JoVE Visualize What is visualize?
Stop Reading. Start Watching.
Advanced Search
Stop Reading. Start Watching.
Regular Search
Find video protocols related to scientific articles indexed in Pubmed.
Viral load versus CD4? monitoring and 5-year outcomes of antiretroviral therapy in HIV-positive children in Southern Africa: a cohort-based modelling study.
AIDS
PUBLISHED: 11-14-2014
Show Abstract
Hide Abstract
Many paediatric antiretroviral therapy (ART) programmes in Southern Africa rely on CD4? to monitor ART. We assessed the benefit of replacing CD4? by viral load monitoring.
Related JoVE Video
Quantification of shared air: a social and environmental determinant of airborne disease transmission.
PLoS ONE
PUBLISHED: 09-02-2014
Show Abstract
Hide Abstract
Tuberculosis is endemic in Cape Town, South Africa where a majority of the population become tuberculosis infected before adulthood. While social contact patterns impacting tuberculosis and other respiratory disease spread have been studied, the environmental determinants driving airborne transmission have not been quantified.
Related JoVE Video
The clinical and economic impact of point-of-care CD4 testing in mozambique and other resource-limited settings: a cost-effectiveness analysis.
PLoS Med.
PUBLISHED: 09-01-2014
Show Abstract
Hide Abstract
Point-of-care CD4 tests at HIV diagnosis could improve linkage to care in resource-limited settings. Our objective is to evaluate the clinical and economic impact of point-of-care CD4 tests compared to laboratory-based tests in Mozambique.
Related JoVE Video
Transmission of Tuberculosis in a South African Community With a High Prevalence of HIV Infection.
J. Infect. Dis.
PUBLISHED: 07-22-2014
Show Abstract
Hide Abstract
?In settings of high tuberculosis transmission, little is known of the interaction between human immunodeficiency virus (HIV) positive and HIV-negative tuberculosis disease and of the impact of antiretroviral treatment (ART) programs on tuberculosis transmission dynamics.
Related JoVE Video
Delayed switch of antiretroviral therapy after virologic failure associated with elevated mortality among HIV-infected adults in Africa.
AIDS
PUBLISHED: 07-01-2014
Show Abstract
Hide Abstract
Routine monitoring of plasma HIV RNA among HIV-infected patients on antiretroviral therapy (ART) is unavailable in many resource-limited settings. Alternative monitoring approaches correlate poorly with virologic failure and can substantially delay switch to second-line therapy. We evaluated the impact of delayed switch on mortality among patients with virologic failure in Africa.
Related JoVE Video
Impact of ART on TB case fatality stratified by CD4 count for HIV-positive TB patients in Cape Town, South Africa (2009-2011).
J. Acquir. Immune Defic. Syndr.
PUBLISHED: 05-14-2014
Show Abstract
Hide Abstract
To identify determinants of tuberculosis (TB) case fatality including the impact of antiretroviral therapy (ART) at different CD4 thresholds for HIV-positive adult and adolescent TB patients.
Related JoVE Video
Provision of antiretroviral therapy in South Africa: the nuts and bolts.
Antivir. Ther. (Lond.)
PUBLISHED: 05-12-2014
Show Abstract
Hide Abstract
Public sector antiretroviral provision had a slow start in South Africa despite a raging epidemic and a World AIDS conference that shed significant public light on the disparities of therapy access globally. This was largely due to political prevarication in the midst of AIDS denialism. There has been an unprecedented expansion in the HIV treatment programme since 2008. As a result, South Africa now has the largest number of patients on antiretroviral drugs in the world, and South African life expectancy has increased by more than a decade. However, this has led to a number of fiscal, logistic and operational challenges that the country must face as the treatment programme continues to expand. Challenges include increasing detection within communities, linkage and retention in care, while strengthening operational support functions such as consistent drug supply, health staffing and infrastructure, diagnostic services, programme monitoring and sustainable financing. As a middle-income country, albeit with marked income inequality, and the heaviest HIV burden in the world, South Africa is a test case of whether a large-scale public health programme can boast of success in the face of numerous other health-system challenges.
Related JoVE Video
Decreasing household contribution to TB transmission with age: a retrospective geographic analysis of young people in a South African township.
BMC Infect. Dis.
PUBLISHED: 04-10-2014
Show Abstract
Hide Abstract
Tuberculosis (TB) transmission rates are exceptionally high in endemic TB settings. Adolescence represents a period of increasing TB infection and disease but little is known as to where adolescents acquire TB infection. We explored the relationship between residential exposure to adult TB cases and infection in children and adolescents in a South African community with high burdens of TB and HIV.
Related JoVE Video
Integrating social contact and environmental data in evaluating tuberculosis transmission in a South African township.
J. Infect. Dis.
PUBLISHED: 03-08-2014
Show Abstract
Hide Abstract
Population models of tuberculosis transmission have not accounted for social contact structure and the role of the environment in which tuberculosis is transmitted.
Related JoVE Video
Factors affecting tuberculosis strain success over 10 years in a high TB- and HIV-burdened community.
Int J Epidemiol
PUBLISHED: 03-07-2014
Show Abstract
Hide Abstract
Factors associated with Mycobacterium tuberculosis (Mtb) strain success over time in high burdened communities are unknown.
Related JoVE Video
Community Treatment Orders: Implications of the drafting of the Mental Health Act 2007 for emergency detention of Community Patients.
Med Sci Law
PUBLISHED: 02-28-2014
Show Abstract
Hide Abstract
Since the introduction of Community Treatment Orders by the Mental Health Act 2007, their use has increased year on year. Clinical experience has, however, demonstrated a weakness in the drafting of the Act, particularly in respect of patients who may be admitted informally for treatment of their mental health while also on a Community Treatment Order and then require detention under the terms of the Mental Health Act 2007. This paper describes these potential problems, particularly with regard to the inability to detain a Community Patient using sections 4 or 5 of the MHA 2007. The authors explore the difficulties that may arise from this, including the need to balance the principle of using the least restrictive option, and the rights of the patient against the potential risks to both the patient and the public. The authors propose possible considerations and options in these circumstances.
