Anemia and Red Blood Cell Abnormalities in HIV-Infected and HIV-Exposed Breastfed Infants: A Secondary Analysis of the Kisumu Breastfeeding Study.

Background: Anemia results in increased morbidity and mortality, underscoring the need to better understand its pathophysiology amongst HIV-exposed and infected children in sub-Saharan Africa, the region where most infant HIV exposure and infections occur.

Methods: This analysis used samples obtained from children in the Kisumu Breastfeeding Study (KiBS). KiBS was a longitudinal phase IIB, open-label, one-arm clinical trial, designed to investigate the safety, tolerability and effectiveness of a maternal triple-antiretroviral (ARV) regimen for prevention of mother-to-child transmission (PMTCT) of HIV, during late pregnancy and early infancy while breastfeeding.

University students and HIV in Namibia: an HIV prevalence survey and a knowledge and attitude survey.

Background: With an overall adult HIV prevalence of 15.3%, Namibia is facing one of the largest HIV epidemics in Africa. Young people aged 20 to 34 years constitute one of the groups at highest risk of HIV infection in Namibia.

Measuring socio-economic data in tuberculosis prevalence surveys.

Addressing social determinants in the field of tuberculosis (TB) has received great attention in the past years, mainly due to the fact that worldwide TB incidence has not declined as much as expected, despite highly curative control strategies. One of the objectives of the World Health Organization Global Task Force on TB Impact Measurement is to assess the prevalence of TB disease in 22 high-burden countries by active screening of a random sample of the general population. These surveys provide a unique opportunity to assess socio-economic determinants in relation to prevalent TB and its risk factors.

HIV acquisition is associated with prior high-risk human papillomavirus infection among high-risk women in Rwanda.

As part of a prospective cohort study to assess HIV incidence among high-risk women in Kigali, Rwanda, we evaluated the association between high-risk human papillomavirus (HPV) infection and subsequent HIV acquisition. Women who seroconverted for HIV between the first and second HPV measurement visit were 4.9 times [95% confidence interval = 1.

Low HIV testing rates among tuberculosis patients in Kampala, Uganda.

Background: HIV testing among tuberculosis patients is critical in improving morbidity and mortality as those found to be HIV positive will be offered a continuum of care including ART if indicated. We conducted a cross-sectional study in three Kampala City primary care clinics: to assess the level of HIV test uptake among newly diagnosed pulmonary tuberculosis (PTB) patients; to assess patient and health worker factors associated with HIV test uptake; and to determine factors associated with HIV test uptake at the primary care clinics

Methods: Adult patients who had been diagnosed with smear-positive PTB at a primary care clinic or at the referral hospital and who were being treated at any of the three clinics were interviewed. Associations between having taken the test as the main outcome and explanatory variables were assessed by multivariate logistic regression.

Dried fluid spots for HIV type-1 viral load and resistance genotyping: a systematic review.

Background: Dried spots on filter paper made of whole blood (dried blood spots; DBS), plasma (dried plasma spots; DPS) or serum (dried serum spots) hold promise as an affordable and practical alternative specimen source to liquid plasma for HIV type-1 (HIV-1) viral load determination and drug resistance genotyping in the context of the rapidly expanding access to antiretroviral therapy (ART) for HIV-1-infected individuals in low- and middle-income countries. This report reviews the current evidence for their utility.

Methods: We systematically searched the English language literature published before 2009 on Medline, the websites of the World Health Organization and US Centers for Disease Control and Prevention, abstracts presented at relevant international conferences and references from relevant articles.

Disentangling contributions of reproductive tract infections to HIV acquisition in African Women.

Objective: : To estimate the effects of reproductive tract infections (RTIs) on HIV acquisition among Zimbabwean and Ugandan women.

Methods: : A multicenter prospective observational cohort study enrolled 4439 HIV-uninfected women aged 18 to 35 attending family planning clinics in Zimbabwe and Uganda. Participants were interviewed, and tested for HIV and RTIs every 3 months for 15 to 24 months.

