Drug Interactions in the Treatment of Malignancy in HIV-Infected Patients.

The number of patients with HIV (human immunodeficiency virus) requiring treatment for malignancy is increasing worldwide. Concurrent treatment of HIV and malignancy is complicated by unpredictable drug-drug interactions, which can cause potentially life-threatening toxicities and ineffective treatment of either disease. This article aims to provide a practical approach to drug interactions and their management in this context to help deliver effective and safe treatment of both the malignancy and HIV.

Effects of vitamin D deficiency and combination antiretroviral therapy on bone in HIV-positive patients.

Objectives: In the era of combination antiretroviral therapy (cART), vitamin D deficiency, low bone mineral density (BMD) and fractures have emerged as subjects of concern in HIV-positive patients. Testing for vitamin D deficiency has been widely adopted in clinical practice even though the benefits of vitamin D supplementation in this population remain uncertain. The objective of this review was to evaluate the evidence for such a strategy.

Efavirenz is associated with severe vitamin D deficiency and increased alkaline phosphatase.

Objective(s): To identify factors (including exposure to specific antiretroviral drugs) associated with severe vitamin D deficiency (VDD) in HIV-infected individuals and to explore the effects of severe VDD and antiretroviral drug exposure on serum alkaline phosphatase (ALP) as surrogate marker of bone turnover.

Design: Cross-sectional survey of vitamin D status among HIV-infected patients attending for routine clinical care at a large London HIV clinic.

Methods: Severe VDD was defined as 25(OH)D levels of less than 10 microg/l (<25 nmol/l).

Population and antenatal-based HIV prevalence estimates in a high contracepting female population in rural South Africa.

Background: To present and compare population-based and antenatal-care (ANC) sentinel surveillance HIV prevalence estimates among women in a rural South African population where both provision of ANC services and family planning is prevalent and fertility is declining. With a need, in such settings, to understand how to appropriately adjust ANC sentinel surveillance estimates to represent HIV prevalence in general populations, and with evidence of possible biases inherent to both surveillance systems, we explore differences between the two systems. There is particular emphasis on unrepresentative selection of ANC clinics and unrepresentative testing in the population.

Continued very high prevalence of HIV infection in rural KwaZulu-Natal, South Africa: a population-based longitudinal study.

Objective: To estimate the prevalence of HIV and associated sociodemographic factors including mobility and migration in a rural population in KwaZulu-Natal, South Africa.

Methods: A household-based HIV serosurvey of a population that has been under longitudinal demographic surveillance since 2000. All residents (women aged 15-49 years; men aged 15-54 years) and a sample of non-residents ('migrants') who return periodically to their households in the area were identified and approached for finger-prick HIV testing.

Antiretroviral treatment in resource-poor settings: public health research priorities.

Many countries in Africa are planning to provide highly active antiretroviral therapy (HAART) to millions of people with acquired immune deficiency syndrome. This will be a highly complex therapy programme. Physician-based models of care adapted from industrialized countries will not succeed in providing treatment to the majority of those who need it in resource-constrained settings.