Browsing by Author "Kharsany, Ayesha Bibi Mahomed."

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Beyond syndromic management: opportunities for diagnosis-based treatment of sexually transmitted infections in low- and middle-income countries.
(Public Library of Science., 2018) Garrett, Nigel Joel.; Osman, Farzana.; Maharaj, Bhavna.; Naicker, Nivashnee.; Gibbs, Andrew.; Norman, Emily.; Samsunder, Natasha.; Ngobese, Hope.; Mitchev, Nireshni.; Singh, Ravesh.; Abdool Karim, Salim Safurdeen.; Kharsany, Ayesha Bibi Mahomed.; Mlisana, Koleka Patience.; Rompalo, Anne.; Mindel, Adrian.
Abstract available in pdf.
Calymmatobacterium granulomatis: culture, electron microscopic studies and molecular analysis.
(1997) Kharsany, Ayesha Bibi Mahomed.; Hoosen, Anwar Ahmed.; Kiepiela, Photini.
Abstract available in PDF.
Challenges in HIV-prevention microbicide research.
(American Association for the Advancement of Science., 2008) Harrison, Polly.; Mellors, John W.; Richardson, Barbra Ann.; Masse, Benoit.; Abdool Karim, Quarraisha.; Abdool Karim, Salim Safurdeen.; Cates, Ward.; Coletti, Anne S.; Derbyshire, Janet.; Dorflinger, Laneta J.; Feldblum, Paul J.; Gabelnick, Henry.; Halpern, Vera Grigorieva.; Jespers, Vicky.; Kharsany, Ayesha Bibi Mahomed.; McCormack, Sheena.; Nunn, Andrew.; McGowan, Ian M.; Omar, Rabeea F.; Padian, Nancy S.; Pedneault, Louise.; Robbiani, Melissa Pope.; Sailer, James.; Taylor, Douglas.; Tolley, Elizabeth E.; Van Damme, Lut.; Vermund, Sten H.; van de Wijgert, Janneke.
No abstract available.
Co-enrollment in multiple HIV prevention trials - experiences from the CAPRISA 004 Tenofovir gel trial.
(Elsevier., 2011) Abdool Karim, Quarraisha.; Kharsany, Ayesha Bibi Mahomed.; Naidoo, Kasavan.; Yende Zuma, Nonhlanhla.; Gengiah, Tanuja Narayansamy.; Omar, Zaheen.; Arulappan, Natasha.; Mlisana, Koleka Patience.; Luthuli, Londiwe R.; Abdool Karim, Salim Safurdeen.
Background—In settings where multiple HIV prevention trials are conducted in close proximity, trial participants may attempt to enroll in more than one trial simultaneously. Co-enrollment impacts on participant’s safety and validity of trial results. We describe our experience, remedial action taken, inter-organizational collaboration and lessons learnt following the identification of co-enrolled participants. Experiences—Between February and April 2008, we identified 185 of the 398 enrolled participants as ineligible. In violation of the study protocol exclusion criteria, there was simultaneous enrollment in another HIV prevention trial (ineligible co-enrolled, n=135), and enrollment of women who had participated in a microbicide trial within the past 12 months (ineligible not co-enrolled, n=50). Following a complete audit of all enrolled participants, ineligible participants were discontinued via study exit visits from trial follow-up. Custom-designed education program on co-enrollment impacting on participants’ safety and validity of the trial results were implemented. Shared electronic database between research units were established to enable verification of each volunteer’s trial participation and to prevent future co-enrollments. Lessons Learnt—Interviews with ineligible enrolled women revealed that high-quality care; financial incentives; altruistic motives; preference for sex with gel; wanting to increase their likelihood of receiving active gel; perceived low risk of discovery and peer pressure as the reasons for their enrolment in the CAPRISA 004 trial. Conclusion—Instituting education programs based on the reasons reported by women for seeking enrolment in more than one trial and using a shared central database system to identify co-enrollments have effectively prevented further co-enrollments.
