Recent Publications

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 

HIV-related Burden on South African Hospitals in the Era of Large-scale Access to Antiretroviral Therapy

Abstract Background: Prior to the large scale roll out of antiretroviral therapy (ART) for HIV in South Africa (RSA), HIV-related conditions were estimated to be responsible for at least half of all inpatient admissions to medical wards of public hospitals. Since 2004, RSA has actively expanded its HIV treatment program and in 2009 had an estimated ART coverage of 56% under the WHO 2006 guidelines. Currently it has 1.4 million patients on ART. We analyzed inpatient records at a large, urban, 

Short-term impacts of a change in ART initiation threshold for patients co-infected with TB in Johannesburg, South Africa

Abstract Introduction: Recent studies showed earlier antiretroviral therapy (ART) initiation in patients co-infected with tuberculosis (TB) leads to reduced mortality. On April 1st, 2010 South Africa changed its HIV treatment guidelines to initiate patients with TB at CD4 counts <350 cells/mm3, up from <200 cells/mm3.  We evaluated short-term impacts of the guideline change by comparing treatment outcomes for co-infected patients before and after the policy change at the Themba