Field evaluation of Standard Diagnostics' Bioline HIV/Syphilis Duo test among female sex workers in Johannesburg, South Africa

BACKGROUND:

Point-of-care tests provide immediate results with the opportunity for same-day interventions with improved public health outcomes. A dual HIV/syphilis test enables early treatment of both diseases.

METHODS:

We conducted a field evaluation of the Standard Diagnostics' SD Bioline HIV/Syphilis Duo test (SD Bioline) among female sex workers. SD Bioline was conducted on finger-prick blood according to manufacturer's instructions and compared with (i) Genscreen HIV1/2 (third generation) and Vironostika Ag/Ab (fourth generation) assays for HIV, and (ii) Treponema pallidum particle agglutination (TPPA) and rapid plasma reagin (RPR) assays for syphilis. A negative TPPA test was considered negative, a TPPA-confirmed RPR titre ≤1:4 as past infection and a TPPA-confirmed RPR titre ≥1:8 as active syphilis. Sensitivity, specificity, positive and negative predictive values were calculated.

RESULTS:

Of 263 women recruited, 14 (5.3%) declined an HIV test. Among the remaining 249 women, 187 (75.1%) were HIV positive, 51 (20.5%) had syphilis antibodies with seven (2.8%) active infections. For HIV, the sensitivity and specificity were 98.9% (95% CI 95.8% to 99.8%) and 100% (95% CI 92.7% to 100%). For syphilis, the sensitivity and specificity were 66.7% (95% CI 52.0% to 78.9%) and 98.0% (95% CI 94.5% to 99.3%). Sera with high TPPA titres were more likely to test positive.

CONCLUSIONS:

In field conditions, while the SD Bioline test has high sensitivity and specificity for HIV and high specificity for syphilis, the test has lower sensitivity for syphilis than reported from laboratory evaluations. As the dual test detects only two thirds of syphilis cases, it should only be used in areas with weak screening programmes.

Purchase full article at:  http://goo.gl/hO5aVk

By:  Black V1, Williams BG2, Maseko V3, Radebe F3, Rees HV2, Lewis DA4.

• 1Faculty of Health Sciences, Wits Reproductive Health and HIV Institute, University of the Witwatersrand, Johannesburg, South Africa Clinical Microbiology and Infectious Diseases, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
• 2Faculty of Health Sciences, Wits Reproductive Health and HIV Institute, University of the Witwatersrand, Johannesburg, South Africa.
• 3Centre for HIV and STIs, National Institute for Communicable Diseases, Johannesburg, South Africa.
• 4Centre for HIV and STIs, National Institute for Communicable Diseases, Johannesburg, South Africa Western Sydney Sexual Health Centre, Western Sydney Local Health District, Parramatta, Australia. 
• Sex Transm Infect. 2016 May 6. pii: sextrans-2015-052474. doi: 10.1136/sextrans-2015-052474.

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

Social Support, Sexual Violence, and Transactional Sex among Female Transnational Migrants to South Africa

OBJECTIVES:

To examine the relationship between sexual violence and transactional sex and assess the impact of social support on this relationship among female transnational migrants in Cape Town, South Africa.

METHODS:

In 2012 we administered a behavioral risk factor survey using respondent-driven sampling to transnational migrant women aged between 16 and 39 years, born outside South Africa, living in Cape Town, and speaking English, Shona, Swahili, Lingala, Kirundi, Kinyarwanda, French, or Somali.

RESULTS:

Controlling for study covariates, travel-phase sexual violence was positively associated with engagement in transactional sex (adjusted prevalence ratio [APR] = 1.38; 95% confidence interval [CI] = 1.07, 1.77), and social support was shown to be a protective factor (APR = 0.84; 95% CI = 0.75, 0.95). The interaction of experienced sexual violence during migration and social support score was APR = 0.85 (95% CI = 0.66, 1.10). In the stratified analysis, we found an increased risk of transactional sex among the low social support group (APR = 1.56; 95% CI = 1.22, 2.00). This relationship was not statistically significant among the moderate or high social support group (APR = 1.04; 95% CI = 0.58, 1.87).

CONCLUSIONS:

Programs designed to strengthen social support may reduce transactional sex among migrant women after they have settled in their receiving communities. 

