Resource Library

Objectives: Widespread access to antiretroviral therapy (ART) has substantially increased life expectancy in sub‐Saharan African countries. As a result, the rates of comorbidities and use of co‐medications among people living with HIV are increasing, necessitating a sound…

Increasing numbers of people living with HIV (PLHIV) in sub-Saharan Africa are experiencing failure of first-line antiretroviral therapy and transitioning onto second-line regimens. However, there is a dearth of research on their treatment experiences. We conducted in-…

In 2017, tuberculosis caused an estimated 1·6 million deaths, including 300 000 deaths among people with HIV, and surpassed HIV/AIDS to become the leading infectious cause of mortality worldwide. Approximately 36% of tuberculosis cases each year (around 3·5 million cases) are not diagnosed or…

BACKGROUND: Expanded HIV prevention options are needed to increase uptake of HIV prevention among women, especially in generalized epidemics. As the dapivirine vaginal ring moves forward through regulatory review and open-label extension studies, the potential public health…

With only a year until 2020 – and the deadline to reach the 90-90-90 targets – South Africa is dangerously off track. Currently 7.1 million people are living with HIV in the country. New HIV infections remain high, according to the Thembisa model1 at 275 000 in 2017, higher than the 231 000…

More adolescents and young adults living with HIV are surviving into adulthood. As a result they must transition from pediatric health services to HIV self-management and adult care. This change is particularly important as many young people have poor adherence to treatment, leading to low rates…

Increasing numbers of people living with HIV (PLHIV) in sub-Saharan Africa are experiencing failure of first-line antiretroviral therapy and transitioning onto second-line regimens. However, there is a dearth of research on their treatment experiences. We conducted in-depth interviews with 43…

OBJECTIVE: To examine the prevalence and magnitude of chronic lung disease (CLD) and its association with empiric anti-tuberculosis treatment (due to lack of bacteriologic confirmation) among recurrent tuberculosis (TB) survivors in a human immunodeficiency virus (HIV) prevalent…

Despite public health interventions targeting sex workers in an attempt to increase condom use, HIV still remains a significant health issue for those involved in the sex industry in many countries. In this paper, we analyse data collected as part of an ethnographic study of sex work in Soweto,…

BACKGROUND: There is a paucity of data describing autoimmune skin diseases in sub-Saharan Africa and in HIV positive cohorts. We describe the incidence of autoimmune skin diseases in public dermatology clinics in Botswana.

METHODS: New patient records…

OBJECTIVES: Vaginal dysbiosis and STIs are important drivers of the HIV epidemic and reproductive complications. These conditions remain prevalent, partly because most cases are asymptomatic. We have shown that inflammatory cytokines interleukin (IL)-1alpha, IL-1beta and…

OBJECTIVES: To determine the proportion of rifampicin-resistant tuberculosis (RR-TB) patients who accessed second-line drug susceptibility testing (SL-DST) results following introduction of the Hain technology in southern provinces, Zimbabwe.

DESIGN:

OBJECTIVES: HIV infection has been associated with an impaired lung function in high-income countries, but the association between HIV infection and pulmonary function in Sub-Saharan Africa remains unclear. This study aims to investigate the relation between HIV infection and…

In East and Southern Africa, where 5% to 10% have chronic hepatitis B virus (HBV) infection, incidence of human immunodeficiency virus (HIV) infection remains unacceptably high. This introduces challenges and opportunities for implementation of HBV care and treatment. We now describe new HIV…

BACKGROUND: The GeneXpert MTB/RIF Assay (Xpert(R)) is known to be a feasible, effective and a hopeful tool for rapid tuberculosis (TB) diagnosis and treatment. However, little is known about the time delay caused by initial negative sputum smear microscopy (NSSM), but…

BACKGROUND: Subclinical tuberculosis is an asymptomatic disease phase with important relevance to persons living with HIV. We describe the prevalence, clinical characteristics, and risk of mortality for HIV-infected adults with subclinical tuberculosis.

METHODS…

BACKGROUND: Xpert MTB/RIF, the most widely used automated nucleic acid amplification test for tuberculosis, is available in more than 130 countries. Although diagnostic accuracy is well documented, anticipated improvements in patient outcomes have not been clearly identified. We…

BACKGROUND:

People living with HIV (PLHIV) are at increased risk of tuberculosis (TB). TB is also the leading opportunistic infection contributing to about one-third of deaths in this population. The World Health Organization recommends regular screening for TB in PLHIV. Those…

Background: Drug resistance is a challenge for the global control of tuberculosis. We examined mortality in patients with tuberculosis from high-burden countries, according to concordance or discordance of results from drug susceptibility testing done locally and in a reference…

Each year, we commemorate World Tuberculosis (TB) Day on March 24 to raise public awareness about the devastating health, social and economic consequences of TB, and to step up efforts to end the global TB epidemic. The date marks the day in 1882 when Dr Robert Koch announced that he had…

Despite advances in prevention, diagnosis and treatment of tuberculosis and human immunodeficiency virus (HIV), tuberculosis remains the leading cause of death and illness among people living with HIV. In 2015, an estimated 1.2 million of the people who developed tuberculosis disease worldwide…

The cascade of care is a model for evaluating patient retention across sequential stages of care required to achieve a successful treatment outcome. This approach was first used to evaluate HIV care and has since been applied to other diseases. The tuberculosis (TB) community has only recently…

The emergence and expansion of the multidrug-resistant tuberculosis epidemic is a threat to the global control of tuberculosis. Multidrug-resistant tuberculosis is the result of the selection of resistance-conferring mutations during inadequate antituberculosis treatment. However, HIV has a…

Background: Little up-to-date information is available about the costs of providing drug-susceptible tuberculosis (DS-TB) treatment to paediatric patients in South Africa (SA), nor have actual costs incurred at clinics been compared with costs expected from guidelines.

Background: In South Africa, roughly half of the drug-resistant TB cases diagnosed are reported to have been started on treatment. We determined the proportion of persons diagnosed with rifampicin resistant (RR-) TB who initiated treatment in Johannesburg after the introduction…

Introduction: Treatment success rates of rifampicin resistant (RR)/multi-drug resistant (MDR) tuberculosis (TB) in South Africa range from 43–48%, falling short of the World Health Organization’s target of ≥75%. We present rates and assess predictors of attrition by 12 months on…

Objective: We describe baseline characteristics, time to treatment initiation and interim patient outcomes at a decentralized, outpatient treatment site for rifampicin-resistant TB (RR-TB).

Methods: Prospective observational cohort study of RR-TB…

Update on recommendations on antiretroviral regimens for treating and preventing HIV infection: In 2016, WHO published the consolidated guidelines on the use of antiretroviral (ARV) drugs for treating and preventing HIV infection and recommended tenofovir disoproxil fumarate (…