A5080500263- HIV/AIDS Research and Interventions
- HIV Research and Treatment
- HIV/AIDS drug development and treatment
- COVID-19 Clinical Research Studies
- Tuberculosis Research and Epidemiology
- Pneumocystis jirovecii pneumonia detection and treatment
- HIV-related health complications and treatments
- HIV, Drug Use, Sexual Risk
- Infective Endocarditis Diagnosis and Management
- Viral-associated cancers and disorders
- SARS-CoV-2 and COVID-19 Research
- Diabetes Treatment and Management
- HIV/AIDS Impact and Responses
- COVID-19 and healthcare impacts
- Global Maternal and Child Health
- Fungal Infections and Studies
- Long-Term Effects of COVID-19
- Antifungal resistance and susceptibility
- Adolescent Sexual and Reproductive Health
- Viral Infections and Outbreaks Research
- Lymphoma Diagnosis and Treatment
- Antimicrobial Resistance in Staphylococcus
- Streptococcal Infections and Treatments
- Polyomavirus and related diseases
- COVID-19 epidemiological studies
Stellenbosch University
2015-2024
Tygerberg Hospital
2012-2024
Western Cape Department of Health
2021-2022
University of Cape Town
2010-2015
Johns Hopkins University
2009-2015
Tan Tock Seng Hospital
2015
Inserm
2015
Indiana University – Purdue University Indianapolis
2015
City University of New York
2015
Capital Medical University
2014
Background Few estimates exist of the life expectancy HIV-positive adults receiving antiretroviral treatment (ART) in low- and middle-income countries. We aimed to estimate patients starting ART South Africa compare it with that HIV-negative adults. Methods Findings Data were collected from six African cohorts. Analysis was restricted 37,740 for first time. Estimates mortality obtained by linking patient records national population register. Relative survival models used excess attributable...
Background Increased mortality among men on antiretroviral therapy (ART) has been documented but remains poorly understood. We examined the magnitude of and risk factors for gender differences in ART. Methods Findings Analyses included 46,201 ART-naïve adults starting ART between January 2002 December 2009 eight programmes across South Africa (SA). Patients were followed from initiation to outcome or analysis closure. The primary was mortality; secondary outcomes loss follow-up (LTF),...
The interaction between COVID-19, non-communicable diseases, and chronic infectious diseases such as HIV tuberculosis is unclear, particularly in low-income middle-income countries Africa. South Africa has a national prevalence of 19% among people aged 15-49 years 0·7% all ages. Using nationally representative hospital surveillance system Africa, we aimed to investigate the factors associated with in-hospital mortality patients COVID-19.In this cohort study, used data submitted DATCOV,...
The objective was to compare COVID-19 outcomes in the Omicron-driven fourth wave with prior waves Western Cape, assess contribution of undiagnosed infection differences a context high seroprevalence due and determine whether protection against severe disease conferred by and/or vaccination maintained.
Little is known about the temporal impact of rapid scale-up large antiretroviral therapy (ART) services on programme outcomes. We describe patient outcomes [mortality, loss-to-follow-up (LTFU) and retention] over time in a network South African ART cohorts.Cohort analysis utilizing routinely collected data.Analysis included adults initiating eight public sector programmes across Africa, 2002-2007. Follow-up was censored at end 2008. Kaplan-Meier methods were used to estimate outcomes,...
To describe the CD4 cell count at start of combination antiretroviral therapy (cART) in low-income (LIC), lower middle-income (LMIC), upper (UMIC), and high-income (HIC) countries.Patients aged 16 years or older starting cART a clinic participating multicohort collaboration spanning 6 continents (International epidemiological Databases to Evaluate AIDS ART Cohort Collaboration) were eligible. Multilevel linear regression models adjusted for age, gender, calendar year; missing counts...
The genus emmonsia contains three species that are associated with human disease. Emmonsia crescens and parva the agents cause adiaspiromycosis, one case of pasteuriana infection has been described. We report a fungal pathogen within is most closely related to E. in immunodeficiency virus (HIV)-infected adults South Africa.Between July 2008 2011, we conducted enhanced surveillance identify systemic, dimorphic infections patients presenting Groote Schuur Hospital other hospitals affiliated...
Objectives: To measure rates and predictors of virologic failure switch to second-line antiretroviral therapy (ART) in South Africa. Design: Observational cohort study. Methods: We included ART-naive adult patients initiated on public sector ART (January 2000 July 2008) at 5 sites Africa who completed ≥6 months follow-up. estimated cumulative risk (viral load ≥400 copies/mL with confirmation above varying thresholds) switching ART. Results: Nineteen thousand six hundred forty-five (29,935...
We aimed to compare COVID-19 outcomes in the Omicron-driven fourth wave with prior waves Western Cape, contribution of undiagnosed infection differences a context high seroprevalence due infection, and whether protection against severe disease conferred by and/or vaccination was maintained.
a b s t r c Objectives: We aimed to compare the clinical severity of Omicron BA.4/BA.5 infection with BA.1 and earlier variant infections among laboratory-confirmed SARS-CoV-2 cases in Western Cape, South Africa, using timing infer lineage/variant causing infection.Methods: included public sector patients aged ≥20 years COVID-19 between May 01-May 21, 2022 (BA.4/BA.5 wave) equivalent previous wave periods.We compared risk waves (i) death (ii) severe hospitalization/death (all within 21 days...
