Browsing by Author "Hanley, Sherika."

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An exploration of anaemia in low birth weight infants exposed to perinatal zidovudine at the neonatal unit in King Edward VIII Hospital.
(2013) Hanley, Sherika.; Ross, Andrew John.; Adhikari, Miriam.
Large clinical trials beginning with the PACTG-076 trial and other trials across Europe and America have showed that perinatal exposure to Zidovudine (AZT) results in haematological side effects in the neonate, mainly anaemia, which are clinically insignificant and reversible. There is however limited data in sub-Saharan Africa on the impact of intrauterine exposure to AZT on neonates, particularly low birth weight neonates, at the height of the HIV/PMTCT era. The aim of the study was to evaluate the prevalence and clinical significance of anaemia among low birth weight neonates, in a diverse South African setting. This observational descriptive study looked at medical records of HIV-exposed, low-birth weight neonates (less than 2500g) admitted to the neonatal unit at King Edward VIII Hospital from May 2008 to February 2010, who have had intrauterine exposure to AZT. A total of 95 neonatal birth and medical records were analysed. The total prevalence of anaemia was 47%. The neonates were placed into categories according to gestational age. The prevalence of anaemia was 16.7% and the mean Hb was 17g/dL in the 26-28 week gestational age category, prevalence of anaemia was 37% and mean Hb was 16g/dL in the 29-31 week category, and the prevalence of anaemia was 54.8% with a mean of 17g/dL in the over 31 week gestational age category. The minimum haemoglobin was 11.0g/dL and maximum haemoglobin was 24g/dL. The mean haemoglobin in the neonates exposed to more than 28 days of Zidovudine was lower than the mean Hb in neonates exposed to less than 28 days in the 29-31week and over 31 week gestational age categories. The haematological side effects of anaemia in neonates resulting from AZT exposure inutero were found to be prevalent but of a mild and clinically insignificant nature in keeping with existing international and continental studies. The severity of anaemia in low birth weight/ pre-term neonates appears to be the same as in term neonates of normal birth weight depicted in these studies. The presence of neonatal anaemia at birth has been shown to be related to the duration of exposure to intrauterine AZT in one of the three age groups. There were no identified issues that would warrant amending current recommendations for the routine use of AZT for the prevention of mother-child HIV transmission however these findings require further research involving larger numbers and follow up of neonates in order to adequately analyse current PMTCT guidelines.
Investigating platelet and endothelial activation in ART-treated women living with HIV and obesity.
(2022) Mfusi, Snenhlanhla Angel.; Nkambule, Bongani Brian.; Hanley, Sherika.
Background: Antiretroviral therapy (ART) has reduced morbidity and mortality in people living with Human immunodeficiency virus (PLWH). However, metabolic and thrombotic complications have now become prevalent in the aging population of PLWH. The spectrum of cardiovascular disease in patients with HIV is broad and the mechanisms underlying the risk of cardiovascular disease (CVD) in PLWH remains complex and multifactorial. This includes an interplay between traditional risk factors such as obesity which in the general population is more prevalent in women. This study aimed to assess the association between platelet activation, endothelial activation and CVD-risk in women living with HIV. Methods: In this study we included 66 female participants living with HIV (n=33 normal weight and n=33 overweight/obese) enrolled in the prospective multi-country PEPFAR PROMise Ongoing Treatment Evaluation (PROMOTE) study from the Umlazi clinical research site. The time of blood draws ranges from December 2018- November 2019. We measured the levels of high sensitivity creactive protein (hsCRP), lipid profiles, platelet activation (P-selectin, CD36 and platelet factor-4) and markers of endothelial activation (endothelin-1, von Willebrand factor). Results:Women living with HIV(WLHIV) and obesity showed significantly elevated levels of soluble CD36 4.36[2.71-9.53] when compared to the control group 2.79[2.24-3.55], p=0.0064. Furthermore, the levels of (vWF) were elevated in WLHIV and obesity 8.83[1.59-9.78] when compared to controls 5.34[0.65-7.7] p=0.0009. However, the levels of soluble P-selectin, platelet factor-4 (PF4) and endothelin-1 (ET-1) were comparable between two study groups (p>0.05). Lastly, the levels of hsCRP levels were significantly higher in WLHIV and obesity (7.71±9.95) when compared to controls (3.68±5.89) p= 0.0005. Conclusion: The levels of platelet and endothelial activation are elevated in WLHIV and obesity despite successful ART. Moreover, the levels of inflammation remain persistently high even during ART. Therefore, WLHIV and obesity are at an increased risk of developing CVD.
The multi-country PROMOTE HIV antiretroviral treatment observational cohort in Sub-Saharan Africa: objectives, design, and baseline findings.
(Public Library of Science., 2018) Taha, Taha E.; Yende-Zuma, Fortunate Nonhlanhla.; Aizire, Jim.; Chipato, Tsungai.; Wambuzi Ogwang, Lillian.; Makanani, Bonus.; Chinula, Lameck.; Nyati, Mandisa M.; Hanley, Sherika.; Brummel, Sean S.; Fowler, Mary Glenn.
Abstract available in pdf.