scholarly journals Importance of Nonenteric Protozoan Infections in Immunocompromised People

2010 ◽  
Vol 23 (4) ◽  
pp. 795-836 ◽  
Author(s):  
J. L. N. Barratt ◽  
J. Harkness ◽  
D. Marriott ◽  
J. T. Ellis ◽  
D. Stark
Keyword(s):  
Highly Active Antiretroviral Therapy ◽  
Neglected Tropical Diseases ◽  
Sub Saharan Africa ◽  
Diagnosis And Treatment ◽  
Free Living ◽  
Western Countries ◽  
Highly Active ◽  
Protozoan Infections ◽  
Sub Saharan ◽  
Global Travel

SUMMARY There are many neglected nonenteric protozoa able to cause serious morbidity and mortality in humans, particularly in the developing world. Diseases caused by certain protozoa are often more severe in the presence of HIV. While information regarding neglected tropical diseases caused by trypanosomatids and Plasmodium is abundant, these protozoa are often not a first consideration in Western countries where they are not endemic. As such, diagnostics may not be available in these regions. Due to global travel and immigration, this has become an increasing problem. Inversely, in certain parts of the world (particularly sub-Saharan Africa), the HIV problem is so severe that diseases like microsporidiosis and toxoplasmosis are common. In Western countries, due to the availability of highly active antiretroviral therapy (HAART), these diseases are infrequently encountered. While free-living amoebae are rarely encountered in a clinical setting, when infections do occur, they are often fatal. Rapid diagnosis and treatment are essential to the survival of patients infected with these organisms. This paper reviews information on the diagnosis and treatment of nonenteric protozoal diseases in immunocompromised people, with a focus on patients infected with HIV. The nonenteric microsporidia, some trypanosomatids, Toxoplasma spp., Neospora spp., some free-living amoebae, Plasmodium spp., and Babesia spp. are discussed.

scholarly journals Held to Ransom: CMV Treatment in South Africa

2010 ◽  
Vol 11 (1) ◽  
Author(s):  
Fatima Laher ◽  
Gail Ashford ◽  
Angela Cescon ◽  
Claire Cullen ◽  
Erica Lazarus ◽  
...  
Keyword(s):  
South Africa ◽  
Antiretroviral Treatment ◽  
Systemic Infection ◽  
Sub Saharan Africa ◽  
Diagnosis And Treatment ◽  
Price Reduction ◽  
Treatment Programme ◽  
Highly Active ◽  
Highly Active Antiretroviral Treatment ◽  
Sub Saharan

Cytomegalovirus is a multi-systemic infection reactivated in the immunocompromised. Diagnosis and treatment are prohibitively costly in sub-Saharan Africa, and efforts need to be made for their price reduction to support the expanding highly active antiretroviral treatment programme in the region.

scholarly journals Associations between highly active antiretroviral therapy and the presence of HPV, premalignant and malignant cervical lesions in sub-Saharan Africa, a systematic review: current evidence and directions for future research

BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e015123 ◽  
Author(s):  
Sonia Menon ◽  
Rodolfo Rossi ◽  
Natasha Zdraveska ◽  
Mbabazi Kariisa ◽  
Sushama D Acharya ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Invasive Cervical Cancer ◽  
Cd4 Count ◽  
Sub Saharan Africa ◽  
Current Evidence ◽  
Cervical Lesions ◽  
Highly Active ◽  
Sub Saharan ◽  
The Impact

ObjectivesIn sub-Saharan Africa, substantial international funding along with evidence-based clinical practice have resulted in an unparalleled scale-up of access to antiretroviral treatment at a higher CD4 count. The role and timing of highly active antiretroviral therapy (HAART) in mediating cervical disease remains unclear. The aim of this article is to systematically review all evidence pertaining to Africa and identify research gaps regarding the epidemiological association between HAART use and the presence of premalignant/malignant cervical lesions.MethodFive databases were searched until January 2017 to retrieve relevant literature from sub-Saharan Africa. Publications were included if they addressed prevalence, incidence or clearance of human papillomavirus (HPV) infection in women undergoing HAART as well as cytological or histological neoplastic abnormalities.Results22 studies were included, of which seven were prospective studies. Women receiving HAART are less likely to develop squamous intraepithelial lesions (SILs). There is evidence that duration of HAART along with the CD4 count may reduce the prevalence of high-risk HPV (HR-HPV), suggesting that without HAART, severe immunosuppression increases the risk of becoming or remaining infected with HR-HPV. Furthermore, according to existent literature, the CD4 count, rather than HAART coverage or its duration, plays a central role in the prevalence of cervical intraepithelial neoplasia (CIN) 2 and CIN 3.ConclusionOur findings suggest a positive impact of HAART duration, in conjunction and interaction with CD4 count, on reducing the prevalence of HR-HPV. The greatest treatment effect might be seen among women starting at the lowest CD4 count, which may have a more instrumental role in cervical oncogenesis than either HAART use or the treatment duration on the prevalence of CIN 2 and CIN 3. There is still insufficient evidence to show a clear association between HAART coverage and the incidence of invasive cervical cancer. Enhanced surveillance on the impact of HAART treatment is crucial.

Initiating highly active antiretroviral therapy in sub-Saharan Africa

AIDS ◽  
2004 ◽  
Vol 18 (8) ◽  
pp. 1159-1168 ◽  
Author(s):  
Motasim Badri ◽  
Linda-Gail Bekker ◽  
Catherine Orrell ◽  
Jennifer Pitt ◽  
François Cilliers ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Sub Saharan Africa ◽  
Highly Active ◽  
Sub Saharan

scholarly journals Cardiac Disease and HIV in Africa: A Case for Physical Exercise

2015 ◽  
Vol 9 (1) ◽  
pp. 62-65 ◽  
Author(s):  
Ana Olga Mocumbi
Keyword(s):  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Opportunistic Infections ◽  
Hiv Infections ◽  
Sub Saharan Africa ◽  
Hiv Patients ◽  
Effective Prevention ◽  
Highly Active ◽  
Sub Saharan ◽  
Type Of Exercise

AIDS-related deaths and new HIV infections have declined globally, but continue to be a major problem in Africa. Prior to the advent of antiretroviral treatment (ART) HIV patients died of immunodeficiency and associated opportunistic infections; Highly Active Antiretroviral Therapy (HAART) has resulted in increased survival of these patients and has transformed this illness into a chronic condition. Cardiovascular, respiratory, neurological and muscular problems interfere with exercise in HIV-infected patients. Particularly cardiovascular disease may be associated with direct damage by the virus, by antiretroviral therapy and by malnutrition and chronic lung disease, resulting in physical and psychological impairment. Recent studies have shown the benefits of exercise training to improvement of physiologic and functional parameters, with the gains being specific to the type of exercise performed. Exercise should be recommended to all HIV patients as an effective prevention and treatment for metabolic and cardiovascular syndromes associated with HIV and HAART exposure in sub-Saharan Africa.

Sign in / Sign up

Export Citation Format

Share Document