All Posters

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 

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 

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,