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- Volume 2005, Issue 20, 2005
Southern African Journal of HIV Medicine - Volume 2005, Issue 20, 2005
Volumes & issues
Volume 2005, Issue 20, 2005
Author Lynn MorrisSource: Southern African Journal of HIV Medicine 2005 (2005)More Less
Extracted from text ... THE SOUTHERN AFRICAN JOURNAL OF HIV MEDICINE SEPTEMBER 2005 3 I am delighted that this edition of the Southern African Journal of HIV Medicine has been devoted to covering some of the highlights of the 2nd South African AIDS Conference, held at the International Convention Centre in Durban on 7 - 10 June 2005. The Conference attracted close to 4 000 participants from all sectors, including National Government, business, civil society, academia, journalists, activists, health care workers, social workers, clinicians, community workers and people living with HIV. The theme of the Conference was Unity and Accountability, and this permeated through ..
Author Mamphela RampheleSource: Southern African Journal of HIV Medicine 2005, pp 5 –8 (2005)More Less
Extracted from text ... THE SOUTHERN AFRICAN JOURNAL OF HIV MEDICINE SEPTEMBER 2005 H O R I Z O N S HIV/AIDS: THE MIRROR IN SOUTH AFRICA'S FACE Let us open with Nkosi Johnson's words of wisdom: 'I want people to understand about AIDS - to be careful and respect AIDS - you can't get AIDS if you touch, hug, kiss, hold hands with someone who is infected. Care for us and accept us - we are human beings. We are normal. We have hands. We have feet. We can walk, we can talk, we have needs just like everyone else - don't ..
Source: Southern African Journal of HIV Medicine 2005, pp 10 –17 (2005)More Less
Extracted from text ... SEPTEMBER 2005 THE SOUTHERN AFRICAN JOURNAL OF HIV MEDICINE 10 Track 1: Basic and clinical sciences G J Churchyard1, 2, C Metcalf1 1Aurum Health Research and 2University of KwaZulu-Natal, Durban Track 1 covered basic and clinical sciences. Highlights from the sessions on mother-to-child transmission (MTCT), paediatric HIV infection and treatment, HIV vaccines and pathogenesis, and adult HIV infection and treatment are summarised below. MOTHER-TO-CHILD TRANSMISSION Globally about half of all adults living with HIV are women and 2.5 million children are infected with HIV. Approximately 90% of the children infected with HIV live in Africa. In South Africa there are ..
Source: Southern African Journal of HIV Medicine 2005 (2005)More Less
Extracted from text ... THE SOUTHERN AFRICAN JOURNAL OF HIV MEDICINE SEPTEMBER 2005 17 To the Editor: The National Government launched the Operational Plan for Comprehensive HIV and AIDS Care, Management and Treatment for South Africa in November 2003. This is one of the most ambitious programmes in the world. In a consultative process with both local and international experts on HIV management a first-line and second-line regimen were chosen. With the drugs that were then available there is little doubt that the best choices were made. Stavudine is in the first line. At Helen Joseph Hospital, the first patients were initiated onto ..
Source: Southern African Journal of HIV Medicine 2005, pp 18 –21 (2005)More Less
Extracted from text ... SEPTEMBER 2005 THE SOUTHERN AFRICAN JOURNAL OF HIV MEDICINE 18 The advent of HAART (highly active antiretroviral therapy) has revolutionised the treatment of HIV, with both patients and physicians enjoying the resultant increases in both quality and quantity of life. A wide variety of drugs are now available for use in the treatment of HIV, allowing individuals the choice of effective therapy, and enabling them to switch to therapies that are easier to comply with and less toxic drugs. Antiretroviral agents are divided into five main classes - nucleoside reverse transcriptase inhibitors (NRTIs), nucleotide reverse transcriptase inhibitors (NtRTIs), non-nucleoside reverse ..
