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How many times have you started to have a conversation with someone about Hepatitis C only to have it blow up in your face? Have you ever heard someone say something about Hep C that didn't seem quite right to you? You were probably right something was amiss. A discussion about Hepatitis C can...
As per Wikipedia, the definition of a stigma is as follows: "Stigma is a word that originally means a "sign", "point", or "branding mark"." Wikipedia goes on to call stigma "A badge of shame, a physical mark of infamy or disgrace." Damn that w...
Recently, the CDC (Center for Disease Control) issued a statement that all Baby Boomers should be tested for Hepatitis C. The question often comes up as to why this particular segment of people is so vulnerable. What does being born between 1945 and 1965 have to do with Hepatitis C? What was di...
Buyer Beware! There are several snake oil salesmen out there who are claiming to have cured their own Hepatitis C with herbs, supplements and parking lot gravel. Okay, maybe not the parking lot gravel but it might as well be. What you need to remember is that there are two different types of...
Most every adult woman (and an occasional man) has enjoyed a manicure and a pedicure at a nail salon or spa. That 30 minute pedicure can be so relaxing but are you aware of the danger lurking in that nail salon? Although few individuals recognize the medical risks associated with this common pr...
Introduction.
Infection with tuberculosis (TB) remains the leading cause of mortality among HIV-infected people worldwide [1]. South Africa has the third highest TB incidence in the world, with ~1,000 cases per 100,000 people per year and the most HIV-infected citizens of any country [2], [3]. Even for people successfully diagnosed with TB in South Africa, TB treatment completion remains a challenge. In 2005, KwaZulu-Natal, the South African province with the highest HIV prevalence, reported the greatest number of smear-positive pulmonary TB cases in the country and had the lowest cure rate (45%) [4].
The emergence of drug-resistant TB, which is challenging to diagnose and treat, threatens to undo the progress made in HIV treatment and care within an overburdened public health infrastructure in South Africa [5], [6].
In 2005, a substantial burden of multi-drug (MDR) and extensively-drug resistant (XDR) TB was identified among HIV-infected patients in the rural Msinga District of KwaZulu-Natal. Enhanced surveillance there revealed 39% MDR TB and 6% XDR TB among HIV-infected patients with culture-confirmed TB, exceeding previous surveys [7]. However, province-wide surveillance in KwaZulu-Natal has largely reflected sputum cultures performed on request based on clinical suspicion of treatment failure. This practice has varied widely among districts, with an estimated 80% of reported cases lacking culture confirmation and drug susceptibility testing [8], [9]. In addition, individual-level data, such as prior TB treatment exposure and HIV status, have not been available in population-based surveys of TB drug resistance.
In the setting of an intensive TB screening program using mycobacterial culture and drug susceptibility testing for all patients, our objective was to assess the prevalence of drug-resistant TB and to describe the resistance patterns in TB culture positive patients commencing ART in an urban HIV clinic in Durban, South Africa.
Abstract.
Objective.
To estimate the prevalence of drug-resistant tuberculosis (TB) and describe the resistance patterns in patients commencing antiretroviral therapy (ART) in an HIV clinic in Durban, South Africa.
Design.
Cross-sectional cohort study.
Methods.
Consecutive HIV-infected adults (≥18y/o) initiating HIV care were enrolled from May 2007–May 2008, regardless of signs or symptoms of active TB. Prior TB history and current TB treatment status were self-reported. Subjects expectorated sputum for culture (MGIT liquid and 7H11 solid medium). Positive cultures were tested for susceptibility to first- and second-line anti-tuberculous drugs. The prevalence of drug-resistant TB, stratified by prior TB history and current TB treatment status, was assessed.
Results.