Related JoVE Video
The impact of mass media interventions on tuberculosis awareness, health-seeking behaviour and health service utilisation: a systematic review protocol.
BMJ Open
PUBLISHED: 01-17-2014
Show Abstract
Hide Abstract
Tuberculosis (TB) is a serious public health problem in many parts of the world. Strategies to curb the spread of TB must match the multifaceted nature of the epidemic. The use of mass media is one of the important strategies in communicating behavioural change in relation to TB prevention and the treatment. However, the benefits of this intervention are unclear. We, therefore, plan to conduct a systematic review on the effects of mass media interventions on TB awareness, health-seeking behaviour and health service utilisation.
Related JoVE Video
Breast cancer threat appraisal: design and psychometric analysis of a new scale for older women.
Int J Older People Nurs
PUBLISHED: 01-15-2014
Show Abstract
Hide Abstract
The prospect of being diagnosed with breast cancer generates emotional responses associated with a high degree of health threat. When considering screening, older women are faced with physical and psychological consequences inherent in considering the threat of disease.
Related JoVE Video
Immunodeficiency at the start of combination antiretroviral therapy in low-, middle-, and high-income countries.
J. Acquir. Immune Defic. Syndr.
PUBLISHED: 01-15-2014
Show Abstract
Hide Abstract
To describe the CD4 cell count at the start of combination antiretroviral therapy (cART) in low-income (LIC), lower middle-income (LMIC), upper middle-income (UMIC), and high-income (HIC) countries.
Related JoVE Video
Prognostic value of a quantitative analysis of lipoarabinomannan in urine from patients with HIV-associated tuberculosis.
PLoS ONE
PUBLISHED: 01-01-2014
Show Abstract
Hide Abstract
Detection of the mycobacterial cell wall antigen lipoarabinomannan (LAM) in urine can be used to diagnose HIV-associated tuberculosis (TB) using a qualitative (positive/negative) read-out. However, it is not known whether the quantity of LAM present in urine provides additional prognostic information.
Related JoVE Video
Shared air: a renewed focus on ventilation for the prevention of tuberculosis transmission.
PLoS ONE
PUBLISHED: 01-01-2014
Show Abstract
Hide Abstract
Despite an improvement in the overall TB cure rate from 40-74% between 1995 and 2011, TB incidence in South Africa continues to increase. The epidemic is notably disquieting in schools because the vulnerable population is compelled to be present. Older learners (age 15-19) are at particular risk given a smear-positive rate of 427 per 100,000 per year and the significant amount of time they spend indoors. High schools are therefore important locations for potential TB infection and thus prevention efforts.
Related JoVE Video
Mobile HIV screening in Cape Town, South Africa: clinical impact, cost and cost-effectiveness.
PLoS ONE
PUBLISHED: 01-01-2014
Show Abstract
Hide Abstract
Mobile HIV screening may facilitate early HIV diagnosis. Our objective was to examine the cost-effectiveness of adding a mobile screening unit to current medical facility-based HIV testing in Cape Town, South Africa.
Related JoVE Video
Determinants of Mortality in a Combined Cohort of 501 Patients With HIV-Associated Cryptococcal Meningitis: Implications for Improving Outcomes.
Clin. Infect. Dis.
PUBLISHED: 12-06-2013
Show Abstract
Hide Abstract
Background.?Cryptococcal meningitis (CM) is a leading cause of death in individuals infected with human immunodeficiency virus (HIV). Identifying factors associated with mortality informs strategies to improve outcomes. Methods.?Five hundred one patients with HIV-associated CM were followed prospectively for 10 weeks during trials in Thailand, Uganda, Malawi, and South Africa. South African patients (n = 266) were followed for 1 year. Similar inclusion/exclusion criteria were applied at all sites. Logistic regression identified baseline variables independently associated with mortality. Results.?Mortality was 17% at 2 weeks and 34% at 10 weeks. Altered mental status (odds ratio [OR], 3.1; 95% confidence interval [CI], 1.7-5.9), high cerebrospinal fluid (CSF) fungal burden (OR, 1.4 per log10 colony-forming units/mL increase; 95% CI, 1.0-1.8), older age (>50 years; OR, 3.9; 95% CI, 1.4-11.1), high peripheral white blood cell count (>10 × 10(9) cells/L; OR, 8.7; 95% CI, 2.5-30.2), fluconazole-based induction treatment, and slow clearance of CSF infection were independently associated with 2-week mortality. Low body weight, anemia (hemoglobin <7.5 g/dL), and low CSF opening pressure were independently associated with mortality at 10 weeks in addition to altered mental status, high fungal burden, high peripheral white cell count, and older age. In those followed for 1 year, overall mortality was 41%. Immune reconstitution inflammatory syndrome occurred in 13% of patients and was associated with 2-week CSF fungal burden (P = .007), but not with time to initiation of antiretroviral therapy (ART). Conclusions.?CSF fungal burden, altered mental status, and rate of clearance of infection predict acute mortality in HIV-associated CM. The results suggest that earlier diagnosis, more rapidly fungicidal amphotericin-based regimens, and prompt immune reconstitution with ART are priorities for improving outcomes.
Related JoVE Video
The Survival Benefits of Antiretroviral Therapy in South Africa.