A drug evaluation of 1% tenofovir gel and tenofovir disoproxil fumarate tablets for the prevention of HIV infection.
(Informa Healthcare., 2011) Gengiah, Tanuja Narayansamy.; Baxter, Cheryl.; Mansoor, Leila Essop.; Kharsany, Ayesha Bibi Mahomed.; Abdool Karim, Salim Safurdeen.
Introduction: More than a million people acquire HIV infection annually. Pre-exposure prophylaxis (PrEP) using antiretrovirals is currently being investigated for HIV prevention. Oral and topical formulations of tenofovir have undergone preclinical and clinical testing to assess acceptability, safety and effectiveness in preventing HIV infection. Areas covered: The tenofovir drug development pathway from compound discovery, preclinical animal model testing and human testing were reviewed for safety, tolerability and efficacy. Tenofovir is well tolerated and safe when used both systemically or applied topically for HIV prevention. High drug concentrations at the site of HIV transmission and concomitant low systemic drug concentrations are achieved with vaginal application. Coitally applied gel may be the favored prevention option for women compared with the tablets, which may be more suitable for prevention in men and sero-discordant couples. However, recent contradictory effectiveness outcomes in women need to be better understood. Expert opinion: Emerging evidence has brought new hope that antiretrovirals can potentially change the course of the HIV epidemic when used as early treatment for prevention, as topical or oral PrEP. Although some trial results appear conflicting, behavioral factors, adherence to dosing and pharmacokinetic properties of the different tenofovir formulations and dosing approaches offer plausible explanations for most of the variations in effectiveness observed in different trials.
The dynamics of HIV transmission in out of school young heterosexual men in South Africa : a systematic scoping review protocol.
(BioMed Central., 2017) Ntombela, Nonzwakazi.; Mashamba-Thompson, Tivani P.; Mtshali, Andile.; Voce, Anna Silvia.; Kharsany, Ayesha Bibi Mahomed.
Abstract available in pdf.
Effectiveness and safety of tenofovir gel, an antiretroviral microbicide, for the prevention of HIV infection in women.
(American Association for the Advancement of Science., 2010) Abdool Karim, Salim Safurdeen.; Abdool Karim, Quarraisha.; Fröhlich, Janet Ann.; Grobler, Anna Christina.; Baxter, Cheryl.; Mansoor, Leila Essop.; Kharsany, Ayesha Bibi Mahomed.; Sibeko, Sengeziwe.; Mlisana, Koleka Patience.; Omar, Zaheen.; Gengiah, Tanuja Narayansamy.; Maarschalk, Silvia.; Arulappan, Natasha.; Mlotshwa, Mukelisiwe.; Morris, Lynn.; Taylor, Douglas.
The Centre for the AIDS Program of Research in South Africa (CAPRISA) 004 trial assessed the effectiveness and safety of a 1% vaginal gel formulation of tenofovir, a nucleotide reverse transcriptase inhibitor, for the prevention of HIV acquisition in women. A double-blind, randomized controlled trial was conducted comparing tenofovir gel (n = 445 women) with placebo gel (n = 444 women) in sexually active, HIV-uninfected 18- to 40-year-old women in urban and rural KwaZulu-Natal, South Africa. HIV serostatus, safety, sexual behavior, and gel and condom use were assessed at monthly follow-up visits for 30 months. HIV incidence in the tenofovir gel arm was 5.6 per 100 women-years (person time of study observation) (38 out of 680.6 women-years) compared with 9.1 per 100 women-years (60 out of 660.7 women-years) in the placebo gel arm (incidence rate ratio = 0.61; P = 0.017). In high adherers (gel adherence > 80%), HIV incidence was 54% lower (P = 0.025) in the tenofovir gel arm. In intermediate adherers (gel adherence 50 to 80%) and low adherers (gel adherence < 50%), the HIV incidence reduction was 38 and 28%, respectively. Tenofovir gel reduced HIV acquisition by an estimated 39% overall, and by 54% in women with high gel adherence. No increase in the overall adverse event rates was observed. There were no changes in viral load and no tenofovir resistance in HIV seroconverters. Tenofovir gel could potentially fill an important HIV prevention gap, especially for women unable to successfully negotiate mutual monogamy or condom use.
