Adult antiretroviral therapy guidelines 2014

Meintjes, Graeme

doi:10.4102/sajhivmed.v15i4.330

Cited by 30 publications

(28 citation statements)

References 49 publications

(55 reference statements)

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“…Life expectancy in South Africa has increased since 2005 with a particularly sharp increase between 2010 and 2011 [16], and may continue to do so with the scale-up of ARV therapy, and the subsequent new guidelines for ARV therapy [17] which include protocols for third-line therapy. Ageing is typically associated with changes in lifestyle behaviours including a reduction in physical activity, an increase in sedentary behaviour, and changes in dietary patterns, all of which may be the result of different environmental and personal factors [18,19].…”

Section: Discussionmentioning

confidence: 99%

Demographic, socio-economic and behavioural correlates of BMI in middle-aged black men and women from urban Johannesburg, South Africa

Micklesfield

Kagura

Munthali

et al. 2018

Global Health Action

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Background: There is a high and increasing prevalence of overweight and obesity in South Africans of all ages. Risk factors associated with overweight and obesity must be identified to provide targets for intervention. Objective: To identify the demographic, socio-economic and behavioural factors associated with body mass index (BMI) in middle-aged black South African men and women. Methods: Data on demographic and socio-economic factors were collected via questionnaire on 1027 men and 1008 women from Soweto Johannesburg, South Africa. Weight and height were measured and BMI was determined. Behavioural factors included tobacco use and consumption of alcohol, and physical activity data were collected using the Global Physical Activity Questionnaire. Menopausal status was determined for the women, and HIV status was available for 93.6% of the men and 39.9% of the women. Results: Significantly more women were overweight or obese than men (87.9 vs. 44.9%). Smoking prevalence (current or former) and minutes spent in moderate to vigorous intensity physical activity was significantly different between the sexes (both p < 0.0001). In the final hierarchical model, marital status (+ married/cohabiting), household asset score (+), current smoking (-), moderate to vigorous physical activity (-) and HIV status (- HIV infected) significantly contributed to 26% of the variance in BMI in the men. In the women, home language (Tswana-speaking compared to Zulu-speaking), marital status (+ unmarried/cohabiting), education (-), current smoking (-) and HIV status (- HIV infected) significantly contributed to 14% of the variance in BMI. Conclusions: The sex difference in BMI and the prevalence of overweight and obesity between black South African men and women from Soweto, as well as the sex-specific associations with various demographic, socio-economic and behavioural factors, highlight the need for more tailored interventions to slow down the obesity epidemic.

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Section: Discussionmentioning

confidence: 99%

Demographic, socio-economic and behavioural correlates of BMI in middle-aged black men and women from urban Johannesburg, South Africa

Micklesfield

Kagura

Munthali

et al. 2018

Global Health Action

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“…Initiation of ART among persons newly diagnosed with HIV at these facilities is in line with national antiretroviral therapy guidelines. Since December 2014, these recommended ART initiation to all pregnant or breastfeeding women and any patient with a CD4 count <500/μL . In September 2016, the treatment eligibility criteria were further revised to include all persons diagnosed with HIV .…”

Section: Methodsmentioning

confidence: 99%

Outcomes of patients lost to follow‐up after antiretroviral therapy initiation in rural north‐eastern South Africa

Ambia

Kabudula

Risher

et al. 2019

Tropical Med Int Health

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Objective The vital status of patients lost to follow‐up often remains unknown in antiretroviral therapy (ART) programmes in sub‐Saharan Africa because medical records are no longer updated once the patient disengages from care. Thus, we aimed to assess the outcomes of patients lost to follow‐up after ART initiation in north‐eastern South Africa. Methods Using data from a rural area in north‐eastern South Africa, we estimated the cumulative incidence of patient outcomes (i) after treatment initiation using clinical records, and (ii) after loss to follow‐up (LTFU) using data from clients that have been individually linked to Agincourt Health and Demographic Surveillance System (AHDSS) database. Aside from LTFU, we considered mortality, re‐engagement and migration out of the study site. Cox proportional hazards regression was used to identify covariates of these patient outcomes. Results Between April 2014 and July 2017, 3700 patients initiated ART and contributed a total of 6818 person‐years of follow‐up time. Three years after ART initiation, clinical record‐based estimates of LTFU, mortality and documented transfers were 41.0% (95% CI: 38.5–43.4%), 1.9% (95% CI 1.0–3.2%) and 0.1% (95% CI 0.0–0.9%), respectively. Among those who were LTFU, the cumulative incidence of re‐engagement, out‐migration and mortality at 3 years were 38.1% (95% CI 33.1–43.0%), 49.4% (95% CI 43.1–55.3%) and 4.7% (95% CI 3.5–6.2%), respectively. Pregnant or breastfeeding women, foreigners and those who initiated ART most recently were at an increased risk of LTFU. Conclusion LTFU among patients starting ART in north‐eastern South Africa is relatively high and has increased in recent years as more asymptomatic patients have initiated treatment. Even though this tendency is of concern in light of the prevention of onwards transmission, we also found that re‐engagement in care is common and mortality among persons LTFU relatively low.

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“…A fixed‐dose combination (FDC) of HAART containing 600 mg of Efavirenz (EFV), 200 mg of Emtricitabine (FTC) and 300 mg of Tenofovir (TDF) [TDF/FTC/EFV] was administered daily. The therapeutic dose of the FDC was adjusted for animal weight using the human therapeutic dose equivalent for a rat model (7.5/5/15 mg/kg) (Meintjes et al, ). The drug was procured from Pharmacare Ltd, Port Elizabeth, South Africa.…”

Section: Methodsmentioning

confidence: 99%

Testicular microanatomical and hormonal alterations following use of antiretroviral therapy inSprague Dawleyrats: Role of Naringenin

et al. 2018

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Human immunodeficiency virus-infected man may require assisted reproductive technology not just for safer conception but also due to subfertility. The study investigated the effect of antiretroviral drugs on the fertility potentials of males and the possible protective role of Naringenin, using Sprague Dawley rats. Thirty adult male Sprague Dawley rats were grouped into-A: Distilled water; B: Highly Active Antiretroviral Therapy (HAART); C: Naringenin 40 mg/kg; D: Naringenin 80 mg/kg, E: HAART + Naringenin 40 mg/kg; F: HAART + Naringenin 80 mg/kg. The rats were euthanised after 10 weeks. Results showed a significant decrease in sperm count in group B when compared to the control and other groups. Spermatozoa with normal morphology also reduced significantly in the B group and progressive sperm motility reduced when compared to the control, D and the F group. The serum testosterone was not significantly different between groups A and B, however the groups C and D displayed significant increase when compared to groups A and B. The serum luteinising hormone was significantly higher in group B when compared to groups A, E and F. Our data suggest that Naringenin improves the male reproductive anatomy and function, therefore, it promises to be a beneficial adjuvant for mitigating HAART testicular and reproductive perturbations.

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Adult antiretroviral therapy guidelines 2014

Cited by 30 publications

References 49 publications

Demographic, socio-economic and behavioural correlates of BMI in middle-aged black men and women from urban Johannesburg, South Africa

Demographic, socio-economic and behavioural correlates of BMI in middle-aged black men and women from urban Johannesburg, South Africa

Outcomes of patients lost to follow‐up after antiretroviral therapy initiation in rural north‐eastern South Africa

Testicular microanatomical and hormonal alterations following use of antiretroviral therapy inSprague Dawleyrats: Role of Naringenin

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