September HIV/AIDS Public Health Journal Club

The September Journal Club featured presentations by two researchers from the Department of Virology at the Nelson R Mandela School of Medicine: Dr Chris Jack, who spoke on the co-epidemics of HIV and TB, and Dr Raveen Parboosing, who presented on "HIV and HCV: Epidemiological Synergy?

Dr Jack referred to three journal articles, the first being: DOUBLE SCOURGE: TB AND HIV CO-INFECTION El-Sadr W, The PRN Notebook Dec. 2001, 6(4): 4-15. In introducing this study, Dr Jack gave a brief background to the scale and nature of the co-epidemics of HIV and TB, followed by coverage of the pathogenesis of TB, the HIV factor, latent TB infection, and the impact of and problems inherent in HAART.

The second journal article on this topic was entitled: TREATMENT OF TB IN HIV-INFECTED PERSONS IN THE ERA OF ACTIVE ART Dean et al, AIDS 2002, 16:75 - 83. Dr Jack described the objectives, design and methodology of the study, as well as its results and discussion thereof, which contained some recommendations.

The third journal article was entitled: EFFECT OF HAART ON INCIDENCE OF TB IN SA Badri et al, Lancet 2002;359:2059-64

After providing a brief overview of the third study, Dr Jack summarised the issues governing the co-epidemiology of HIV and TB as follows: TB and HIV are intimately linked; preventive strategies are very important for management of TB; the evidence suggests that treating both conditions simultaneously is beneficial but complex.

Issues requiring further investigation include:
Can the existing DOTS programme incorporate ARV?
Does the time to initiate ARV in patients influence the outcome?

Dr Parboosing then introduced his subject by explaining that research is being focused on determining how HCV and HIV affect each other in terms of transmission, influence on disease and treatment, as well as effects on diagnosis and monitoring.

These investigations were the basis of a project entitled "Hepatitis C Virus Prevalence among Patients Infected with Human Immunodeficiency Virus: A Cross-sectional Analysis of the US Adult AIDS Clinical Trials Group", published in Clinical Infectious Diseases, 15 March 2002, and conducted by Sherman et al, University of Cincinnati, Massachusetts General Hospital and Harvard Medical School.

Dr Parboosing took the gathering through the study's rationale, patient profile and methods, results and discussion. Several limitations affecting the relevance of the project were noted.

A further study, referenced as "Epidemiology of Chronic Hepatitis C virus infection in Sub-Saharan Africa", (Madhava et al, Lancet Infectious Diseases, May 2002, Albert Einstein College of Medicine, New York; WHO, Geneva) was then discussed. Again, it was noted that several methodological and conceptual limitations undermined the usefulness of this research.

To download the PowerPoint versions of the presentations, click on the hyperlinks in the righthand column.