• Cost and cost-effectiveness of switching from d4T or AZT to a TDF-based first-line regimen in a resource-limited setting in rural Lesotho

      Jouquet, Guillaume; Bygrave, Helen; Kranzer, Katharina; Ford, Nathan; Gadot, Laurent; Lee, Janice; Hilderbrand, Katherine; Goemaere, Eric; Vlahakis, Natalie; Trivino, Laura; Makakole, Lipontso; Cleary, Susan; Medecins Sans Frontieres, Morija, Lesotho; Department of Infectious and Tropical Diseases, Clinical Research Unit, London School of Hygiene and Tropical Medicine, UK; Medecins Sans Frontieres, Cape Town, South Africa; Centre for Infectious Disease Epidemiology and Research, University of Cape Town, South Africa; Medecins Sans Frontieres, Geneva, Switzerland; Scott Hospital, Morija, Lesotho; Health Economics Unit, University of Cape Town, South Africa (Lippincott Williams & Wilkins, 2011-11-01)
      Latest World Health Organization guidelines recommend shifting away from Stavudine (d4T)-based regimens due to severe side effects. However, widespread replacement of d4T by Tenofovir (TDF) or Zidovudine (AZT) is hampered by cost concerns.
    • Distribution of antiretroviral treatment through self-forming groups of patients in Tete province, Mozambique

      Decroo, Tom; Telfer, Barbara; Biot, Marc; Maïkéré, Jacob; Dezembro, Sergio; Cumba, Luisa Isabel; Dores, Carla das; Chu, Kathryn; Ford, Nathan; Medecins Sans Frontieres, Tete, Mozambique; Medecins Sans Frontieres, Maputo, Mozambique; Provincial Health Department, Tete, Mozambique; Medecins Sans Frontieres, Cape Town, South Africa; Department of International Health, Johns Hopkins School of Public Health, Baltimore, MD; and Centre for Infectious Disease Epidemiology and Research, University of Cape Town, Cape Town, South Africa (2010-11-13)
      BACKGROUND
    • Drug resistance and viral tropism in HIV-1 subtype C-infected patients in KwaZulu-Natal, South Africa: implications for future treatment options

      Singh, Ashika; Sunpath, Henry; Green, Taryn N; Padayachi, Nagavelli; Hiramen, Keshni; Lie, Yolanda; Anton, Elizabeth D; Murphy, Richard; Reeves, Jacqueline D; Kuritzkes, Daniel R; Ndung'u, Thumbi; HIV Pathogenesis Programme, Doris Duke Medical Research Institute, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa; McCord Hospital, Durban, KwaZulu-Natal, South Africa; Monogram Biosciences Inc., South San Francisco, CA, United States of America; Operational Support Unit, Doctors Without Borders, New York, USA; Section of Retroviral Therapeutics, Brigham and Women's Hospital, Boston, USA; Harvard Medical School, Boston, Massachusetts, USA (Lippincott Williams & Wilkins, 2011-11-01)
      Drug resistance poses a significant challenge for the successful application of highly active antiretroviral therapy (HAART) globally. Furthermore, emergence of HIV-1 isolates that preferentially use CXCR4 as a coreceptor for cell entry, either as a consequence of natural viral evolution or HAART use, may compromise the efficacy of CCR5 antagonists as alternative antiviral therapy.
    • Time to initiation of antiretroviral therapy among patients with HIV-associated tuberculosis in Cape Town, South Africa

      Lawn, Stephen D; Campbell, Lucy; Kaplan, Richard; Boulle, Andrew; Cornell, Morna; Kerschberger, Bernhard; Morrow, Carl; Little, Francesca; Egger, Matthias; Wood, Robin; The Desmond Tutu HIV Centre, Institute for Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa; Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK; Department of Statistical Sciences, Faculty of Science, University of Cape Town, South Africa; School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa; Medecins Sans Frontieres, Cape Town, South Africa; Division of International and Environmental Health, Institute of Social and Preventive Medicine (ISPM), University of Bern, Switzerland (Lippincott Williams & Wilkins, 2011-06-01)
      We studied the time interval between starting tuberculosis treatment and commencing antiretroviral treatment (ART) in HIV-infected patients (n = 1433; median CD4 count 71 cells per microliter, interquartile range: 32-132) attending 3 South African township ART services between 2002 and 2008. The overall median delay was 2.66 months (interquartile range: 1.58-4.17). In adjusted analyses, delays varied between treatment sites but were shorter for patients with lower CD4 counts and those treated in more recent calendar years. During the most recent period (2007-2008), 4.7%, 19.7%, and 51.1% of patients started ART within 2, 4, and 8 weeks of tuberculosis treatment, respectively. Operational barriers must be tackled to permit further acceleration of ART initiation as recommended by 2010 WHO ART guidelines.
    • Virologic failure and second-line antiretroviral therapy in children in South Africa--the IeDEA Southern Africa collaboration

      Davies, Mary-Ann; Moultrie, Harry; Eley, Brian; Rabie, Helena; Van Cutsem, Gilles; Giddy, Janet; Wood, Robin; Technau, Karl; Keiser, Olivia; Egger, Matthias; Boulle, Andrew; School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa; Enhancing Children's HIV Outcomes (Harriet Shezi Children's Clinic, Chris Hani Baragwanath Hospital, Soweto) and School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa; Red Cross Children's Hospital and School of Child and Adolescent Health, University of Cape Town, Cape Town, South Africa; Tygerberg Academic Hospital, University of Stellenbosch, Stellenbosch, South Africa; Médecins Sans Frontières, Khayelitsha, South Africa and Khayelitsha ART Programme; McCord Hospital, Durban, South Africa; Gugulethu Community Health Centre and Desmond Tutu HIV Centre, Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Cape Town, South Africa; Empilweni Service and Research Unit, Rahima Moosa Mother and Child Hospital, University of the Witwatersrand, Johannesburg, South Africa; Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland (Lippincott Williams & Wilkins, 2011-03-01)
      With expanding pediatric antiretroviral therapy (ART) access, children will begin to experience treatment failure and require second-line therapy. We evaluated the probability and determinants of virologic failure and switching in children in South Africa.