All Posters

Incident pulmonary tuberculosis on antiretroviral therapy: seven years of experience at the Themba Lethu Clinic in Johannesburg, South Africa

Abstract Background: South Africa continues to have the largest HIV treatment program in the w orld alongside one of the w orld's largest tuberculosis (TB) epidemics. While antiretroviral therapy (ART) reduces the risk of acquiring TB for HIV-infected patients, rates of TB for those on ART remain high. After seven years of delivering HIV treatment, w e describe rates and predictors of incident TB over time in patients initiating ART at a large HIV clinic in South Africa. Methods: We 

Patient retention from HIV diagnosis through one year on antiretroviral therapy at a primary health clinic in Johannesburg, South Africa

Abstract Background: A significant challenge to South Africa's national ART program is poor retention among HIV-positive patients. Studies investigating retention typically focus on post-ART retention, or isolated periods of pre-ART care (i.e. CD4 staging), but do not follow a cohort from testing through time on treatment to measure retention throughout early HIV care. We report patient retention at three stages of pre-ART care and two stages of post-ART care to identify when greatest 

Reduced loss to ART initiation among patients initiating cotrimoxazole prophylaxis therapy in Johannesburg, South Africa

Abstract Background: Loss of patients eligible for ART prior to initiation is a major challenge for HIV care throughout sub-Saharan Africa, yet few effective interventions have been identified to mitigate the problem. Cotrimoxazole prophylaxis therapy has been shown to reduce HIV-related opportunistic infections and mortality on antiretroviral therapy, and limited research suggests it may be associated with improved patient retention. We investigated the effect of cotrimoxazole on ART 

Initiation of ART at higher CD4 counts under South Africa’s revised antiretroviral therapy guidelines results in improved patient outcomes

Abstract Background: In August 2011, in accordance with current WHO guidelines, South Africa expanded its ART guidelines to allow treatment initiation at CD4 values ≤350 cells/mm3 for all adults and adolescents. While mortality and morbidity are known to be improved at initiating at higher CD4 levels, the impact on patient loss to follow-up (LTFU) remains unclear. Using data from a Johannesburg primary health clinic that has offered routine ART initiation at CD4 ≤350 since 2010, 

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 

What to do with Xpert negatives? The cost of alternative diagnostic algorithms for TB suspects who are Xpert MTB negative in a high HIV/MDR-TB burden setting

Abstract Background: South Africa is rapidly implementing the World Health Organization’s recommendation to adopt Xpert MTB/RIF technology (Xpert) for first-line diagnosis of pulmonary tuberculosis (TB). With a high burden of HIV/TB co-infection and a high proportion of patients with smear-negative TB, however, determining a diagnostic algorithm for Xpert negative TB suspects remains important. South Africa’s current Xpert algorithm calls for HIV-infected TB suspects with an initial