Purchase full article at:   http://goo.gl/uB7VNO

By:  Giorgio M1, Townsend L1, Zembe Y1, Guttmacher S1, Kapadia F1, Cheyip M1, Mathews C1.

• 1At the time of this study, Margaret Giorgio, Sally Guttmacher, and Farzana Kapadia were with the Department of Nutrition, New York University, New York, NY. Loraine Townsend, Yanga Zembe, and Catherine Mathews are with the Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa. Mireille Cheyip is with the Centers for Disease Control and Prevention, Pretoria, South Africa. 
• Am J Public Health. 2016 Apr 14:e1-e7

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

Characteristics of Age-Discordant Partnerships Associated with HIV Risk among Young South African Women

OBJECTIVE:

Sexual liaisons between older men and younger women have been linked to greater risk of HIV acquisition. This study aims to: 1) identify psychosocial and behavioral factors associated with age-discordant (partner ≥ 5 years older) versus age-concordant partnerships (-1<partner< 5); and 2) examine the association between partner age discordance and young South African women's sexual behavior.

METHODS:

We used generalized estimating equations to analyze responses from 656 sexually-experienced females (aged 13-20 years) from rural Mpumalanga province.

RESULTS:

Partner age discordance was associated with greater odds of reporting both more frequent sex and having a partner with concurrent partnerships. Age-discordant partnerships were associated with greater odds of: casual partnerships, having a partner with concurrent partnerships and more frequent intercourse (i.e., having sex at least 2 or 3 times per month). They were associated with lower odds of reporting condom use at last sex and always using condoms in age-discordant partnerships.

CONCLUSION:

Our findings suggest that a history of age-discordant partnerships, and to a lesser extent having an age-discordant partner, is linked to HIV risk among young South African women; however, the link between partner age discordance and HIV risk may be more strongly related to the characteristics of age-discordant partnerships than to characteristics of young women who form such partnerships.

Purchase PDF full article at:  http://goo.gl/QTPiAc

By:  Ritchwood TD1, Hughes JP, Jennings L, MacPhail C, Williamson B, Selin A, Kahn K, Gómez-Olivé FX, Pettifor A.

• 1 Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC.  
• 2 Department of Biostatistics, School of Public Health, University of Washington, Seattle, WA. 
• 3 Fred Hutchinson Cancer Research Institute, Seattle, WA.
• 4 Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. 
• 5 School of Health, University of New England, Armidale, NSW. 
• 6 Wits Reproductive Health & HIV Institute, University of the Witwatersrand, Johannesburg, South Africa. 
• 7 Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC.
• J Acquir Immune Defic Syndr. 2016 Mar 11. 

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

Long-Term Financing Needs for HIV Control in Sub-Saharan Africa in 2015-2050

OBJECTIVES:

To estimate the present value of current and future funding needed for HIV treatment and prevention in 9 sub-Saharan African (SSA) countries that account for 70% of HIV burden in Africa under different scenarios of intervention scale-up. To analyse the gaps between current expenditures and funding obligation, and discuss the policy implications of future financing needs.

DESIGN:

We used the Goals module from Spectrum, and applied the most up-to-date cost and coverage data to provide a range of estimates for future financing obligations. The four different scale-up scenarios vary by treatment initiation threshold and service coverage level. We compared the model projections to current domestic and international financial sources available in selected SSA countries.

RESULTS:

In the 9 SSA countries, the estimated resources required for HIV prevention and treatment in 2015-2050 range from US$98 billion to maintain current coverage levels for treatment and prevention with eligibility for treatment initiation at CD4 count of <500/mm(3) to US$261 billion if treatment were to be extended to all HIV-positive individuals and prevention scaled up. With the addition of new funding obligations for HIV-which arise implicitly through commitment to achieve higher than current treatment coverage levels-overall financial obligations (sum of debt levels and the present value of the stock of future HIV funding obligations) would rise substantially.

CONCLUSIONS:

Investing upfront in scale-up of HIV services to achieve high coverage levels will reduce HIV incidence, prevention and future treatment expenditures by realising long-term preventive effects of ART to reduce HIV transmission. Future obligations are too substantial for most SSA countries to be met from domestic sources alone. New sources of funding, in addition to domestic sources, include innovative financing. Debt sustainability for sustained HIV response is an urgent imperative for affected countries and donors.

