Recent Publications

How to estimate the cost of point-of-care CD4 testing in program settings: An example using the Alere PimaTM analyser in South Africa

Abstract: Integrating POC CD4 testing technologies into HIV counseling and testing (HCT) programs may improve post-HIV testing linkage to care and treatment. As evaluations of these technologies in program settings continue, estimates of the costs of POC CD4 tests to the service provider will be needed and estimates have begun to be reported. Without a consistent and transparent methodology, estimates of the cost per CD4 test using POC technologies are likely to be difficult to compare and may 

Prevalence of hepatitis B virus (HBV) co-infection in HBV serologically-negative South African HIV patients and retrospective evaluation of the clinical course of mono- and co-infection

Abstract: Objectives: Hepatitis B virus (HBV) infection with undetectable hepatitis B surface antigen (HBsAg) has been reported in HIV patients, but the clinical significance is unknown. This study presents the prevalence of HBV DNA in HIV-positive patients negative for all HBV serological markers and a retrospective evaluation of the clinical course of mono- and co-infection. Methods: Of 502 HIV-positive patients, 222 tested negative for HBsAg, antibody to hepatitis B surface antigen 

Prevalent tuberculosis and mortality among HAART initiators

Abstract: The effect of tuberculosis on mortality in people initiating highly-active antiretroviral therapy (HAART) remains unclear; here, we strengthened a previous cohort analysis. Multivariate Cox proportional hazards models were used to assess the association of baseline tuberculosis and time to all-cause mortality among HAART initiators. In reanalysis, treatment for tuberculosis at time of HAART initiation remained unassociated with increased risks of all-cause mortality, with adjusted 

Polymorphisms of innate immunity genes influence disease progression in HIV-1-infected children

Abstract: Toll-like receptors (TLRs) and defensins (DEFs) play a crucial role in the host's innate immunity and may influence HIV-1 disease progression. We investigated the impact of TLR9 +1174G > A, 1635A > G and DEFβ1 -44C > G, -52G > A single nucleotide polymorphisms on the clinical outcome of 95 HIV-1-infected children. The TLR9 1635AG genotype and TLR9 haplotype were associated with rapid disease progression, whereas the DEFβ1 -44CG genotype and DEFβ1 

Effectiveness and safety of 30mg versus 40mg stavudine regimens: a cohort study among HIV-infected adults initiating HAART in South Africa

Abstract: Background: As stavudine remains an important and widely prescribed drug in resource-limited settings, the effect of a reduced dose of stavudine (from 40 mg to 30 mg) on outcomes of highly active antiretroviral therapy (HAART) remains an important public health question. Methods: We analyzed prospectively collected data from the Themba Lethu Clinic in Johannesburg, South Africa. We assessed the relationship between stavudine dose and six- and/or 12-month outcomes of stavudine 

The Feasibility of Using Criteria to Identify Stable Patients on HAART at Themba Lethu Clinic

Abstract Background: With recent increases in eligibility criteria to a CD4 count <350, South Africa has begun to see rapid growth in the number of patients on highly-active antiretroviral therapy (ART). The expanding number of patients is creating a substantial burden on HIV treatment staff and contributing to long waiting times for patients. HIV clinics are exploring ways to reduce the overall number of visits patients need to reduce the burden on staff. We sought to use routinely