Evaluation of laboratory tests for COVID-19 in South Africa.
(2023) Samsunder, Natasha.; Kharsany, Ayesha Bibi Mahomed.; Sivro, Aida.
Abstract available in PDF.
High burden of human papillomavirus (HPV) infection among young women in KwaZulu-Natal, South Africa.
(Public Library of Science., 2016) Ebrahim, Sumayyah.; Mndende, Xolani K.; Kharsany, Ayesha Bibi Mahomed.; Mbulawa, Zizipho Z.; Naranbhai, Vivek.; Werner, Lise.; Samsunder, Natasha.; Abdool Karim, Quarraisha.; Williamson, Anna-Lise.; Fröhlich, Janet Ann.
Abstract available in PDF file.
High prevalence of abnormal Pap smears among young women co-infected with HIV in rural South Africa – implications for cervical cancer screening policies in high HIV prevalence populations.
(South African Medical Association / Health & Medical Publications Group., 2006) Gaym, Asheber.; Mashego, May.; Kharsany, Ayesha Bibi Mahomed.; Walldorf, Jenny.; Fröhlich, Janet Ann.; Abdool Karim, Quarraisha.
Objective. To establish the relationship between HIV infection and cervical dysplasia in young women in rural South Africa. Methods. This cross-sectional study was conducted at a primary health care clinic in Vulindlela, KwaZulu-Natal. Standardised questionnaires were used to collect sociodemographic and clinical presentation data from women attending family planning and other reproductive health services. Pap smears were done using standard methods. Pap smear data were linked to HIV serostatus. Results. Four hundred and sixty-six women were included in the study. The median age was 24.3 years (range 15 - 55 years), and 80% were younger than 30 years. The HIV prevalence rate was 24.5% (95% confidence interval: 20.7 - 28.7%) and the prevalence of abnormal Pap smears was 16.9 - 6.4% ASCUS (atypical squamous cells of undetermined significance), 9.2% LGSIL (low-grade squamous intraepithelial lesions), and 1.3% HGSIL (high-grade squamous intraepithelial lesions). The association between HIV seropositivity and abnormal Pap results was statistically significant (p < 0.05). Conclusion. There is a need for more data on cervical changes in HIV co-infected women and for review of guidelines on selective Pap smear screening in high HIV prevalence settings such as sub-Saharan Africa and where access to antiretroviral treatment remains limited.
HIV incidence in young girls in KwaZulu-Natal, South Africa - public health imperative for their inclusion in HIV biomedical intervention trials.
(Springer U.S., 2012) Abdool Karim, Quarraisha.; Kharsany, Ayesha Bibi Mahomed.; Werner, Lise.; Mlotshwa, Mukelisiwe.; Madlala, Bernadette T.; Abdool Karim, Salim Safurdeen.; Fröhlich, Janet Ann.
Young women are particularly vulnerable for acquiring HIV yet they are often excluded from clinical trials testing new biomedical intervention. We assessed the HIV incidence and feasibility of enrolling a cohort of young women for potential participation in future clinical trials. Between March 2004 and May 2007, 594 HIV uninfected 14–30 year old women were enrolled into a longitudinal HIV risk reduction study in KwaZulu-Natal, South Africa. The overall HIV prevalence at screening in young girls below the age of 18 years was 27.6 % compared to 52.0 % in the women above 18 years, p<0.001. HIV incidence was 4.7 [95 % Confidence interval (CI) 1.5–10.9) and 6.9 (95 % CI 4.8–9.6)/100 women years (wy), p = 0.42 and pregnancy rates were 23.7 (95 % CI 14.9–35.9) and 16.4 (95 % CI 12.9–20.6)/100 wy, p = 0.29, in the women below and above 18 years respectively. Retention was similar in both groups (71.0 vs. 71.5 %, p = 0.90). This study demonstrates that the inclusion of young girls between the ages of 14 and 17 years in longitudinal studies is feasible and their inclusion in clinical trials would maintain scientific integrity and power of the study.