J. Infect. Dis.
PUBLISHED: 12-03-2013
Show Abstract
Hide Abstract
Background.?We sought to quantify the survival benefits attributable to antiretroviral therapy (ART) in South Africa since 2004.Methods.?We used the Cost-Effectiveness of Preventing AIDS Complications-International model (CEPAC) to simulate 8 cohorts of human immunodeficiency virus (HIV)-infected patients initiating ART each year during 2004-2011. Model inputs included cohort-specific mean CD4(+) T-cell count at ART initiation (112-178 cells/µL), 24-week ART suppressive efficacy (78%), second-line ART availability (2.4% of ART recipients), and cohort-specific 36-month retention rate (55%-71%). CEPAC simulated survival twice for each cohort, once with and once without ART. The sum of the products of per capita survival differences and the total numbers of persons initiating ART for each cohort yielded the total survival benefits.Results.?Lifetime per capita survival benefits ranged from 9.3 to 10.2 life-years across the 8 cohorts. Total estimated population lifetime survival benefit for all persons starting ART during 2004-2011 was 21.7 million life-years, of which 2.8 million life-years (12.7%) had been realized by December 2012. By 2030, benefits reached 17.9 million life-years under current policies, 21.7 million life-years with universal second-line ART, 23.3 million life-years with increased linkage to care of eligible untreated patients, and 28.0 million life-years with both linkage to care and universal second-line ART.Conclusions.?We found dramatic past and potential future survival benefits attributable to ART, justifying international support of ART rollout in South Africa.
Related JoVE Video
An update to the HIV-TRePS system: the development of new computational models that do not require a genotype to predict HIV treatment outcomes.
J. Antimicrob. Chemother.
PUBLISHED: 11-24-2013
Show Abstract
Hide Abstract
The optimal individualized selection of antiretroviral drugs in resource-limited settings is challenging because of the limited availability of drugs and genotyping. Here we describe the development of the latest computational models to predict the response to combination antiretroviral therapy without a genotype, for potential use in such settings.
Related JoVE Video
When to start antiretroviral therapy in children aged 2-5 years: a collaborative causal modelling analysis of cohort studies from southern Africa.
PLoS Med.
PUBLISHED: 11-01-2013
Show Abstract
Hide Abstract
There is limited evidence on the optimal timing of antiretroviral therapy (ART) initiation in children 2-5 y of age. We conducted a causal modelling analysis using the International Epidemiologic Databases to Evaluate AIDS-Southern Africa (IeDEA-SA) collaborative dataset to determine the difference in mortality when starting ART in children aged 2-5 y immediately (irrespective of CD4 criteria), as recommended in the World Health Organization (WHO) 2013 guidelines, compared to deferring to lower CD4 thresholds, for example, the WHO 2010 recommended threshold of CD4 count <750 cells/mm(3) or CD4 percentage (CD4%) <25%.
Related JoVE Video
Cost-effectiveness of HIV treatment as prevention in serodiscordant couples.
N. Engl. J. Med.
PUBLISHED: 11-01-2013
Show Abstract
Hide Abstract
The cost-effectiveness of early antiretroviral therapy (ART) in persons infected with human immunodeficiency virus (HIV) in serodiscordant couples is not known. Using a computer simulation of the progression of HIV infection and data from the HIV Prevention Trials Network 052 study, we projected the cost-effectiveness of early ART for such persons.
Related JoVE Video
Long-term safety study of fosamprenavir-containing regimens in HIV-1-infected patients.
HIV Clin Trials
PUBLISHED: 10-23-2013
Show Abstract
Hide Abstract
Safety and efficacy of the protease inhibitor fosamprenavir (FPV) ± ritonavir (r) was evaluated in 3 pivotal 48-week phase III studies. A follow-on study provides long-term data on FPV-based regimens.
Related JoVE Video
Management of HIV-associated tuberculosis in resource-limited settings: a state-of-the-art review.
BMC Med
PUBLISHED: 09-03-2013
Show Abstract
Hide Abstract
The HIV-associated tuberculosis (TB) epidemic remains a huge challenge to public health in resource-limited settings. Reducing the nearly 0.5 million deaths that result each year has been identified as a key priority. Major progress has been made over the past 10 years in defining appropriate strategies and policy guidelines for early diagnosis and effective case management. Ascertainment of cases has been improved through a twofold strategy of provider-initiated HIV testing and counseling in TB patients and intensified TB case finding among those living with HIV. Outcomes of rifampicin-based TB treatment are greatly enhanced by concurrent co-trimoxazole prophylaxis and antiretroviral therapy (ART). ART reduces mortality across a spectrum of CD4 counts and randomized controlled trials have defined the optimum time to start ART. Good outcomes can be achieved when combining TB treatment with first-line ART, but use with second-line ART remains challenging due to pharmacokinetic drug interactions and cotoxicity. We review the frequency and spectrum of adverse drug reactions and immune reconstitution inflammatory syndrome (IRIS) resulting from combined treatment, and highlight the challenges of managing HIV-associated drug-resistant TB.
Related JoVE Video
HIV-associated tuberculosis: relationship between disease severity and the sensitivity of new sputum-based and urine-based diagnostic assays.
BMC Med
PUBLISHED: 07-15-2013
Show Abstract
Hide Abstract
Reducing mortality from HIV-associated tuberculosis (TB) requires diagnostic tools that are rapid and have high sensitivity among patients with poor prognosis. We determined the relationship between disease severity and the sensitivity of new sputum-based and urine-based diagnostic assays.
Related JoVE Video
Temporal association between incident tuberculosis and poor virological outcomes in a South African antiretroviral treatment service.
J. Acquir. Immune Defic. Syndr.
PUBLISHED: 07-13-2013
Show Abstract
Hide Abstract
The temporal relationship between incident tuberculosis (TB) and virological outcomes during antiretroviral therapy (ART) is poorly defined. This was studied in a cohort in Cape Town, South Africa.
Related JoVE Video
Accelerated biological ageing in HIV-infected individuals in South Africa: a case-control study.
