Article Type: Brief article
Subject: AIDS (Disease) (Risk factors)
AIDS (Disease) (Diagnosis)
AIDS (Disease) (Research)
Disease transmission (Research)
HIV infection (Risk factors)
HIV infection (Research)
HIV infection (Diagnosis)
Pub Date: 05/01/2011
Publication: Name: South African Medical Journal Publisher: South African Medical Association Audience: Academic Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2011 South African Medical Association ISSN: 0256-9574
Issue: Date: May, 2011 Source Volume: 101 Source Issue: 5
Topic: Event Code: 310 Science & research
Geographic: Geographic Scope: South Africa Geographic Code: 6SOUT South Africa
Accession Number: 257352889
Full Text: South Africa experienced a measles outbreak beginning in 2009, which peaked in early 2010. Spread of the highly contagious infection was fuelled by overcrowding and poor vaccine coverage of the population. The prevailing HIV epidemic promoted the rare complication of subacute measles encephalitis (SME), (5) and 8 'silent casualties' in the evanescent phase of this outbreak are reported. SME, the diagnosis of which is difficult to make, proved almost uniformly fatal. Measles immunisation of the entire population, including those who are HIV infected, is key to preventing future outbreaks and protecting those living with HIV/AIDS.

GPs and specialists prescribing antiretrovirals (ARVs) to their HIV-positive patients are warned (6) that drug-drug toxic interactions are common, because all ARVs are metabolised through the same hepatic enzyme system. Such drug-drug interactions frequently go unrecognised and arise chiefly from errors in selecting daily doses. Advice is offered regarding appropriate paediatric and adult dosing to achieve efficacy and tolerability.

A survey among newly diagnosed, ARV-naive HIV-infected individuals in Limpopo province (7) shows a reassuringly low prevalence of drug-resistant HI virus mutations, as reported elsewhere in South Africa and in Zambia and Malawi. This contrasts with higher rates in chronically infected but ARV-naive patients in developed countries, perhaps reflecting earlier exposure of the virus to single-drug therapy before the advent of potent multidrug regimens.
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