1,035 subjects had complete culture results. Median CD4 count was 92/µl (IQR 42–150/µl). 267 subjects (26%) reported a prior history of TB and 210 (20%) were receiving TB treatment at enrollment; 191 (18%) subjects had positive sputum cultures, among whom the estimated prevalence of resistance to any antituberculous drug was 7.4% (95% CI 4.0–12.4). Among those with prior TB, the prevalence of resistance was 15.4% (95% CI 5.9–30.5) compared to 5.2% (95% CI 2.1–8.9) among those with no prior TB. 5.1% (95% CI 2.4–9.5) had rifampin or rifampin plus INH resistance.
Conclusions.
The prevalence of TB resistance to at least one drug was 7.4% among adults with positive TB cultures initiating ART in Durban, South Africa, with 5.1% having rifampin or rifampin plus INH resistance. Improved tools for diagnosing TB and drug resistance are urgently needed in areas of high HIV/TB prevalence.
Please sign the ATC Salvage Therapy Petition Join us in asking Congressman Alcee Hastings and Congresswomen Maxine Waters to send a ‘Dear Colleague’ letter to Anthony Fauci, Director of NIAID, asking for the federal facilitation of apricitabine (ATC). ATC is a phase III nucleoside reverse transcriptase inhibitor (NRTI) that has been shown to be safe and effective in treating people with HIV. It works against viruses that are resistant to several other nukes and could ...
Researchers from Johns Hopkins Children’s Center, the University of Mississippi Medical Center and the University of Massachusetts Medical School announced today at CROI2013 the discovery of the first infant functionally cured of HIV. The baby, a female now two and a half years old, received 3 HIV medications when brought to the hospital at 30 hours old. Viral load tests were performed during the first few weeks that showed a rapidly decreasing viral load which reached ...
At the 19th International AIDS Conference (AIDS 2012) in Washington D.C., the CDC reported that only 1 out of 4 HIV patients in the U.S. have HIV under control, which is defined as complete viral suppression. Warning bells should be ringing in the scientific and HIV advocacy communities. While much progress has been made in the last three decades in the treatment of HIV, tens of thousands of people living with HIV (PLWH) are currently struggling to construct viable treat...
Paige Rawl is 17 and HIV positive, but while her life has been shaped by HIV it isn't ruled by it. When Paige Rawl starts her senior year at Indianapolis’s Herron High School next month, she'll be cheer captain and a member of the student government and prom committee. This summer, the 17-year-old held down a part-time job at Hollister, hawking the popular Southern California-inspired clothing brand. The all-American girl — who happens to be HIV positive. Paige was in...
The HIV community has been abuzz with the August FDA approval of what had been termed “the Quad”, the second one-pill-once-a-day combination antiretroviral drug. Marketed by Gilead under the name Stribild, the drug contains two NRTIs (tenofovir and emtricitabine), an integrase inhibitor (elvitegravir) and an integrase booster (cobicistat) and is approved for use in treatment naïve patients with either drug resistant or wild type virus. In comparison to Atripla, the first...
Bristol-Myers Squibb Company (NYSE: BMY) today announced that the U.S. Food and Drug Administration (FDA) has approved a supplemental new drug application (sNDA) for SUSTIVA® (efavirenz), including dosing recommendations for...
California and other states would be pressured to amend or repeal criminal laws that single out HIV-positive people under a bipartisan bill co-authored and introduced this week by Rep. Barbara...
Mission Statement
At HIV Haven we wish to provide our readers with vital cutting edge information to help expand HIV knowledge and promote activism, particularly that which works towards an end to the HIV pandemic. It is our desire to bring to you the scientific, medical and social advances that given the appropriate attention and support, could change the course of the HIV pandemic, lessen the devastating effects of HIV and AIDS, better the quality and quantity of life for people living with HIV and even yield an eventual end to the HIV pandemic. We also provide the basics of HIV transmission and treatment.
We will focus on issues such as innovative drug development, strategic activist campaigns, HIV relationships and novel HIV and HIV cure research. We also will bring you advances in Hepatitis C (HCV), a common HIV co-infection. Whether you are living with HIV/AIDS, HIV and HCV, love someone who is, are an activist, advocate, researcher, physician or just an interested party, we hope here at HIV Haven we can help you find what you are looking for.
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