AIDS
PUBLISHED: 06-12-2013
Show Abstract
Hide Abstract
Little is known about the impact of HIV infection on biological ageing in sub-Saharan Africa. The study aimed to assess biological ageing in South African HIV-infected adults and HIV-seronegative individuals using two validated biomarkers, telomere length and CDKN2A expression (a mediator of cellular senescence).
Related JoVE Video
Safety, feasibility and efficacy of a rapid ART initiation in pregnancy pilot programme in Cape Town, South Africa.
S. Afr. Med. J.
PUBLISHED: 06-11-2013
Show Abstract
Hide Abstract
Antiretroviral therapy (ART) in pregnancy is a crucial intervention in the prevention of mother-to-child transmission (PMTCT) of HIV. It is recognised that mother-to-child transmission is reduced with each week on ART. However, in most South African settings, ART initiation is delayed owing to slow determination of treatment eligibility and separation of HIV and antenatal care services.
Related JoVE Video
Mobile phone text messaging for promoting adherence to anti-tuberculosis treatment: a systematic review.
BMC Infect. Dis.
PUBLISHED: 05-29-2013
Show Abstract
Hide Abstract
Mobile phone text messaging (SMS) has the potential to promote adherence to tuberculosis treatment. This systematic review aims to synthesize current evidence on the effectiveness of SMS interventions in improving patients adherence to tuberculosis treatment.
Related JoVE Video
Ocular parameters of biological ageing in HIV-infected individuals in South Africa: relationship with chronological age and systemic biomarkers of ageing.
Mech. Ageing Dev.
PUBLISHED: 05-18-2013
Show Abstract
Hide Abstract
HIV-infected individuals have an increased risk of age-related morbidity despite antiretroviral treatment (ART). Several anatomic and functional ophthalmological parameters are associated with increasing chronological age. These may, therefore, potentially serve as biomarkers of ageing. We investigated associations between ocular parameters (lens density, retinal vessel calibre, corneal endothelium and retinal nerve fibre layer thickness) and two cellular biomarkers of ageing (leukocyte telomere length and CDKN2A expression) and with frailty in a cross-sectional study of 216 HIV-infected individuals. All ocular parameters, telomere length and frailty were associated with chronological age, whereas CDKN2A expression was not. Retinal venular calibre and lens density were associated with shorter telomere length (p-trend=0.04, and 0.08, respectively), whereas CDKN2A expression and frailty status were not associated with ocular parameters. Longitudinal studies are warranted to assess the integration of retinal vascular calibre and lens density with systemic markers to develop an overall index of biological ageing in HIV infection.
Related JoVE Video
Zidovudine impairs immunological recovery on first-line antiretroviral therapy: collaborative analysis of cohort studies in southern Africa.
AIDS
PUBLISHED: 05-11-2013
Show Abstract
Hide Abstract
Zidovudine (ZDV) is recommended for first-line antiretroviral therapy (ART) in resource-limited settings. ZDV may, however, lead to anemia and impaired immunological response. We compared CD4+ cell counts over 5 years between patients starting ART with and without ZDV in southern Africa.
Related JoVE Video
Community viral load and CD4 count distribution among people living with HIV in a South African Township: implications for treatment as prevention.
J. Acquir. Immune Defic. Syndr.
PUBLISHED: 04-11-2013
Show Abstract
Hide Abstract
The goals of scale-up of antiretroviral therapy (ART) have expanded from prevention of morbidity and death to include prevention of transmission. Morbidity and mortality risk are associated with CD4 count; transmission risk depends on plasma viral load (VL). This study aimed to describe CD4 count and VL distributions among HIV-infected individuals in a South African township to gain insights into the potential impact of ART scale-up on community HIV transmission risk.
Related JoVE Video
Life expectancies of South African adults starting antiretroviral treatment: collaborative analysis of cohort studies.
PLoS Med.
PUBLISHED: 04-01-2013
Show Abstract
Hide Abstract
Few estimates exist of the life expectancy of HIV-positive adults receiving antiretroviral treatment (ART) in low- and middle-income countries. We aimed to estimate the life expectancy of patients starting ART in South Africa and compare it with that of HIV-negative adults.
Related JoVE Video
Cost-effectiveness of point-of-care viral load monitoring of antiretroviral therapy in resource-limited settings: mathematical modelling study.
AIDS
PUBLISHED: 03-07-2013
Show Abstract
Hide Abstract
Monitoring of HIV viral load in patients on combination antiretroviral therapy (ART) is not generally available in resource-limited settings. We examined the cost-effectiveness of qualitative point-of-care viral load tests (POC-VL) in sub-Saharan Africa.
Related JoVE Video
Frailty in HIV-infected adults in South Africa.
J. Acquir. Immune Defic. Syndr.
PUBLISHED: 02-27-2013
Show Abstract
Hide Abstract
Some evidence suggests that HIV infection is associated with premature frailty-a syndrome typically viewed as being related to ageing. We determined the prevalence and predictors of frailty in a population of HIV-infected individuals in South Africa.
Related JoVE Video
Modeling the role of public transportation in sustaining tuberculosis transmission in South Africa.
Am. J. Epidemiol.
PUBLISHED: 02-18-2013
Show Abstract
Hide Abstract
Current tuberculosis notification rates in South Africa are among the highest ever recorded. Although the human immunodeficiency virus epidemic has been a critical factor, the density of respiratory contacts in high-risk environments may be an important and underappreciated driver. Using a modified Wells-Riley model for airborne disease transmission, we estimated the risk of tuberculosis transmission on 3 modes of public transit (minibus taxis, buses, and trains) in Cape Town, South Africa, using exhaled carbon dioxide as a natural tracer gas to evaluate air exchange. Carbon dioxide measurements were performed between October and December of 2011. Environmental risk, reflected in the rebreathed fraction of air, was highest in minibus taxis and lowest in trains; however, the average number of passengers sharing an indoor space was highest in trains and lowest in minibus taxis. Among daily commuters, the annual risk of tuberculosis infection was projected to be 3.5%-5.0% and was highest among minibus taxi commuters. Assuming a duration of infectiousness of 1 year, the basic reproductive number attributable to transportation was more than 1 in all 3 modes of transportation. Given its poor ventilation and high respiratory contact rates, public transportation may play a critical role in sustaining tuberculosis transmission in South African cities.