Author W.D. Francois VenterSource: Southern African Journal of HIV Medicine 2005, pp 21 –28 (2005)More Less
Extracted from text ... THE SOUTHERN AFRICAN JOURNAL OF HIV MEDICINE SEPTEMBER 2005 21 PLENARY: NATIONAL TREATMENT PROGRAMME A critical evaluation of the South African state antiretroviral programme W D Francois Venter Reproductive Health and HIV Research Unit (RHRU), University of the Witwatersrand, Johannesburg The South African Department of Health (DoH) has a Comprehensive Plan comprising all components required for the prevention, treatment and care of HIV-infected children and adults. On 1 April 2004, the antiretroviral element of the Comprehensive Plan, so obviously lacking, was added to this jigsaw of components. In so doing, the DoH initiated probably the most complex, expensive and ambitious ..
Author Fatima HassanSource: Southern African Journal of HIV Medicine 2005, pp 28 –30 (2005)More Less
Extracted from text ... SEPTEMBER 2005 THE SOUTHERN AFRICAN JOURNAL OF HIV MEDICINE 28 At the opening of the 2nd SA AIDS Conference, Dr Mamphele Ramphele stressed and warned that our approach to human rights must be premised on recognising the constitutional right to dignity and freedom. This is a timely reminder given the historical context of widespread abuse of and discrimination against people living with HIV/AIDS. My paper focuses on four key areas where human rights protections and a rights based approach are most at stake - where the potential for human rights violations are the greatest. First, scaling up voluntary counselling and ..
Author Nicoli NattrassSource: Southern African Journal of HIV Medicine 2005, pp 30 –32 (2005)More Less
Extracted from text ... SEPTEMBER 2005 THE SOUTHERN AFRICAN JOURNAL OF HIV MEDICINE 30 PLENARY: ECONOMICS AIDS, Unemployment and Disability in South Africa: The Case for Welfare Reform Nicoli Nattrass AIDS and Society Research Unit, Centre for Social Science Research, University of Cape Town South Africa is facing a dual crisis of AIDS and unemployment.1 According to the ASSA2002 demographic model, by 2005 19% of adults (and 11% of all South Africans) were HIV-positive. This amounts to a socioeconomic crisis of significant proportions. AIDS undermines the economic security of households by reducing the productivity of (and eventually killing) mainly prime-age adults while simultaneously ..
Source: Southern African Journal of HIV Medicine 2005, pp 33 –35 (2005)More Less
This article summarises three of the presentations made at a TB symposium at the recent 2nd South African AIDS Conference in Durban. <BR>HIV infection is the most potent risk factor for active tuberculosis (TB) and and as a result TB has become the leading lifethreatening opportunistic infection. In addition it has changed the epidemiology of TB in high HIV prevalence settings; HIV makes the diagnosis of TB more difficult and is associated with a far higher risk of death. Preventive treatment regimens in HIV-infected adults have been shown to be efficacious and cost effective but their widespread implementation is hampered by poor adherence, concerns about development of resistance and the potential burden to the TB control programme. Results of adult cohort studies suggest that antiretroviral treatment has a powerful preventive effect on active TB; however, successful ARV treatment does not restore immune function and TB risk to levels seen in HIV-uninfected adults. Novel strategies are therefore urgently needed to combat TB in high HIV prevalence settings.
Author Clive GraySource: Southern African Journal of HIV Medicine 2005, pp 36 –38 (2005)More Less
An HIV vaccine symposium was organised for the third day of the 2nd South African AIDS Conference in Durban. The focus was to:<UL> <LI>outline the challenges of developing preventive HIV vaccines, and</LI> <LI>summarise some of the scientific advances in making preventive HIV vaccines for South Africa and strategies for designing novel vaccine candidates and measuring responses to them.</LI></UL>
Source: Southern African Journal of HIV Medicine 2005, pp 38 –41 (2005)More Less
Laboratory monitoring of HIV / AIDS represents a significant challenge to any Third-World country where the total cost of disease monitoring may in fact exceed their annual health budget. Many obstacles are noted in the provision of affordable and accessible laboratory diagnosis and monitoring of HIV / AIDS in a resource-poor setting. These include lack of or poor laboratory infrastructure, absence of technical skills, and more specifically absent or poor laboratory management skills. Reagent costs are generally high and large capital outlay for sophisticated equipment is required. Facilitating informed decision-making for implementation of the appropriate technology is therefore essential. The wide array of technologies available for CD4 and viral load monitoring, in particular, pose significant dilemmas for laboratories initiating such programmes. Potential laboratory sites are flooded with information and literature and seldom have the infrastructure or funds to complete validations of optional methodologies before implementation. <BR>The objectives of this session were to introduce participants to technologies available for monitoring of HIV with particular reference to resource-poor settings and to highlight particular technologies currently in the research and development phase that may have relevance in future implementation strategies. The panel comprised a team of local researchers in the field (Professors Stevens, Glencross and Sherman, Ms Rekhviashvili and Ms Wallis) with an international perspective on the field of HIV viral load monitoring provided by Dr Susan Fiscus, a virologist representing the University of North Carolina and the Forum for Collaborative HIV Research in Washington, DC. Dr Terry Marshall, responsible for the laboratory component of the South African National ARV Rollout Programme, presented the progress of this implementation to date.