HIV infection and AIDS in Sub-Saharan Africa : current status, challenges and opportunities.
(Bentham Open., 2016) Kharsany, Ayesha Bibi Mahomed.; Abdool Karim, Quarraisha.
Abstract available in PDF file.
HIV infection in high school students in rural South Africa: role of transmissions among students.
(Mary Ann Liebert, Inc., 2014) Kharsany, Ayesha Bibi Mahomed.; Buthelezi, Thulasizwe John.; Fröhlich, Janet Ann.; Yende-Zuma, Fortunate Nonhlanhla.; Samsunder, Natasha.; Mahlase, Gethwana.; Williamson, Carolyn.; Travers, Simon A.; Marais, Jinny C.; Dellar, Rachael Claire.; Abdool Karim, Salim Safurdeen.; Abdool Karim, Quarraisha.
Abstract available in pdf.
HIV prevalence among high school learners - opportunities for schools-based HIV testing programmes and sexual reproductive health services.
(BioMed Central., 2011) Kharsany, Ayesha Bibi Mahomed.; Mlotshwa, Mukelisiwe.; Fröhlich, Janet Ann.; Yende Zuma, Nonhlanhla.; Samsunder, Natasha.; Abdool Karim, Salim Safurdeen.; Abdool Karim, Quarraisha.
Background: Young girls in sub Saharan Africa are reported to have higher rates of human immunodeficiency virus (HIV) infection compared to boys in the same age group. Knowledge of HIV status amongst high schools learners provides an important gateway to prevention and treatment services. This study aimed at determining the HIV prevalence and explored the feasibility of HIV testing among high school learners. Methods: Between September 2010 and February 2011, a linked, anonymous cross-sectional survey was conducted in two public sector high schools in the rural KwaZulu-Natal midlands. Following written informed consent, dried blood spot samples (DBS) were collected and tested for HIV. The overall and age-specific HIV prevalence were compared with select demographic variables. Results: The HIV prevalence in learners aged 12 to 25 in school A was 4.7% (95% CI 2.8-6.5) compared to 2.5% (95% CI 1.6-3.5) in school B, (p = 0.04). Whilst the HIV prevalence was similar for boys at 1.3% (95% CI 0-2.8) in school A and 1.7% (95% CI 0.5-2.8) in school B, the prevalence in girls was consistently higher and was 7.7% (95% CI 4.5-10.9) in school A and 3.2% (95% CI 1.8-4.6) in school B. The age-specific HIV prevalence in girls increased 1.5 to 2 fold for each two year age category, while for boys the prevalence was stable across all age groups. Conclusions: The high HIV prevalence in female learners underscores the importance of sexual reproductive health and schools-based HIV testing programs as an important gateway to prevention and treatment services. Keywords: Young girls, HIV prevalence, surveillance
HIV risk among adolescent girls and young women in age-disparate partnerships: evidence from KwaZulu-Natal, South Africa.
(Wolters Kluwer., 2018) Maughan-Brown, Brendan.; George, Gavin Lloyd.; Beckett, Sean.; Evans, Meredith.; Lewis, Lara.; Cawood, Cherie.; Khanyile, David.; Kharsany, Ayesha Bibi Mahomed.
Abstract available in pdf.
HIV-1 drug resistance before initiation or re-initiation of first-line antiretroviral therapy in low-income and middle-income countries: a systematic review and meta-regression analysis.