Related JoVE Video
Increasing transfers-out from an antiretroviral treatment service in South Africa: patient characteristics and rates of virological non-suppression.
PLoS ONE
PUBLISHED: 01-28-2013
Show Abstract
Hide Abstract
To determine the proportion, characteristics and outcomes of patients who transfer-out from an antiretroviral therapy (ART) service in a South African township.
Related JoVE Video
CD4 count slope and mortality in HIV-infected patients on antiretroviral therapy: multicohort analysis from South Africa.
J. Acquir. Immune Defic. Syndr.
PUBLISHED: 01-25-2013
Show Abstract
Hide Abstract
In many resource-limited settings monitoring of combination antiretroviral therapy (cART) is based on the current CD4 count, with limited access to HIV RNA tests or laboratory diagnostics. We examined whether the CD4 count slope over 6 months could provide additional prognostic information.
Related JoVE Video
Monitoring of antiretroviral therapy and mortality in HIV programmes in Malawi, South Africa and Zambia: mathematical modelling study.
PLoS ONE
PUBLISHED: 01-24-2013
Show Abstract
Hide Abstract
Mortality in patients starting antiretroviral therapy (ART) is higher in Malawi and Zambia than in South Africa. We examined whether different monitoring of ART (viral load [VL] in South Africa and CD4 count in Malawi and Zambia) could explain this mortality difference.
Related JoVE Video
Corneal endothelial cells provide evidence of accelerated cellular senescence associated with HIV infection: a case-control study.
PLoS ONE
PUBLISHED: 01-21-2013
Show Abstract
Hide Abstract
Cellular senescence may be a key factor in HIV-related premature biological aging. We assessed features of the corneal endothelium that are known to be associated with biological aging, and cellular senescence markers in HIV-infected adults.
Related JoVE Video
Resistance in pediatric patients experiencing virologic failure with first-line and second-line antiretroviral therapy.
Pediatr. Infect. Dis. J.
PUBLISHED: 01-11-2013
Show Abstract
Hide Abstract
We examined HIV-1 resistance in children failing first-line and second-line antiretroviral therapy in South Africa, all with clade C virus. Those exposed to full-dose ritonavir had multiple protease resistance mutations. Nineteen percent had wild-type virus. Appropriate antiretroviral therapy sequencing in sub-Saharan African children is essential for prolong treatment options.
Related JoVE Video
Prevalent and incident tuberculosis are independent risk factors for mortality among patients accessing antiretroviral therapy in South Africa.
PLoS ONE
PUBLISHED: 01-02-2013
Show Abstract
Hide Abstract
Patients with prevalent or incident tuberculosis (TB) in antiretroviral treatment (ART) programmes in sub-Saharan Africa have high mortality risk. However, published data are contradictory as to whether TB is a risk factor for mortality that is independent of CD4 cell counts and other patient characteristics.
Related JoVE Video
Temporal Trends in the Characteristics of Children at Antiretroviral Therapy Initiation in Southern Africa: The IeDEA-SA Collaboration.
PLoS ONE
PUBLISHED: 01-01-2013
Show Abstract
Hide Abstract
Since 2005, increasing numbers of children have started antiretroviral therapy (ART) in sub-Saharan Africa and, in recent years, WHO and country treatment guidelines have recommended ART initiation for all infants and very young children, and at higher CD4 thresholds for older children. We examined temporal changes in patient and regimen characteristics at ART start using data from 12 cohorts in 4 countries participating in the IeDEA-SA collaboration.
Related JoVE Video
Low Prevalence of Liver Disease but Regional Differences in HBV Treatment Characteristics Mark HIV/HBV Co-Infection in a South African HIV Clinical Trial.
PLoS ONE
PUBLISHED: 01-01-2013
Show Abstract
Hide Abstract
Hepatitis B virus (HBV) infection is endemic in South Africa however, there is limited data on the degree of liver disease and geographic variation in HIV/HBV coinfected individuals. In this study, we analysed data from the CIPRA-SA Safeguard the household study in order to assess baseline HBV characteristics in HIV/HBV co-infection participants prior to antiretroviral therapy (ART) initiation.
Related JoVE Video
Related JoVE Video
Cost effectiveness of cryptococcal antigen screening as a strategy to prevent HIV-associated cryptococcal meningitis in South Africa.
PLoS ONE
PUBLISHED: 01-01-2013
Show Abstract
Hide Abstract
Cryptococcal meningitis (CM)-related mortality may be prevented by screening patients for sub-clinical cryptococcal antigenaemia (CRAG) at antiretroviral-therapy (ART) initiation and pre-emptively treating those testing positive. Prior to programmatic implementation in South Africa we performed a cost-effectiveness analysis of alternative preventive strategies for CM.
Related JoVE Video
Blood neutrophil counts in HIV-infected patients with pulmonary tuberculosis: association with sputum mycobacterial load.
PLoS ONE
PUBLISHED: 01-01-2013
Show Abstract
Hide Abstract
Increasing evidence suggests that neutrophils play a role in the host response to Mycobacterium tuberculosis. We determined whether neutrophil counts in peripheral blood are associated with tuberculosis (TB) and with mycobacterial load in sputum in HIV-infected patients.