Below:  Annual resources required by nine sub-Saharan countries (US$ billions) from 2015 to 2050 (3% discounting).

Below:  Per capita annual resources required by nine sub-Saharan countries ($US) from 2015 to 2050 (3% discounting).

Below:  Total expenditures on HIV from domestic and international sources combined (current US$) in selected sub-Saharan African countries, compared with estimated resource needs for treatment, prevention and structural interventions in 2015 under different coverage levels and eligibility for treatment. EAE, external AIDS expenditure; GEA, Government Expenditure on AIDS; RNE, resource needs estimate. GEA and EAE estimates are from Resch et al 2015.

Full article at:   http://goo.gl/C2PXSW

By:  Atun R¹, Chang AY¹, Ogbuoji O¹, Silva S¹, Resch S¹, Hontelez J¹, Bärnighausen T¹.

¹Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA.

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

Predictors of Perceived Male Partner Concurrency among Women at Risk for HIV & STI Acquisition in Durban, South Africa

Background

Women in sub-Saharan Africa continue to be at greater risk for HIV acquisition than men. Concurrency, viz. multiple sexual partnerships that overlap over time, has been studied as a possible risk factor for HIV transmission. The aim of this study was to identify predictors of perceived male partner concurrency among sexually active, HIV negative women.

Methods

Socio-demographic and behavioural data from women enrolled in a biomedical HIV prevention clinical trial were assessed in relation to perceived male partner concurrency using the Chi squared test. Univariate and multivariate logistic regression was performed to assess the independent predictors of perceived male partner concurrency. Kaplan–Meier survival estimates were obtained for HIV and STI incidence in relation to male partner concurrency. A Cox Proportional Hazards model was used to assess the association between perceived male partner concurrency and HIV and STI incidence.

Results

The results revealed that 29 % of women reported their male partners to be in concurrent sexual relationships, 22 % reported partners that were not engaging in concurrency, whilst 49 % reported not knowing their partners concurrency status. Older women, having never married, experiencing economic abuse, and women reporting individual concurrency, were found to be significant predictors of perceived male partner concurrency in the studied population. Perceived male partner concurrency was not found to be a significantly associated with incident HIV and STI infections in this analysis.

Conclusions

The study provides insight into predictors of perceived male partner concurrency among women at high risk for STI and HIV acquisition. These results may inform the design of behavioural and biomedical interventions, to address the role of multiple sexual partnerships in HIV prevention.

Below:  Kaplan-Meier survival curve for HIV incidence versus partner concurrency status, among a cohort of women in Durban, South Africa

Below:  Kaplan-Meier survival curve for STI incidence versus partner concurrency status, among a cohort of women in Durban, South Africa

Full article at:   http://goo.gl/PHHOQV

By:  Zakir Gaffoor, Handan Wand, Renée A. Street, Nathlee Abbai, and Gita Ramjee

HIV Prevention Research Unit, South African Medical Research Council, Durban, South Africa

The Kirby Institute, University of New South Wales, Sydney, Australia

Zakir Gaffoor, Phone: + (27)-31 242 3600

AIDS Res Ther. 2016; 13: 14. Published online 2016 Mar 8. doi:  10.1186/s12981-016-0098-7

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

Exposure to Violence & Psychological Well-Being Over Time in Children Affected by HIV/AIDS in South Africa & Malawi

Many of the risk factors for violence against children are particularly prevalent in families and communities affected by HIV/AIDS. Yet, in sub-Saharan Africa, where HIV rates are high, efforts to prevent or address violence against children and its long-lasting effects are hampered by a lack of evidence. 

We assessed the relationship between violence exposure and mental health among HIV-affected children attending community-based organisations in South Africa (n = 834) and Malawi (n = 155, total sample n = 989) at baseline and 12-15-month follow-up. Exposure to violence in the home and in the community was high. HIV-negative children who lived with an HIV-positive person experienced most violence overall, followed by HIV-positive children. Children unaffected by HIV experienced least violence (all p < .05). 