Treatment and research options for paediatric HIV infection in South Africa : towards improving careSource: Southern African Journal of HIV Medicine 2005, pp 42 –44 (2005)More Less
This satellite meeting at the 2nd South African AIDS Conference was organised to facilitate and inspire paediatric networking opportunities within South Africa and Africa. The meeting was a collaborative venture between recipients of the Elizabeth Glaser Pediatric AIDS Foundation International Leadership Award (Clive Gray and Tammy Meyers), the African Network for the Care of Children Affected by AIDS (ANECCA) and the Institute of Healthcare Improvement (IHI). The treatment needs of many HIV-infected children in South Africa are not being met, the antiretroviral rollout for children lags behind that of adults, and there are many unanswered clinical and scientific questions that should be addressed by local researchers and scientists to improve paediatric care. The overall purpose of this satellite meeting was to introduce clinical and research networks that are working towards improving the care for HIV-infected children in Africa. More specifically, the objectives of the meeting were:<UL> <LI>to promote awareness of paediatric networks functioning in Africa</LI> <LI>to link seemingly disparate areas of knowledge around treatment and research in immunology and health care, and</LI> <LI>to facilitate networking through established African paediatric networks.</LI></UL>
Scaling up HIV testing in resource-constrained settings : debates on the role of VCT and routine 'opt-in or opt-out' HIV testingSource: Southern African Journal of HIV Medicine 2005, pp 45 –49 (2005)More Less
Scaling up of the numbers of people voluntarily undergoing HIV testing has become vital, especially in resource- constrained settings, where the need for knowledge of HIV status for both prevention and care is critical. The reality is that for most people in Africa, access to HIV testing and to voluntary counselling and testing (VCT) has been very limited, and this has human rights implications - missing the opportunity to be diagnosed with a disease that is now well understood, manageable and treatable means certain death. <BR>The key challenge in our current context is how scaling up of HIV testing should be done. In responding to this challenge, we are guided by Gruskin and Loff, who state that 'A human rights approach mandates that any public strategy, whether or not rights are to be restricted, be informed by evidence and widely debated. This approach protects against unproved and potentially counterproductive strategies, even those motivated by the genuine despair in the face of overwhelming public health challenges.' <BR>This article describes the arguments and discussion raised during a session on models for increasing access to HIV testing at the 2nd National Conference on HIV / AIDS held in Durban in June 2005. It describes the legal framework for HIV testing in South Africa, frames the issues at the heart of the debate, and describes and discusses the various models of HIV testing, routine HIV testing, VCT and mandatory or compulsory HIV testing, within the context of HIV prevention and care. It concludes with recommendations.
Source: Southern African Journal of HIV Medicine 2005, pp 49 –51 (2005)More Less
Extracted from text ... THE SOUTHERN AFRICAN JOURNAL OF HIV MEDICINE SEPTEMBER 2005 49 Initiating antiretroviral therapy Gary Maartens Division of Clinical Pharmacology, University of Cape Town The current South African Department of Health guideline on when to initiate highly active antiretroviral therapy (HAART) in adults is based on the 2002 WHO guidelines. It is a very conservative guideline, with HAART being initiated with AIDS, diagnosed either clinically (World Health Organization (WHO) stage 4) or immunologically (CD4+ lymphocyte count < 200 cells/?l). The current Southern African HIV Clinicians Society guidelines extend these conservative guidelines to include patients with other evidence of clinical immune suppression (WHO clinical stage 3) and patients with CD4 counts 200 - 350 cells/?l. ..