Related JoVE Video
Rates of switching antiretroviral drugs in a primary care service in South Africa before and after introduction of tenofovir.
PLoS ONE
PUBLISHED: 01-01-2013
Show Abstract
Hide Abstract
Antiretroviral changes (single drug substitutions and regimen switches) limit treatment options and introduce challenges such as increased cost, monitoring and adherence difficulties. Patterns of drug substitutions and regimen switches from stavudine (d4T) and zidovudine (AZT) regimens have been well described but data on tenofovir (TDF) are more limited. This study describes the patterns and risk factors for drug changes of these antiretroviral drugs in adults.
Related JoVE Video
Social mixing patterns within a South African township community: implications for respiratory disease transmission and control.
Am. J. Epidemiol.
PUBLISHED: 11-09-2011
Show Abstract
Hide Abstract
A prospective survey of social mixing patterns relevant to respiratory disease transmission by large droplets (e.g., influenza) or small droplet nuclei (e.g., tuberculosis) was performed in a South African township in 2010. A total of 571 randomly selected participants recorded the numbers, times, and locations of close contacts (physical/nonphysical) and indoor casual contacts met daily. The median number of physical contacts was 12 (interquartile range (IQR), 7-18), the median number of close contacts was 20 (IQR, 13-29), and the total number of indoor contacts was 30 (IQR, 12-54). Physical and close contacts were most frequent and age-associative in youths aged 5-19 years. Numbers of close contacts were 40% higher than in corresponding populations in industrialized countries (P < 0.001). This may put township communities at higher risk for epidemics of acute respiratory illnesses. Simulations of an acute influenza epidemic predominantly involved adolescents and young adults, indicating that control strategies should be directed toward these age groups. Of all contacts, 86.2% occurred indoors with potential exposure to respiratory droplet nuclei, of which 27.2%, 20.1%, 20.0%, and 8.0% were in transport, own household, crèche/school, and work locations, respectively. Indoor contact time was long in households and short during transport. High numbers of indoor contacts and intergenerational mixing in households and transport may contribute to exceptionally high rates of tuberculosis transmission reported in the community.
Related JoVE Video
Comparison of the early fungicidal activity of high-dose fluconazole, voriconazole, and flucytosine as second-line drugs given in combination with amphotericin B for the treatment of HIV-associated cryptococcal meningitis.
Clin. Infect. Dis.
PUBLISHED: 11-03-2011
Show Abstract
Hide Abstract
HIV-associated cryptococcal meningitis is associated with an estimated 600 000 deaths worldwide per year. Current standard initial therapy consists of amphotericin B (AmB) plus flucytosine (5-FC), but 5-FC remains largely unavailable in Asia and Africa. Alternative, more widely available, and/or more effective antifungal combination treatment regimens are urgently needed.
Related JoVE Video
Diagnostic accuracy of a low-cost, urine antigen, point-of-care screening assay for HIV-associated pulmonary tuberculosis before antiretroviral therapy: a descriptive study.
Lancet Infect Dis
PUBLISHED: 10-17-2011
Show Abstract
Hide Abstract
The diagnostic accuracy of sputum smear microscopy and routine chest radiology for HIV-associated tuberculosis is poor, and culture-based diagnosis is slow, expensive, and is unavailable in most resource-limited settings. We assessed the diagnostic accuracy of a urine antigen test Determine TB-LAM Ag (Determine TB-LAM; Alere, Waltham, MA, USA) for screening for HIV-associated pulmonary tuberculosis before antiretroviral therapy (ART).
Related JoVE Video
Tuberculosis in antiretroviral treatment services in resource-limited settings: addressing the challenges of screening and diagnosis.
J. Infect. Dis.
PUBLISHED: 10-15-2011
Show Abstract
Hide Abstract
The high burden of tuberculosis (TB) among patients accessing antiretroviral treatment (ART) services in resource-limited settings is a major cause of morbidity and mortality and is associated with nosocomial transmission risk. These risks are greatly compounded by multidrug-resistant disease. Screening and diagnosis of TB in this clinical setting is difficult. However, progress has been made in defining a high-sensitivity, standardized symptom screening tool that assesses a combination of symptoms, rather than relying on report of cough alone. Moreover, newly emerging diagnostic tools show great promise in providing more rapid diagnosis of TB, which is predominantly sputum smear-negative. These include culture-based systems, simplified versions of nucleic acid amplification tests (such as the Xpert MTB/RIF assay), and detection of lipoarabinomannan antigen in urine. In addition, new molecular diagnostics now permit rapid detection of drug resistance. Further development and implementation of these tools is vital to permit rapid and effective screening for TB in ART services, which is an essential component of patient care.
Related JoVE Video
Early outcomes and the virological effect of delayed treatment switching to second-line therapy in an antiretroviral roll-out programme in South Africa.
Antivir. Ther. (Lond.)
PUBLISHED: 09-09-2011
Show Abstract
Hide Abstract
More patients in resource-limited settings are starting second-line antiretroviral treatment (ART) following first-line ART failure. We aimed to describe predictors of lack of virological suppression in HIV-infected patients on second-line ART in a roll-out programme in South Africa.
Related JoVE Video
Antiretroviral treatment cohort analysis using time-updated CD4 counts: assessment of bias with different analytic methods.
PLoS ONE
PUBLISHED: 09-02-2011
Show Abstract
Hide Abstract
Survival analysis using time-updated CD4+ counts during antiretroviral therapy is frequently employed to determine risk of clinical events. The time-point when the CD4+ count is assumed to change potentially biases effect estimates but methods used to estimate this are infrequently reported.
Related JoVE Video
Linkage to HIV care from a mobile testing unit in South Africa by different CD4 count strata.
J. Acquir. Immune Defic. Syndr.
PUBLISHED: 08-13-2011
Show Abstract
Hide Abstract
The linkage and barriers of linkage to facility-based HIV care from a mobile HIV testing unit have not previously been described.