Interpersonal violence in the home predicted child depression, trauma symptoms, lower self-esteem, and internalising and externalising behavioural problems, while exposure to community violence predicted trauma symptoms and behavioural problems. Harsh physical discipline predicted lower self-esteem and behavioural problems for children. Exposure to home and community violence predicted risk behaviour. Over time, there was a decrease in depressed mood and problem behaviours, and an increase in self-esteem for children experiencing different types of violence at baseline. This may have been due to ongoing participation in the community-based programme. 

These data highlight the burden of violence in these communities and possibilities for programmes to include violence prevention to improve psychosocial well-being in HIV-affected children.

Purchase full article at:   http://goo.gl/dDdbur

By:  Skeen S1,2, Macedo A3, Tomlinson M1, Hensels IS3, Sherr L3.

• 1 Department of Psychology , Stellenbosch University , Stellenbosch , South Africa.
• 2 Department of Psychiatry and Mental Health , University of Cape Town , Cape Town , South Africa.
• 3 Department of Infection and Population Health , University College London , London , UK.
• AIDS Care. 2016 Mar;28 Suppl 1:16-25. doi: 10.1080/09540121.2016.1146219.

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

Chronic Hepatitis B Increases Mortality & Complexity among HIV-Coinfected Patients in South Africa

OBJECTIVES:

To assess the effect of chronic hepatitis B on survival and clinical complexity among people living with HIV following antiretroviral therapy (ART) initiation.

METHODS:

We evaluated mortality and single-drug substitutions up to 3 years from ART initiation (median follow-up 2.75 years; interquartile range 2-3 years) among patients with and without chronic hepatitis B (CHB) enrolled in a workplace HIV care programme in South Africa.

RESULTS:

Mortality was increased for CHB patients with hepatitis B virus (HBV) DNA levels > 10 000 copies/mL (adjusted hazard ratio 3.1; 95% confidence interval 1.2-8.0) compared with non-CHB patients. We did not observe a similar difference between non-CHB patients and those with CHB and HBV DNA < 10 000 copies/mL (adjusted hazard ratio 0.70; 95% confidence interval 0.2-2.3). Single-drug substitutions occurred more frequently among coinfected patients regardless of HBV DNA level.

CONCLUSIONS:

Our findings suggest that CHB may increase mortality and complicate ART management.

Purchase full article at:   http://goo.gl/PvnJ70

By:  Velen K1, Charalambous S1,2, Innes C1, Churchyard GJ1,2, Hoffmann CJ1,3,2.

• 1The Aurum Institute, Johannesburg, South Africa.
• 2School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.
• 3Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USA. 
• HIV Med. 2016 Mar 17. doi: 10.1111/hiv.12367.

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

Contraception Usage and Timing of Pregnancy among Pregnant Teenagers in Cape Town, South Africa

OBJECTIVE:

To evaluate knowledge and use of contraception among pregnant teenagers in the Cape Town metropolitan area.

METHODS:

A cross-sectional study enrolled women aged 16 to 19 years who were pregnant and attending prenatal clinics, and prenatal and labor wards at regional hospitals and midwife-run obstetric clinics in the Cape Town area between March 1, 2011 and September 30, 2011. Data were collected using an administered questionnaire.

RESULTS:

The study enrolled 314 participants. Of the participants, 240 (76.4%) felt their pregnancies had occurred at the "wrong time" but only 38 (12.1%) were using contraception at the time of conception. The form of contraception that participants most commonly had knowledge of was injectable hormonal contraception (274 [87.3%]). Contraception use was low, with 126 (40.1%) participants having never used contraception. The forms of contraception used most commonly were the male condom (106 [33.8%]) and injectable contraception (98 [31.2%]). The majority of participants found it easy to get contraception (192 [61.1%]) and felt that information regarding contraception was readily available (233 [74.2%]).

CONCLUSION:

Contraception use is suboptimal but this may not simply be a reflection of ineffective family-planning services. Further research is needed to fully explain the lack of contraceptive use in this population.

Purchase full article at:   http://goo.gl/aX3TR4

By:  Vollmer LR1, van der Spuy ZM2.

