A5086632008- HIV/AIDS Research and Interventions
- HIV/AIDS drug development and treatment
- HIV Research and Treatment
- Pneumocystis jirovecii pneumonia detection and treatment
- HIV-related health complications and treatments
- Pharmaceutical Practices and Patient Outcomes
- Atrial Fibrillation Management and Outcomes
- Pharmacovigilance and Adverse Drug Reactions
- Pharmaceutical studies and practices
- Drug-Induced Hepatotoxicity and Protection
- Tuberculosis Research and Epidemiology
- Health Systems, Economic Evaluations, Quality of Life
- Blood Pressure and Hypertension Studies
- Venous Thromboembolism Diagnosis and Management
- Adolescent Sexual and Reproductive Health
- COVID-19 Clinical Research Studies
- Psychosomatic Disorders and Their Treatments
- HIV/AIDS Impact and Responses
- Pharmacological Effects and Toxicity Studies
- Pharmacogenetics and Drug Metabolism
- SARS-CoV-2 and COVID-19 Research
- Pharmaceutical Economics and Policy
- Liver Disease and Transplantation
- Reproductive tract infections research
- Health Policy Implementation Science
University of Cape Town
2015-2024
Department of Health
2020-2024
Groote Schuur Hospital
2009-2024
South African Medical Research Council
2023
University of KwaZulu-Natal
2023
Cecilia Makiwane Hospital
2023
Walter Sisulu University
2023
Stellenbosch University
2023
Centre for the AIDS Programme of Research in South Africa
2023
Canadian Psychological Association
2012-2022
HIV-positive individuals are at increased risk for kidney disease, including HIV-associated nephropathy, noncollapsing focal segmental glomerulosclerosis, immune-complex and comorbid as well injury resulting from prolonged exposure to antiretroviral therapy or opportunistic infections. Clinical guidelines disease prevention treatment in largely extrapolated studies the general population, do not fully incorporate existing knowledge of unique HIV-related pathways genetic factors that...
There are conflicting findings about whether mobile phone text message reminders impact on antiretroviral adherence. We hypothesized that sent when dosing was late would improve adherence and HIV viral suppression.Antiretroviral therapy (ART)-naive participants, from a South African outpatient ART clinic, were randomized to standard of care (SoC, 3 pretreatment education sessions), or intervention (SoC automated if >30 minutes late). Dosing time recorded by real-time electronic monitoring...
The incidence of work resumption two groups differentially treated workman's compensation patients with chronic pain was retrospectively examined. Significantly more who were directed to return during the treatment program (group II) did so (60%), than in another group I) similarly but for whom not a component therapy (25%). At follow-up an average 9.6 months later, 90% II still working. As well, receiving fewer benefits and had received less additional their I patients.
Fatal adverse drug reactions (ADRs) are important causes of death, but data from resource-limited settings scarce. We determined the proportion deaths in South African medical inpatients attributable to ADRs, and their preventability, stratified by human immunodeficiency virus (HIV) status.We reviewed folders all patients who died over a 30 day period wards four hospitals. identified ADR-related (deaths where an ADR was 'possible', 'probable' or 'certain' using WHO-UMC criteria contributed...
Limited data exist on the burden of serious adverse drug reactions (ADRs) in sub-Saharan Africa, which has high HIV and tuberculosis prevalence. We determined proportion adult admissions attributable to ADRs at 4 hospitals South Africa. characterized drugs implicated in, risk factors for, preventability ADR-related admissions. prospectively followed patients admitted hospitals' medical wards over sequential 30-day periods 2013 identified suspected with aid a trigger tool. A multidisciplinary...
Abstract Background Incomplete adherence to antiretroviral therapy (ART) results in virologic failure and resistance. It remains unclear which measure best predicts these outcomes. We compared six patient-reported objective measures one ART-naïve cohort South Africa. Methods recruited 230 participants from a community ART clinic prospectively collected demographic data, CD4 count HIV-RNA at weeks 0, 16 48. quantified using 3-day self-report (SR), clinic-based pill (CPC), average by pharmacy...
Nevirapine-containing antiretroviral therapy (ART) and rifampicin-based antitubercular are commonly co-administered in Africa, where nevirapine is often the only available non-nucleoside reverse transcriptase inhibitor. Rifampicin induces metabolism of nevirapine, but extent reduction concentrations has varied widely previous studies. We describe steady-state pharmacokinetics during after South African patients.Sixteen patients receiving ART including standard doses were admitted twice for...
Nosocomial infections due to multi-drug resistant Acinetobacter baumannii are often treated with colistin, but there few data comparing its safety and efficacy other antimicrobials.A retrospective cohort study of patients colistin or tobramycin for A. in intensive care units (ICUs) at Groote Schuur hospital. Colistin was used isolates which were all available antimicrobials. In the group, 53% only susceptible colistin. We assessed ICU mortality, nephrotoxicity time first negative culture.32...
ABSTRACT Artemether-lumefantrine and nevirapine-based antiretroviral therapy (ART) are the most commonly recommended first-line treatments for malaria HIV, respectively, in Africa. Artemether, lumefantrine, nevirapine metabolized by cytochrome P450 3A4 enzyme system, which induces, creating potential important drug interactions. In a parallel-design pharmacokinetic study, concentration-time profiles were obtained two groups of HIV-infected patients: ART-naïve patients those stable on...
Efavirenz is the preferred nonnucleoside reverse transcriptase inhibitor (NNRTI) in first-line antiretroviral therapy (ART) regimens low- and middle-income countries, where prevalence of diabetes increasing. Randomized control trials have shown mild increases plasma glucose participants efavirenz arms, but no association has been reported with overt diabetes. We explored between exposure incident a large Southern African cohort commencing NNRTI-based ART. Our included HIV-infected adults...
Background Rifampicin induces expression of the cytochrome P450 isoenzyme 2B6 (CYP2B6), which metabolizes efavirenz. The CYP2B6 516G>T polymorphism impairs efavirenz metabolism and occurs more commonly in Africans than Caucasians. We explored effect rifampicin-based antitubercular therapy on concentrations HIV- infected patients South Africa. Methods Between-patient within-patient comparisons were made mid-dosing interval plasma adults antiretroviral including 600 mg daily, with without...
High rates of second-line antiretroviral treatment (ART) failure are reported. The association with resistance and nonadherence on switching to ART requires clarification.Using prospectively collected data from patients in South Africa, we constructed a cohort switched (1 January 2003 through 31 December 2008). Genotyping drug concentrations (lamivudine, nevirapine, efavirenz) were measured stored samples preswitch. Their viral load (VL) <400 copies/mL by 15 months was assessed using...
Purpose We determined the prevalence and correlates of low bone mineral density (BMD) in HIV-infected South Africans as there is a paucity such data from Africa. Methods BMD serum 25-hydroxyvitamin D were measured HIV-positive participants on antiretroviral therapy (ART) those not yet ART (ART-naïve). Results enrolled 444 [median age 35(IQR: 30, 40) years; 77% women]. was (z score <-2SD) 17% 5% at lumbar spine total hip, respectively. Total hip [0.909 (SD 0.123) vs 0.956 0.124) g/cm2, p =...
Abstract Introduction : Tenofovir has been associated with decline in kidney function, but patients low baseline improvements over time have reported. Additionally, the magnitude and trajectory of estimated glomerular filtration rate (eGFR) changes may differ according to how eGFR is calculated. We described time, incidence of, risk factors for, toxicity, a South African cohort. Methods included antiretroviral‐naïve ≥16 years old who started tenofovir‐containing antiretroviral therapy (ART)...