Related JoVE Video
Accuracy of immunological criteria for identifying virological failure in children on antiretroviral therapy - the IeDEA Southern Africa Collaboration.
Trop. Med. Int. Health
PUBLISHED: 08-11-2011
Show Abstract
Hide Abstract
To determine the diagnostic accuracy of World Health Organization (WHO) 2010 and 2006 as well as United States Department of Health and Human Services (DHHS) 2008 definitions of immunological failure for identifying virological failure (VF) in children on antiretroviral therapy (ART).
Related JoVE Video
Provider-initiated HIV testing increases access of patients with HIV-associated tuberculosis to antiretroviral treatment.
S. Afr. Med. J.
PUBLISHED: 07-27-2011
Show Abstract
Hide Abstract
Timely initiation of antiretroviral treatment (ART) is a critical component of the case management of patients with HIV-associated tuberculosis (TB) and advanced immunodeficiency. We sought to determine the impact of the introduction of provider-initiated HIV-testing in TB clinics in 2005 on subsequent referrals of patients with HIV-associated TB at a community-based ART service in Cape Town.
Related JoVE Video
Loss to follow-up in a community clinic in South Africa--roles of gender, pregnancy and CD4 count.
S. Afr. Med. J.
PUBLISHED: 07-27-2011
Show Abstract
Hide Abstract
Faith-based organisations have expanded antiretroviral therapy (ART) in community clinics across South Africa. Loss to follow-up (LTFU), however, limits the potential individual and population treatment benefits and optimal care.
Related JoVE Video
Antiretroviral treatment as prevention: impact of the test and treat strategy on the tuberculosis epidemic.
Curr. HIV Res.
PUBLISHED: 07-11-2011
Show Abstract
Hide Abstract
Antiretroviral therapy (ART) has been remarkably effective in ameliorating Human Immunodeficiency Virus (HIV)-associated morbidity and mortality. The rapid decline in viral load during ART also presents an opportunity to develop a "treatment as prevention" strategy in order to reduce HIV transmission at a population level. Modelling exercises have demonstrated that for this strategy to be effective, early initiation of ART with high coverage of the HIV-infected population will be required. The HIV epidemic has fueled a resurgence of tuberculosis (TB) particularly in sub- Saharan Africa and widespread early initiation of ART could also impact this epidemic via several mechanisms. The proportion of patients with low CD4 cell counts who are at high risk of TB disease from progression of both latent and new TB infection would be greatly reduced. Entry into a life-long ART program provides an ongoing opportunity for intensified TB case finding among the HIV-infected population. Regular screening for HIV infection also presents an opportunity for intensified TB case finding in the general population. The combined effect of reduced progression of infection to disease and intensified case finding could reduce the overall prevalence of infectious TB, thereby further decreasing TB transmission. In addition, decreasing prevalence of HIV infection would reduce the TB-susceptible pool within the population. The test and treat strategy therefore has potential to reduce the TB risk at both an individual and a population level. In this paper we explore the expected "TB dividend" of wider access to ART and also explore the potential of the "test and treat" strategy to impact on TB transmission, particularly in the heavily burdened setting of sub- Saharan Africa.
Related JoVE Video
Treatment as prevention: preparing the way.
J Int AIDS Soc
PUBLISHED: 07-06-2011
Show Abstract
Hide Abstract
Potent antiretroviral therapy (ART) reduces mortality and morbidity in people living with HIV by reducing viral load and allowing their immune systems to recover. The reduction in viral load soon after starting ART has led to the hypothesis that early and widespread ART could prevent onward transmission and therefore eliminate the HIV epidemic in the long term. While several authors have argued that it is feasible to use HIV treatment as prevention (TasP), provided treatment is started sufficiently early, others have reasonably drawn attention to the many operational difficulties that will need to be overcome if the strategy is to succeed in reducing HIV transmission. Furthermore, international public health policy must be based on more than theoretical studies, no matter how appealing. Community randomized controlled trials provide the gold standard for testing the extent to which early treatment reduces incidence, but much still needs to be understood and the immediate need is for operational studies to explore the practical feasibility of this approach. Here, we examine some of the issues to be addressed, the obstacles to be overcome, and strategies that may be necessary if TasP is to be effective. Studies of this kind will provide valuable information for the design of large-scale trials, as well as essential information that will be needed if early treatment is to be incorporated into public health policy.
Related JoVE Video
Efavirenz and rifampicin in the South African context: is there a need to dose-increase efavirenz with concurrent rifampicin therapy?
Antivir. Ther. (Lond.)
PUBLISHED: 06-21-2011
Show Abstract
Hide Abstract
Increasing efavirenz (EFV) dose from 600 mg to 800 mg daily has been suggested with concomitant rifampicin (RFN), as induction of cytochrome P450 isoenzymes may reduce EFV plasma concentrations.
Related JoVE Video
Tuberculosis control has failed in South Africa--time to reappraise strategy.
S. Afr. Med. J.
PUBLISHED: 06-18-2011
Show Abstract
Hide Abstract
South Africas rate of tuberculosis (TB) has increased over the last 20 years, to now having the third-highest TB burden in the world. The TB control programme has primarily focused on effective case management of passively presenting TB cases, and progress has been recorded towards international treatment targets. While outcomes for notified TB cases have improved, this strategy failed to contain the TB epidemic. South Africa has the highest per capita annual risk of TB disease of comparably sized countries globally, and its communities have extremely high TB transmission rates. The rates of TB infection of children and adolescents are now similar to those reported 100 years ago in Europe long before chemotherapy became available. High rates of HIV testing of TB patients in Cape Town allows analysis of TB notification data stratified by age, type of TB and HIV status, and a better understanding of TB epidemiology. TB infection prevalence data from Cape Town communities allow estimation of the prevailing force of TB infection and, together with TB notification and prevalence data, the effective number of secondary infections and case finding proportions can be estimated. This better understanding of the major drivers of the TB epidemic allows reasons to be identified for failure of the present strategy. New control strategies can also be identified, that must be accompanied by novel TB control targets.