• 1Department of Obstetrics and Gynaecology, University of Cape Town, Cape Town, South Africa. Electronic address: lindivollmer@hotmail.com.
• 2Department of Obstetrics and Gynaecology, University of Cape Town, Cape Town, South Africa. 
• Int J Gynaecol Obstet. 2016 Jan 28. pii: S0020-7292(16)00039-4. doi: 10.1016/j.ijgo.2015.10.011. 

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

Biological Factors that Place Women at Risk For HIV: Evidence from a Large-Scale Clinical Trial in Durban

Background

It is well documented that the mucosal linings of the female genital tract (FGT) usually provides a robust barrier that protects against sexually acquired infections. However, to the best of our knowledge there are limited South African studies that have investigated the association between damage to the mucosal linings and the acquisition of HIV infections. We hypothesize that in this cohort of women, a higher rate of HIV seroconversions will be observed for women who present with evidence of mucosal damage.

Methods

We undertook a secondary analysis of the Methods for Improving Reproductive Health in Africa (MIRA) trial that assessed the effectiveness of the latex diaphragm and lubricant gel on HIV prevention among women. Participants underwent a physical examination which included a pelvic examination to detect the presence of mucosal abnormalities. During the physical examinations, the study clinicians examined the genitalia, cervix and vagina for signs of epithelial disruptions and abnormal vaginal discharge. The association between the various genital factors and HIV seroconversion was modeled using Cox proportional hazards regression analysis.

Results

In this cohort of 1485 women that had enrolled to participate in the study, women that had presented with genital epithelial disruptions and abnormal vaginal discharge were shown to be at highest risk for HIV acquisition respectively. In addition, the Kaplan Meier analysis showed that the highest number of seroconversions was observed in women that had disrupted genital epithelia (27 per 100/py) and abnormal vaginal discharge (12 per 100/py). Other significant factors included: genital signs and symptoms and genital ulcers/sores.

Conclusion

We have shown that damage to the mucosal epithelial lining increases a women’s risk of HIV seroconversion. Future studies that provide an in depth understanding of the mechanisms associated with the FGT and mucosal immunity will be most valuable. An understanding of all of these mechanisms will be key in directing the advancement of products most suitable for combating HIV infection in women.

Below:  Kaplan Meier plots showing the survival rates for the individual genital factors with the crude HIV incidence rates calculated for each variable with the respective p-values. a epithelial disruption and b abnormal vaginal discharge

Full article at:   http://goo.gl/nztvyB

By:  Nathlee Samantha Abbai^1*, Handan Wand³ and Gita Ramjee¹²

¹HIV Prevention Research Unit, Medical Research Council, 123 Jan Hofmeyr Road, Westville, Durban 3630, South Africa

²Department of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK

³The Kirby Institute, University of New South Wales, Sydney 2052, NSW, Australia

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

The Male Factor: Outcomes from a Cluster Randomized Field Experiment with a Couples-Based HIV Prevention Intervention in a South African Township

Highlights

• Men in the couples arm were less likely to report heavy drinking at 6-months.
• Men in the couples arm were more likely to report past-month consistent condom use.
• Women tested at twice the prevalence of HIV (26%) as men (13%).
• At 6-months, HIV incidence was significantly lower among women in the intervention.
• Couples-based interventions focusing on intersecting HIV risks can improve outcomes.

BACKGROUND:

This study examined the effects of the Couples Health CoOp intervention on heavy drinking, condom use, and HIV incidence.

METHODS:

Thirty neighborhoods from one South African township were cluster randomized into three intervention arms: Couples Health CoOp (CHC), Women's Health CoOp/Men's Health CoOp (WHC/MHC), or a comparison arm. We recruited 290 men from informal drinking establishments who reported drinking alcohol regularly. We also recruited their main heterosexual sex partners.

RESULTS:

At 6-month follow-up, men in the CHC arm were less likely to report heavy drinking (OR 0.47, 95% CI: 0.25, 0.90) and were more likely to report consistent condom use during the past month (OR 2.66, 95% CI: 1.23, 5.76) than men in the comparison arm. At baseline, 26% of women and 13% of men were HIV-infected; at 6-month follow-up, 16 females and 5 males had seroconverted. HIV incidence was significantly lower among women in the CHC arm (IRR 0.22, 95% CI: 0.04, 1.01) than in the WHC/MHC arm.

