All Posters

Obesity or hypertension at ART initiation and outcomes amongst HIV patients in South Africa

Abstract Background: Aging, antiretroviral therapy (ART) and HIV infection itself have all been associated with increasing rates of chronic comorbidities in HIV patients but there are limited data on chronic disease risk factors and HIV treatment outcomes in resource-limited settings. We evaluated the association between high body mass index (BMI) or hypertension at ART initiation and mortality, loss to follow-up (LTF), and immunological and virologic response among HIV-positive patients on 

Predictors of incident hypertension in HIV-positive adults over 24 months on ART in South Africa

Abstract  Background: As the current HIV population ages and access to antiretroviral therapy (ART) increases in resource-limited settings, the number of patients developing non-communicable chronic diseases on ART will also increase. In view of limited research on this topic in resource-limited settings, we sought to examine predictors of hypertension in a large urban HIV clinic in South Africa. Methods. Prospective study of hypertension over 24 months on ART among 12376 ART naïve adults 

The Relation Between Efavirenz. vs. Nevirapine and Virologic Failure in Johannesburg, South Africa

Abstract Background: Previous research has raised concerns that patients given nevirapine (NVP)-based regimens experience more virologic failure than patients initiated on efavirenz (EFV)-based regimens. We investigated this hypothesis in a cohort of HIV-infected patients at a large HIV treatment clinic in South Africa. Methods: All antiretroviral therapy (ART)-naïve non-pregnant patients, ≥18 years old, without tuberculosis, who initiated treatment with either NVP or EFV between 

Human Papillomavirus (HPV) testing on self-collected specimens: Perceptions among HIV positive women attending rural and urban clinics in South Africa

Abstract Background: HPV screening through patient self-collection has a high sensitivity and specificity for the detection of high risk HPV types which can lead to cervical cancer. We aimed to identify which self-collection device women prefer and if they would consider using them. Methods: We interviewed 151 HIV positive patients (>18 years) from one urban (n=97) and one rural (n=54) site. Following informed consent and an education session on HIV, HPV and cervical cancer participants 

Incidence and Risk Factors Associated with Tuberculosis in HIV-positive Children Receiving Antiretroviral Therapy in a Large South African Multicenter Cohort

Abstract Background: Tuberculosis (TB) in children is a direct consequence of adult TB and is a good marker of current trends in community transmission. We sought to estimate rates of, and risk factors for,  incident TB among HIV-infected children and adolescents receiving antiretroviral treatment (ART) in South Africa. Methods: We conducted a cohort analysis using prospectively collected data among HIV-infected children <18 years old who initiated ART between April 2004 and May 2011 at 

Incidence of Herpes Zoster among HIV-infected Patients on Antiretroviral Therapy in Johannesburg, South Africa – Who Should We Vaccinate?

Abstract Background: Herpes zoster, caused by the varicella zoster virus, is a predominantly dermatologic condition which results in a painful rash in those infected. Commonly seen in the elderly, it can also present as an opportunistic infection associated with HIV infection. Zoster diagnosed early in treatment combined with an increase in CD4 count may be attributed to immune reconstitution inflammatory syndrome (IRIS). Methods: We included all antiretroviral therapy (ART)-naïve patients, 

A Decline in Community Viral Load in Cape Town and Johannesburg, South Africa between 2004 to 2011

Abstract Background: The total number of people living with HIV in South Africa in 2011 is estimated at approximately 5.4 million, with a prevalence of 16.6% in the adult antenatal population: ranging from 6.2% in the Western Cape to 16.6% in Gauteng provinces, respectively. Antiretroviral therapy (ART) became accessible in 2004, with an estimated 1.4 million on treatment by December 2011. Prior work has suggested that a community viral load (CVL) can be used as a tool for monitoringthe 

Viremia Copy-years as a Measure of Viral Load Burden and Associated Mortality Risk among Antiretroviral Therapy Patients in Johannesburg, South Africa

Abstract Background: A detectable HIV viral load after antiretroviral therapy (ART) initiation is associated with poor outcomes; however simple measures of detectable viremia may miss the cumulative effects of exposure to circulating virus over time. Viremia copy-years has been demonstrated to have prognostic value for mortality in resource-rich cohorts. We evaluated the relationship between viremia copy-years and mortality versus dichotomous measures of viremia amongst patients on ART in 

Attrition through Multiple Stages of HIV Care in South Africa: A Challenge for Test-and-Treat

Abstract Introduction: While momentum for test-and-treat strategies has been increasing in resource limited settings, if patients cannot be retained in HIV care continuously from the time of testing positive through long term adherence to antiretroviral therapy (ART), such strategies may fall well short of the expected gains. While numerous estimates of retention on ART exist, few cohorts have data on retention from testing positive through pre-ART and on ART care. Methods: We explored 

The Effect of 30 vs. 40mg of Stavudine vs. Tenofovir on Treatment Outcomes amongst HIV-positive Patients in Johannesburg, South Africa

Abstract Background: In 2007 the WHO recommended reducing stavudine (d4T) dosage from 40 to 30mg for all HIV-positive adults on antiretroviral therapy (ART) and in 2009 recommended discontinuing d4T for initial HIV treatment due to side effects. Although many resource-limited countries have changed treatment guidelines to substitute tenofovir (TDF) for d4T, in others, d4T is still used. Therefore, determining the effect on treatment outcomes, specifically single-drug substitutions, of reduced 

AIDS 2012: The impact of antiretroviral therapy on quality of life and economic outcomes for South African patients: five-year follow-up

Abstract Background: The rapid expansion of antiretroviral therapy (ART) programs in resource-constrained countries in the previous decade has led to large numbers of patients reaching !5 years on ART, but little evidence exists about long-term economic outcomes. We report the effect of ART on symptoms, general health, ability to perform normal activities, and employment among patients in South Africa during the first five years on treatment. Methods: A cohort of 1065 adult South African 

AIDS 2012: 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