(Elsevier., 2018) Gupta, Ravindra K.; Gregson, John.; Parkin, Neil.; Haile-Selassie, Hiwot.; Tanuri, Amilcar.; Andrade Forero, Liliana.; Kaleebu, Pontiano.; Watera, Christine.; Aghokeng, Avelin.; Mutenda, Nicholus.; Dzangare, Janet.; Hone, San.; Hang, Zaw Zaw.; Garcia, Judith.; Garcia, Judith.; Garcia, Zully.; Marchorro, Paola.; Beteta, Enrique.; Giron, Amalia.; Hamers, Raph.; Inzaule, Seth.; Frenkel, Lisa M.; Chung, Michael H.; De Oliveira, Tulio De Paiva Nazareth Andrade.; Pillay, Deenan.; Naidoo, Kogieleum.; Kharsany, Ayesha Bibi Mahomed.; Kugathasan, Ruthiran.; Cutino, Teresa.; Hunt, Gillian.; Avila Rios, Santiago.; Doherty, Meg.; Jordan, Michael R.; Bertagnolio, Silvia.
Abstract available in pdf.
HIV-positive status disclosure in patients in care in rural South Africa: implications for scaling up treatment and prevention interventions.
(Springer., 2015) Abdool Karim, Quarraisha.; Dellar, Rachael Claire.; Bearnot, Benjamin.; Werner, Lise.; Fröhlich, Janet Ann.; Kharsany, Ayesha Bibi Mahomed.; Abdool Karim, Salim Safurdeen.
Abstract available in pdf.
The impact of sexually transmitted infections (STI) and genital tract inflammation on HIV-1 acquisition and rate of disease progression in subtype C infected women.
(2014) Mlisana, Koleka Patience.; Kharsany, Ayesha Bibi Mahomed.; Passmore, Jo-Ann Shelley.
Introduction: Women carry more than half the burden of HIV disease globally and this burden is even higher in sub-Saharan Africa (SSA). Young women, in particular, are at disproportionate risk of HIV infection in South Africa. Understanding risk behaviours and factors associated with ability to negotiate safe sex and condom use is one of the key elements in curbing the spread of HIV. Sexually transmitted infections (STI) and bacterial vaginosis (BV), which cause female genital tract inflammation, have been identified as key drivers of the HIV epidemic. This inflammation, which is also present in the absence of symptoms, is associated with increased susceptibility to HIV infection. Although syndromic management of symptomatic STIs or BV at the first encounter with a health care provider is an important public health measure, its effectiveness is minimised because a substantial proportion of individuals have either asymptomatic infections or fail to recognise signs and symptoms of STI and are therefore excluded. Most new HIV infections in SSA occur among young people and particularly among young girls. Prompt diagnosis of acute HIV infection (AHI) is critical and benefits the individual as well as providing opportunities for public health intervention. In South Africa, the majority of HIV infections are due to infection with HIV-1 subtype C for which there is limited data compared to subtype-B HIV-1 infections. The overall aim of this study was to assess the impact of BV, STIs, and associated genital tract inflammation on acquisition of HIV-1 subtype C infections; and evaluate the rate of subsequent disease progression in women. The objectives were: i. to investigate STIs and genital tract inflammation as risk factors for HIV infection in high risk women and adequacy of syndromic management; ii. to evaluate the challenges associated with diagnosing recently acquired (acute) HIV infection in a subtype C prevalent population; iii. and to evaluate the relationship between clinical disease progression and genital and or systemic inflammation in high-risk women who became infected with HIV. We assessed the adequacy of syndromic diagnosis of STIs, compared with laboratory diagnosis of STIs, and evaluated the association between STI diagnosis and the risk of HIV acquisition in a cohort of high-risk women. Genital cytokine profiles and the degree of inflammation associated with common STIs and bacterial vaginosis were assessed. The most common signs and symptoms of acute HIV infection (AHI) were described and a clinical algorithm to identify acute HIV cases was developed. We investigated rates of HIV disease progression of subtype C–infected South African women. Methods: The CAPRISA 002 study was a prospective cohort study established to examine the pathogenesis and natural history of HIV-1 subtype