To compare outcomes of antiretroviral therapy (ART) in South Africa, where viral load monitoring is routine, with those Malawi and Zambia, based on CD4 cell counts.We included 18,706 adult patients starting ART Africa 80,937 Zambia or Malawi. We examined responses models for repeated measures the probability switching to second-line regimens, mortality loss follow-up multistate models, measuring time from 6 months.In 9.8% [95% confidence interval (CI) 9.1-10.5] had switched at 3 years, 1.3%...
Many HIV-infected children in Southern Africa have been started on antiretroviral therapy (ART), but loss to follow up (LTFU) can be substantial. We analyzed mortality retained care and all starting ART, taking LTFU into account.Children who ART before the age of 16 years 10 programs South Africa, Malawi, Mozambique, Zimbabwe were included. Risk factors for death first year identified Weibull models. A meta-analytic approach was used estimate cumulative at 1 year.Eight thousand two hundred...
Background. We describe the geographic distribution, clinical characteristics, and management of patients with disease caused by Emmonsia sp., a novel dimorphic fungal pathogen recently described in South Africa. Methods. performed multicenter, retrospective chart review laboratory-confirmed cases emmonsiosis diagnosed across Africa from January 2008 through February 2015. Results. Fifty-four were 5/9 provinces. Fifty-one (94%) human immunodeficiency virus coinfected (median CD4 count 16...
Having 90% of patients on antiretroviral therapy (ART) and achieving an undetectable viral load (VL) is 1 the 90:90:90 by 2020 targets. In this global analysis, we investigated proportions adult paediatric with VL suppression in first 3 years after ART initiation.
South Africa (SA) has a high prevalence of HIV and tuberculosis. Cape Town was the SA metropole most affected in early stages COVID-19 pandemic. Early observational data from may provide valuable insight into what can be expected as pandemic expands across continent. To describe prevalence, clinical features, comorbidities outcome an cohort HIV-positive HIV-negative patients admitted with COVID-19. This descriptive study adults pneumonia 25 March to 11 May 2020. Of 116 (mean age 48 years,...
The incidence of Kaposi's Sarcoma (KS) is high in South Africa but the impact antiretroviral therapy (ART) not well defined. We examined and survival KS HIV-infected patients enrolled African ART programs. analyzed data three programs: Khayelitsha township Tygerberg Hospital programs Cape Town Themba Lethu program Johannesburg. included aged >16 years. was defined as a regimen at least drugs. estimated rates for on ART. calculated Cox models adjusted age, sex time-updated CD4 cell counts...
Abstract Introduction : South Africa has the largest number of individuals living with HIV and antiretroviral therapy (ART) programme worldwide. In September 2016, ART eligibility was extended to all 7.1 million HIV‐positive Africans. To ensure that further expansion services does not compromise quality care, long‐term outcomes must be monitored. Few studies have reported mortality in resource‐constrained settings, where ascertainment is challenging. Combining site records data linked...
To evaluate long-term outcomes in HIV-infected adolescents, it is important to identify ways of tracking after transfer a different health facility. The Department Health (DoH) the Western Cape Province (WCP) South Africa uses single unique identifier for all patients across service platform. We examined adolescent by linking data from four International epidemiology Databases Evaluate AIDS Southern (IeDEA-SA) cohorts WCP with DoH data.We included adolescents on antiretroviral therapy who...
Background: The risk of Kaposi sarcoma (KS) among HIV-infected persons on antiretroviral therapy (ART) is not well defined in resource-limited settings. We studied KS incidence rates and associated factors children adults ART Southern Africa. Methods: included patient data 6 programs Botswana, South Africa, Zambia, Zimbabwe. estimated patients measuring time from 30 days after initiation to diagnosis, last follow-up visit, or death. assessed (age, sex, calendar year, WHO stage, tuberculosis,...
Skin lesions are common in advanced HIV infection and sometimes caused by serious diseases like systemic mycoses (SM). AIDS-related SM endemic to Western Cape, South Africa, include emergomycosis (formerly disseminated emmonsiosis), histoplasmosis, sporotrichosis. We previously reported that 95% of patients with had skin lesions, although these were frequently overlooked or misdiagnosed clinically. Prospective studies needed characterize Africa help distinguish from HIV-related dermatoses.We...
Mental disorders can adversely affect HIV treatment outcomes and survival. Data are scarce on premature deaths in people with mental HIV-positive populations, particularly low-income middle-income countries. In this study, we quantified excess mortality associated South Africa, adjusting for outcomes.For cohort analysed routinely collected data adults receiving antiretroviral therapy (ART) Cape Town, Africa between Jan 1, 2004, to Dec 31, 2017. from three ART programmes were linked routine...
Abstract Introduction : Chronic immune activation due to ongoing HIV replication may lead impaired responses against opportunistic infections such as tuberculosis (TB). We studied the role of a risk factor for incident TB after starting antiretroviral therapy (ART). Methods included all HIV‐positive adult patients (≥16 years) in care between 2000 and 2014 at three ART programmes South Africa. Patients with previous were excluded. Missing CD4 cell counts HIV‐RNA viral loads start (baseline)...
There is uncertainty regarding the completeness of death recording by civil registration and health centres in South Africa. This paper aims to compare two systems, cohorts African patients receiving antiretroviral treatment (ART).Completeness was estimated using a capture-recapture approach. Six ART programmes linked their patient record systems vital system identity document (ID) numbers provided data comparing outcomes recorded files registration. Patients were excluded if they had...