Related JoVE Video
Delays in starting antiretroviral therapy in patients with HIV-associated tuberculosis accessing non-integrated clinical services in a South African township.
BMC Infect. Dis.
PUBLISHED: 06-17-2011
Show Abstract
Hide Abstract
Delays in the initiation of antiretroviral therapy (ART) in patients with HIV-associated tuberculosis (TB) are associated with increased mortality risk. We examined the timing of ART among patients receiving care provided by non-integrated TB and ART services in Cape Town, South Africa.
Related JoVE Video
Burden of new and recurrent tuberculosis in a major South African city stratified by age and HIV-status.
PLoS ONE
PUBLISHED: 06-04-2011
Show Abstract
Hide Abstract
To describe the burden of tuberculosis (TB) in Cape Town by calculating TB incidence rates stratified by age and HIV-status, assessing the contribution of retreatment disease and estimating the cumulative lifetime TB risk in HIV-negative individuals.
Related JoVE Video
Transmission elasticity in communities hyperendemic for tuberculosis.
Clin. Infect. Dis.
PUBLISHED: 06-02-2011
Show Abstract
Hide Abstract
Despite consistently meeting international performance targets for tuberculosis case detection and treatment success, areas where tuberculosis is hyperendemic fail to achieve the predicted epidemiological impact. In this article, we explore the anomalous relationship between defined performance targets and actual reduction in tuberculosis transmission.
Related JoVE Video
Force of tuberculosis infection among adolescents in a high HIV and TB prevalence community: a cross-sectional observation study.
BMC Infect. Dis.
PUBLISHED: 06-01-2011
Show Abstract
Hide Abstract
Understanding of the transmission dynamics of tuberculosis (TB) in high TB and HIV prevalent settings is required in order to develop effective intervention strategies for TB control. However, there are little data assessing incidence of TB infection in adolescents in these settings.
Related JoVE Video
Low rates of nucleoside reverse transcriptase inhibitor resistance in a well-monitored cohort in South Africa on antiretroviral therapy.
Antivir. Ther. (Lond.)
PUBLISHED: 05-29-2011
Show Abstract
Hide Abstract
The emergence of complex HIV-1 drug resistance mutations has been linked to the duration of time patients are on a failing antiretroviral drug regimen. This study reports on resistance profiles in a closely monitored subtype C infected cohort.
Related JoVE Video
Tuberculosis in a South African prison - a transmission modelling analysis.
S. Afr. Med. J.
PUBLISHED: 05-25-2011
Show Abstract
Hide Abstract
Prisons are recognised internationally as institutions with very high tuberculosis (TB) burdens where transmission is predominantly determined by contact between infectious and susceptible prisoners. A recent South African court case described the conditions under which prisoners awaiting trial were kept. With the use of these data, a mathematical model was developed to explore the interactions between incarceration conditions and TB control measures.
Related JoVE Video
Asking the right questions: developing evidence-based strategies for treating HIV in women and children.
BMC Public Health
PUBLISHED: 05-25-2011
Show Abstract
Hide Abstract
In July 2010, the World Health Organization (WHO) issued formal revisions of its guidelines on the use of highly active antiretroviral therapy for HIV. The new guidelines greatly expand eligibility for treatment of adults and children, as well as for pregnant women seeking prophylaxis for vertical HIV transmission. WHOs new recommendations bring the guidelines closer to practices in developed countries, and its shift to earlier treatment alone will increase the number of treatment-eligible people by 50% or more.Scaling up access to HIV treatment is revealing important gaps in our understanding of how best to provide for all those in need. This knowledge gap is especially significant in developing countries, where women and children comprise a majority of those living with HIV infection. Given the magnitude and significance of these populations, the International AIDS Society, through its Industry Liaison Forum, prioritized HIV treatment and prophylaxis of women and children. In March 2010, the International AIDS Society and 15 partners launched a Consensus Statement outlining priority areas in which a relative lack of knowledge impedes delivery of optimal prevention of mother to child transmission (PMTCT) and treatment to women and children.The Consensus Statement, "Asking the Right Questions: Advancing an HIV Research Agenda for Women and Children", makes a special appeal for a more gender-sensitive approach to HIV research at all stages, from conception to design and implementation. It particularly emphasizes research to enhance the understanding of sex-based differences and paediatric needs in treatment uptake and response. In addition to clinical issues, the statement focuses on programmatic research that facilitates access and adherence to antiretroviral regimens. Better coordination of HIV management with sexual and reproductive healthcare delivery is one such approach.We discuss here our knowledge gaps concerning effective, safe PMTCT and treatment for women and children in light of the expansion envisioned by WHOs revised guidelines. The guidelines new goals present an opportunity for advancing the women and childrens agenda outlined in the Consensus Statement.
Related JoVE Video

What is Visualize?

JoVE Visualize is a tool created to match the last 5 years of PubMed publications to methods in JoVE's video library.

How does it work?

We use abstracts found on PubMed and match them to JoVE videos to create a list of 10 to 30 related methods videos.

Video X seems to be unrelated to Abstract Y...

In developing our video relationships, we compare around 5 million PubMed articles to our library of over 4,500 methods videos. In some cases the language used in the PubMed abstracts makes matching that content to a JoVE video difficult. In other cases, there happens not to be any content in our video library that is relevant to the topic of a given abstract. In these cases, our algorithms are trying their best to display videos with relevant content, which can sometimes result in matched videos with only a slight relation.