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- Volume 3, Issue 1, 2002
Southern African Journal of HIV Medicine - Volume 3, Issue 1, 2002
Volumes & issues
Volume 3, Issue 1, 2002
Source: Southern African Journal of HIV Medicine 3 (2002)More Less
Finding an effective vaccine against HIV has become a global health priority. No one country can undertake this task alone, and success will only be possible if collaborative and co-operative efforts are established between scientists, clinicians and communities. South Africa is on the brink of testing several HIV-1 candidate vaccines. Here we will review three promising vaccines targeted for testing in South Africa, including the VEE (Venezuelan equine encephalitis) replicon vaccine and the combination DNA vaccine plus MVA (modified vaccinia Ankara) vaccine. A more general overview of HIV vaccine progress in South Africa has been published previously.
Author Des MartinSource: Southern African Journal of HIV Medicine 3 (2002)More Less
The issues surrounding the provision of antiretroviral therapies, in particular the provision of a single dose of nevirapine to pregnant mothers and newborn infants to interrupt mother-to-child transmission (MTCT) of HIV, have filled the pages of our popular press. We in the Southern African HIV Clinicians Society believe that the time for research has passed and the time for implementation is at hand, to which end the Society issued a strongly worded press release in early February 2002. In so doing we added our voice to other strident voices emanating from the medical community, particularly those of Professor James McIntyre and Dr Glenda Gray. It is with particular pride that I would like to extend my congratulations to McIntyre and Gray on their receipt of the 2002 Nelson Mandela Award for Health and Human Rights.
Author Linda-Gail BekkerSource: Southern African Journal of HIV Medicine 3, pp 6 –7 (2002)More Less
'Manto, AIDS drugs DO work after rape' : Headlines from the Mail & Guardian of 18 January this year reflect the frustration felt by both lay and professional people in trying to convince our government that there IS impressive evidence for the benefit of antiretroviral (ARV) drugs. The government continues to object to the administration of these agents from state hospitals.
Author L.M. WebberSource: Southern African Journal of HIV Medicine 3, pp 8 –9 (2002)More Less
Prophylaxis can be defined as a means to prevent an event occurring and is often applied as a specific mode of intervention. Within the health care context, it is most frequently used to prevent or abort infection. Chemoprophylaxis appears to be the most popular concept, yet prevention and eradication programmes, public health interventions, education and awareness campaigns, chemical agents, physical barriers, vector control and finally, immunoglobulin use and vaccination complete the scope of health care prevention strategies. The successful global eradication of smallpox remains a triumphant victory for mankind against viral pathogens; however, many other viruses may not be so easily controlled. Prevention and intervention strategies must therefore still encompass the use of antiviral agents, immunoglobulins and/or vaccines. The global scourge of the human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) pandemic highlights continued reliance on viral prophylactic measures.
Author Jean NachegaSource: Southern African Journal of HIV Medicine 3, pp 15 –16 (2002)More Less
At the end of the year 2001, UNAIDS estimated that 25million of the 36 million people living with HIV infection globally resided in sub-Saharan Africa. While the epidemic has stabilised or declined in some parts of Africa, in southern Africa it continues to be explosive. HIV prevalence exceeds 20% in countries such as Botswana, Zimbabwe and Zambia, in which 30 - 50% of pregnant women in urban areas are HIV-infected. AIDS is now the leading cause of death in sub-Saharan Africa, with tuberculosis (TB) being the leading killer among people with AIDS. The impact of the epidemic is devastating - HIV-related mortality is increasing, hospitals are overflowing, the workforce, including health workers and teachers, is becoming depleted, and the number of orphans is increasing.
The prevention and treatment of opportunistic infections in HIV-infected adults : clinical guidelinesAuthor G. MaartensSource: Southern African Journal of HIV Medicine 3, pp 17 –20 (2002)More Less
A number of lengthy and comprehensive articles and guidelines exist with regard to the treatment and prevention of opportunistic infections, but this guideline is designed to be easy and simple for a practitioner to use. It is presented in a simplified format. The guideline is supported by evidence-based studies and adapted to be appropriate to the local situation. It should be noted that only the drugs that are licensed in South Africa have been recommended and in addition, at all times, the most cost-effective regiments have been endorsed. Alternative regiments have been listed where appropriate, but these are not exhaustive. A practitioner dealing with a more complex problem may find it necessary to consult with a colleague or refer to more comprehensive material.
Source: Southern African Journal of HIV Medicine 3, pp 21 –23 (2002)More Less
HIV infections and deaths from AIDS continue to ravage many countries around the world, with most infected people living in the poorest nations. In terms of morbidity and mortality, the HIV/AIDS pandemic is worse than the Black Death of the 14th century. The search for an HIV vaccine was seen as the logical solution to the burgeoning epidemic soon after the discovery of HIV, but early enthusiasm became muted as the realities of the challenge became evident.
Author David BrittainSource: Southern African Journal of HIV Medicine 3, pp 24 –28 (2002)More Less
As the incidence of HIV increases in Africa the coincidental infection of cancer patients will rise. Owing to the effects of HIV on haemopoiesis and immune function, HIV infection of patients with cancer poses management difficulties for both the physician managing the cancer and the physician managing the HIV infection. For most cancers, the dose intensity (total dose over total time) of the chemotherapy or radiotherapy is strongly associated with response rates. This is even more noticeable in haematological malignancies and cancers with curable potential. Maintaining dose intensity in the presence of HIV requires control of the HIV infection and frequently the use of external growth factor support, especially in intensive regimens. It is not usually appropriate to attempt anything except palliative treatment if these resources are not available.
Author Elsabe KlinckSource: Southern African Journal of HIV Medicine 3 (2002)More Less
Every patient has a constitutional right to privacy and every doctor has an ethical duty to maintain patient confidentiality. The principle is that any third party such as an insurance company can only access information to which a patient (the insured) has provided informed consent. Informed consent means that the person is aware of the consequences of his/her consent. Therefore the South African Medical Association does not regard blanket consent or consent obtained years ago as informed consent. In insurance law, a person (the insured) has to disclose all material facts that may affect the insurance to the insurer. The relationship is between the insurer and the insured, and unless the insured has consented to the medical practitioner making medical information known on his/her behalf, the practitioner is bound to preserve confidentiality. The family of a deceased person may consent to an insurer requesting information from the practitioner in terms of the Promotion of Access to Information Act of 2000. The Regulations to the Act must be used to request the information.
Author Martin SchonteichSource: Southern African Journal of HIV Medicine 3, pp 30 –34 (2002)More Less
Crime levels in South Africa are likely to increase over the next two decades because of the HIV/AIDS epidemic. The epidemic will result in an unprecedented increase in the country's orphan population. Growing up without parents, and badly supervised by relatives and welfare organisations, this growing pool of orphans will be at greater than average risk of engaging in criminal activity. Many orphans will also be vulnerable to victimisation.
Author Gerald FriedlandSource: Southern African Journal of HIV Medicine 3, pp 35 –42 (2002)More Less
The availability and use of highly active antiretroviral therapy (HAART) has dramatically altered the natural history of HIV disease. During the past 5 years those with access to potent combinations of antiretroviral agents (largely in the developed world) have derived benefits of immune restoration and prolonged maintenance of good health, and reduced morbidity, hospitalisation and mortality. In parallel with these benefits, there has been an increasing recognition of the central therapeutic importance and challenges of adherence to HAART.