microbiology in 1989, shortly before he entered private practice. Dr Miller's involvement in HIV medicine and research dates back to 1984 when he helped to establish the HIV Clinic at the Johannesburg Hospital. Since then he has lectured and published widely on HIV infection and has served on a number of local and national AIDS planning committees. He is a founder member of the HIV Clinicians' Society of Southern Africa and is chairman of its Treatment Guidelines Committee. He has been principal investigator of several international collaborative clinical trials and continues to play an active role in clinical research.