CONCLUSIONS:

A couples-based intervention focusing on intersecting risks for HIV can improve biobehavioral outcomes, underscoring the importance of engaging couples together in HIV prevention.

Purchase full article at:   http://goo.gl/lyOHw9

By:  Wechsberg WM1, Zule WA2, El-Bassel N3, Doherty IA4, Minnis AM5, Novak SD2, Myers B6, Carney T7.

• 1RTI International, 3040 East Cornwallis Road, Research Triangle Park, NC, United States; University of North Carolina, Chapel Hill, NC, United States; Department of Psychology in the Public Interest, North Carolina State University, Raleigh, NC, United States; Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, United States. Electronic address: wmw@rti.org.
• 2RTI International, 3040 East Cornwallis Road, Research Triangle Park, NC, United States.
• 3Columbia University School of Social Work, New York, NY, United States.
• 4RTI International, 3040 East Cornwallis Road, Research Triangle Park, NC, United States; University of North Carolina, Chapel Hill, NC, United States.
• 5RTI International, 351 California Street, San Francisco, CA, United States.
• 6Alcohol, Tobacco & Other Drug Research Unit, South African Medical Research Council, Cape Town, South Africa; Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
• 7Alcohol, Tobacco & Other Drug Research Unit, South African Medical Research Council, Cape Town, South Africa. 
• Drug Alcohol Depend. 2016 Apr 1;161:307-15. doi: 10.1016/j.drugalcdep.2016.02.017. Epub 2016 Feb 18.

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

Anti-Retroviral Therapy Increases the Prevalence of Dyslipidemia in South African HIV-Infected Patients

Purpose

Data on the prevalence of dyslipidaemia and associated risk factors in HIV-infected patients from sub-Saharan Africa is sparse. We performed a cross-sectional analysis in a cohort of HIV-infected South African adults.

Methods

We studied HIV-infected patients who were either antiretroviral therapy (ART)-naive or receiving non-nucleoside reverse transcriptase inhibitor (NNRTI)-based or protease inhibitor (PI)-based ART. Evaluation included fasting lipograms, oral glucose tolerance tests and clinical anthropometry. Dyslipidemia was defined using the NCEP ATPIII guidelines.

Results

The median age of the participants was 34 years (range 19–68 years) and 78% were women. The prevalence of dyslipidemia in 406 ART-naive and 551 participants on ART was 90.0% and 85%, respectively. Low HDL-cholesterol (HDLC) was the most common abnormality [290/406 (71%) ART-naïve and 237/551 (43%) ART- participants]. Participants on ART had higher triglycerides (TG), total cholesterol (TC), LDL-cholesterol (LDLC) and HDLC than the ART-naïve group. Severe dyslipidaemia, (LDLC> 4.9 mmol/L or TG >5.0 mmol/L) was present in <5% of participants. In multivariate analyses there were complex associations between age, gender, type and duration of ART and body composition and LDLC, HDLC and TG, which differed between ART-naïve and ART-participants.

Conclusion

Participants on ART had higher TG, TC, LDLC and HDLC than those who were ART-naïve but severe lipid abnormalities requiring evaluation and treatment were uncommon.

Below:  Distribution of lipid abnormalities in treatment naïve (A) and participants receiving ART (B).

The left-sided Venn diagrams indicate % with dyslipidaemia. The right-sided diagrams indicate the individual lipid abnormalities in dyslipidaemic participants. Percentages in the right diagrams refer to % dyslipidaemic participants. Rounding accounts for percentages not equal to 100. 

Full article at:   http://goo.gl/HqvLhU

By:  

Joel A. Dave, Naomi S. Levitt, Ian L. Ross 
Divisions of Diabetic Medicine and Endocrinology, Department of Medicine, University of Cape Town, Cape Town, South Africa

Miguel Lacerda 

Department of Statistical Sciences, University of Cape Town, Cape Town, South Africa

Gary Maartens 

Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa

Dirk Blom 

Division of Lipidology, Department of Medicine, University of Cape Town, Cape Town, South Africa 

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health