C infection and to describe the immunologic, virologic and clinical characteristics of acute and early infection in KwaZulu Natal, South Africa. A total of 775 high-risk women were screened for HIV infection, and 245 HIV-uninfected women were enrolled into the study. At each monthly visit for a total of 24 months behavioural and clinical data were collected. Cervico-vaginal lavage (CVL) samples were collected at enrolment and at each six month follow-up visits and were tested for STI pathogens (including Chlamydia trachomatis, Neisseria gonorrhoeae, herpes simplex virus type 2 (HSV-2) and Trichomonas vaginalis) and bacterial vaginosis. Forty-two cytokines were measured from the CVL and 13 from the plasma samples at enrolment. All women received monthly HIV-1 antibody and RNA testing and were assessed for AHI. Signs and symptoms at the visit with HIV-1 antibody or HIV-1 RNA positive test were compared to HIV negative visits. Logistic regression identified clinical predictors of AHI and a model-based score was assigned to each predictor to create a risk score for every woman. All women who seroconverted were followed up for more than five years and monitored for HIV disease progression. Rapid disease progression was defined as CD4+ T cell count decline to <350 cells/μl within two years post-infection. Serial clinical and laboratory assessments were compared using survival analysis and logistic regression models. CAPRISA had established several cohorts of HIV negative women to determine the feasibility of establishing cohorts and sites for HIV biomedical prevention trials. Women seroconverting in these studies were referred to the CAPRISA 002 study for longitudinal follow-up for HIV post seroconversion. Results: In this study, the HIV-1 prevalence at screening was 59.6% (95% CI: 55.9% to 62.8%). During a total of 390 person-years of follow-up, 28 new infections occurred, yielding a seroincidence rate of 7.2 (95% CI: 4.5 to 9.8) per 100 person-years. A total of 62 participants, including seroconvertors from other CAPRISA cohorts, were enrolled into the acute HIV infection Women from the HIV-1 negative cohort generally demonstrated a high level of knowledge on HIV/AIDS, and 60.3% reported use of condoms. Reported condom use at last sexual encounter varied slightly by partner type (57.0% with steady versus 64.4% with casual partners; p = 0.36), whilst self-perceived ability to choose to use a condom was significantly lower with steady partners compared to casual partners (20.8% versus 53.9%; p=0.01). An important finding was that vaginal discharge was a poor predictor of laboratory-diagnosed STIs, as only 12.3% of women (25/204) who had a laboratory-confirmed discharge causing pathogen had clinical evidence of a discharge (yielding a sensitivity of 12.3% and a specificity of 93.8%). CVL cytokine concentrations did not differ between women with asymptomatic or symptomatic STIs; and were elevated in women with either asymptomatic or symptomatic STIs compared to women with no STIs or BV. Women with chlamydia or gonorrhoea had the highest genital cytokine concentrations, with 17/42 and 14/42 of the cytokines measured in CVL being up-regulated compared with women with no infections, respectively. While BV was associated with elevated pro-inflammatory cytokine concentrations in CVL, women with BV had lower levels of chemokines and haematopoietic cytokines than women with no infections or BV. HSV-2 reactivation was inflammatory, but yielded a comparatively lower level of inflammation than Chlamydia or gonnorhoea. Trichomoniasis, despite being relatively common in this cohort, did not cause significant changes in genital tract cytokine concentrations compared to women with no infections or BV. Genital infections did not influence plasma cytokine concentrations, suggesting that the compartments were not linked with respect to cytokine responses. Although laboratorydiagnosed STIs were associated with increased risk of HIV infection [hazard ratio, 3.3 (95% confidence interval, 1.5 – 7.2)], clinical symptoms were not. Of the women who became infected, factors predictive of AHI included age, 25 years (OR = 3.2; 1.4 – 7.1), rash (OR = 6.1; 2.4 –15.4), sore throat (OR = 2.7; 1.0 – 7.6), weight loss (OR = 4.4; 1.5 – 13.4), genital ulcers (OR = 8.0; 1.6 – 39.5) and vaginal discharge (OR = 5.4; 1.6 – 18.4). A risk score of 2 correctly predicted AHI in 50.0% of cases. The number of signs and symptoms correlated with higher HIV-1 RNA at diagnosis (r = 0.63; p = 0.001). The 62 acutely infected women were identified at a median of 42 days post-infection (IQR = 34 – 59). Mean CD4 count dropped by 39.6% at 3 months and 46.7% at 6 months post-infection in women with pre-infection measurements. CD4 decline to <350 cells/μL occurred in 31%, 44%, and 55% of women at 1, 2, and 3 years post-infection, respectively, and to <500 cells/μL in 69%, 79%, and 81% at equivalent time-points. Predictors of rapid progression were CD4 count at 3 months post-infection (hazard ratio [HR], 2.07; 95% confidence interval [CI], 1.31–3.28; P = .002), setpoint viral load (HR, 3.82; 95% CI, 1.51–9.67; P = .005), and hepatitis B coinfection (HR, 4.54; 95% CI, 1.31–15.69; P = .017). Conversely, presence of any of HLAB*1302, B*27, B*57, B*5801, or B*8101 alleles predicted non–rapid progression (HR, 0.19; 95% CI, .05–.74; P = .016). Discussion/Conclusion: This study showed that syndromic STI diagnosis, which is dependent on clinical signs of vaginal discharge, was poorly predictive of laboratory-diagnosed STIs or BV and missed a significant proportion of women with asymptomatic infections. However, the level of genital inflammation, as measured by cytokine concentrations in CVL, was similar in women with symptomatic and asymptomatic infections and therefore place women at increased risk for HIV infection. While laboratory-diagnosed STIs and the presence of inflammatory cytokines in the genital tract were associated with increased susceptibility to HIV acquisition, vaginal discharge was not. Chlamydial infection was associated with the highest genital cytokine concentrations, followed by gonorrhoea, HSV-2, trichomoniasis, and BV. In regions where HIV is prevalent and STIs are managed syndromically, targeted screening of populations at risk for STIs is critical and urgently needed. Recognition of signs and symptoms of AHI is important for early diagnosis of HIV infection. The proposed algorithm of risk-stratifying individuals for AHI provides a useful clinical tool especially in resource-limited settings where there are limited or no routinely available tests for AHI. However, validation of the algorithm on another cohort is needed to assess its utility further. Point-of-care HIV antigen or viral load testing is needed, to detect asymptomatic, antibody negative cases enabling early interventions and prevention of transmission. This cohort showed high rates of rapid disease progression, with nearly half of these subtype C–infected women progressing to a CD4+ T cell count of below 350 cells/μL within 2 years of infection. Implementing 2013 World Health Organization treatment guidelines (CD4+ T cell counts less than 500cells/μL) would require most individuals to start antiretroviral therapy within 1 year of HIV infection. The economic and health systems planning implicated by these findings need to be explored and addressed to guide policy makers as countries adopt the current WHO guidelines.
Increasing burden of pulmonary tuberculosis in young women.
(South African Medical Association / Health & Medical Publications Group., 2006) Kharsany, Ayesha Bibi Mahomed.; Connolly, Catherine A.; Olowolagba, Ayo.; Abdool Karim, Salim Safurdeen.; Abdool Karim, Quarraisha.
No abstract available.
Killer-cell Immunoglobulin-like Receptor (KIR) gene profiles modify HIV disease course, not HIV acquisition in South African women.
(BioMed Central., 2016) Naranbhai, Vivek.; de Assis Rosa, Debra.; Werner, Lise.; Moodley, Ramona.; Hong, Heather.; Kharsany, Ayesha Bibi Mahomed.; Mlisana, Koleka Patience.; Sibeko, Sengeziwe.; Garrett, Nigel Joel.; Chopera, Denis Rutendo.; Carr, William Henry.; Abdool Karim, Quarraisha.; Hill, Adrian V. S.; Abdool Karim, Salim Safurdeen.; Altfeld, Marcus.; Gray, Clive M.; Ndung'u, Peter Thumbi.
Abstract available in PDF file.