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- Volume 2007, Issue 26, 2007
Southern African Journal of HIV Medicine - Volume 2007, Issue 26, 2007
Volumes & issues
Volume 2007, Issue 26, 2007
Author Andrew BlackSource: Southern African Journal of HIV Medicine 2007, pp 8 –10 (2007)More Less
The emergence and recognition of extensively drug-resistant tuberculosis (XDR TB) in South Africa led to a wave of panic fuelled by media hype. The response was predictable: meetings, circulars and finally a seven-point emergency action plan. Fortunately Mycobacterium tuberculosis (TB) replicates slowly, as very little seems to have happened in the 5 months since the proposal of the seven-point plan.
The seven-point emergency action plan for XDR TB is based on the seven-point plan devised for MDR TB in the 1990s. The emergence of XDR TB is a consequence of the earlier planâ??s failure. Are we doing any better this time?
Author P. BarnardtSource: Southern African Journal of HIV Medicine 2007, pp 11 –14 (2007)More Less
Acquired immunodeficiency syndrome (AIDS) malignancies are a well-recognised and potentially lethal consequence of thedisease. Three malignancies have shown an increased incidence and qualify as AIDS-defining conditions when they occur in conjunction with HIV infection: Kaposi's sarcoma (KS), non-Hodgkin's lymphoma (NHL), including primary central nervous system lymphoma (PCNSL), and invasive cancer of the cervix. Data from the AIDS-Cancer Match Registry Study Group demonstrate the relative increased risk for the development of the three current AIDS-defining cancers, but also suggest an increase in Hodgkin's disease (HD) and, to a lesser degree, anal carcinoma, testicular seminoma and lip cancer. Highly active antiretroviral therapy (HAART) has exerted an effect on the incidence of malignancies. Since its implementation the incidence of KS and NHL has declined substantially, but there has been no major change in the incidence of cervical cancer or Hodgkin's disease. The most common source of morbidity and mortality from AIDS has been opportunistic infections (OIs). Since the improvement in survival of patients with HIV infection, due to better prevention, the treatment of infectious complications and HAART, there appears to have been an increase in the incidence of malignant tumours, in particular those non-diagnostic of AIDS.
Increasing the scope and intensity of interventions to prevent HIV infection in infants : best interests of women and children : clinicalSource: Southern African Journal of HIV Medicine 2007 (2007)More Less
- There is a mismatch between the HIV prevention needs of children and the quality and scope of prevention of mother-tochild transmission (PMTCT) services.
- Although near-elimination of paediatric HIV has taken place in many settings, PMTCT programmes in Africa have little impact so far.
- Given that it is in the child's best interests to detect exposure to HIV shortly after birth and to institute preventive interventions, routine HIV testing may be justified for all infants born to women of unknown HIV status.
- HIV testing for women at child health and immunisation clinics would enable more women to benefit from knowing their status and to receive infant feeding counselling and support.
Why is HIV prevalence so severe in southern Africa? : the role of multiple concurrent partnerships and lack of male circumcision - implications for HIV prevention : opinionSource: Southern African Journal of HIV Medicine 2007, pp 19 –25 (2007)More Less
Source: Southern African Journal of HIV Medicine 2007, pp 27 –41 (2007)More Less
An HIV-infected infant with Bacille Calmette-GuÃ©rin disease, recurrent and multidrug-resistant tuberculosis complicated by acute cor pulmonale and hepatitis while on antiretroviral therapy : paediatric case studySource: Southern African Journal of HIV Medicine 2007, pp 49 –52 (2007)More Less
We describe the management of an HIV-infected infant with multisystem disease. The infant presented with severe disease at 3 months of age. Initiation of antiretroviral therapy (ART) was delayed through initial lack of access, after which she developed immune reconstitution inflammatory syndrome to BCG. At this time she was also infected with Mycobacterium tuberculosis, with a later recurrence due to multidrug-resistant (MDR) tuberculosis (TB). During this episode she presented with acute cor pulmonale, possibly due to a pulmonary embolus and also transaminitis. Although such infants are seen frequently in sub- Saharan Africa, there are few guidelines or case descriptions to assist clinicians.
Author Adele Caterino-de-AraujoSource: Southern African Journal of HIV Medicine 2007, pp 53 –54 (2007)More Less
This article presents a brief review on 'epidemic' Kaposi's sarcoma (KS), an AIDS-defining illness, and laboratory data obtained by a group of researchers from SÃ£o Paulo, Brazil, concerning the aetiological agent of KS (human herpesvirus 8, HHV-8). Brazil earned international acclaim in the fight against AIDS, providing universal free access to antiretroviral treatment for all patients and promoting education programmes for blocking virus transmission / acquisition. Drawing on her experience, the author suggests the use of highly active antiretroviral therapy (HAART) to combat AIDS and KS in countries where both diseases are epidemic. The lessons learned by Brazil, a developing country, and the techniques used there might help sub-Saharan countries to fight HIV and KS / AIDS, decreasing morbidity and mortality in these geographical regions.