Public-private partnerships and new models of healthcare access.

Purpose Of Review: The aim of this article is to lay the ground for the engagement and support of a well managed and effectively regulated private sector in the delivery of healthcare in sub-Saharan Africa.

Recent Findings: About 60% of healthcare financing in sub-Saharan Africa comes from private sources, and about 50% of total health expenditure goes to private providers, often in the form of out-of-pocket contributions by the poor. Yet, regulatory frameworks are weak and private sector healthcare providers are hardly ever eligible to receive donor funds.

The status of HIV-1 resistance to antiretroviral drugs in sub-Saharan Africa.

Access to highly active antiretroviral therapy (HAART) for persons infected with HIV in sub-Saharan Africa has greatly improved over the past few years. However, data on long-term clinical outcomes of Africans receiving HAART, patterns of HIV resistance to antiretroviral drugs and implications of HIV type-1 (HIV-1) subtype diversity in Africa for resistance, are limited. In resource-limited settings, concerns have been raised that deficiencies in health systems could create the conditions for accelerated development of resistance.

Bacterial vaginosis and vaginal yeast, but not vaginal cleansing, increase HIV-1 acquisition in African women.

Objective: To evaluate interrelationships between bacterial vaginosis (BV), vaginal yeast, vaginal practices (cleansing and drying/tightening), mucosal inflammation, and HIV acquisition.

Methods: A multicenter, prospective, observational cohort study was conducted, enrolling 4531 HIV-negative women aged 18 to 35 years attending family planning clinics in Zimbabwe and Uganda. Participants were tested for HIV and reproductive tract infections and were interviewed about vaginal practices every 3 months for 15 to 24 months.

Discontinuation of nevirapine because of hypersensitivity reactions in patients with prior treatment experience, compared with treatment-naive patients: the ATHENA cohort study.

Background: Recommendations that nevirapine (NVP) should be avoided in female individuals with CD4 cell counts >250 cells/microL and in male individuals with CD4 cell counts >400 cells/microL are based on findings in treatment-naive patients. It is unclear whether these guidelines also apply to treatment-experienced patients switching to NVP-based combination therapy.

Methods: Patients in the ATHENA cohort study who had used NVP-based combination therapy were included.

Differentiating normal from abnormal rates of genital epithelial findings in vaginal microbicide trials.

Background: Candidate vaginal microbicides could cause genital irritation, which in turn could facilitate HIV transmission instead of preventing it. While genital epithelial findings are documented in a standardized manner in most microbicide trials, little is known about background rates and predictors for many types of genital findings.

Study Design: A secondary analysis was conducted using data from a Phase II expanded safety study of the candidate microbicide Carraguard gel (Population Council, NY, USA) in Thailand.

[AIDS treatment in Africa: the risk of antiretroviral resistance].

--In recent years, implementation of antiretroviral therapy in developing countries with a high prevalence of HIV-1 has been recognised as a public health priority. Consequently, the availability ofantiretroviral combination therapy for people with HIV is increasing rapidly in sub-Saharan Africa. --HIV treatment programmes are implemented according to the standardised, simplified public health guidelines developed by the World Health Organization (WHO).

[The use of the non-nucleoside reverse transcriptase inhibitors nevirapine and efavirenz in the treatment of patients with a chronic HIV-I infection].

The non-nucleoside reverse transcriptase inhibitors (NNRTIs) are an important group ofantiretroviral drugs in the treatment of a chronic HIV-I infection. The risk of viral resistance to NNRTIs is strongly diminished when they are used as part of a highly active antiretroviral combination therapy (HAART). Randomised trials have shown that nevirapine and efavirenz have a comparable antiretroviral efficacy.

We must not let protestors derail trials of pre-exposure prophylaxis for HIV.

The international AIDS community is being held hostage by a small number of activist groups, argues Lange.