Robert Colebunders

..In this article, the authors provide an overview of the significant advances made in improving access to antiretrovirals in low-resource settings, as well as the challenges facing new approaches to ART in the next decade...

..We conducted a community based survey to estimate the prevalence of pulmonary TB and spoligotype pattern of the Mycobacterium tuberculosis isolates in Southwest Ethiopia...

..In this report, we describe three HIV-infected individuals (one woman and two children) presenting with extensive pulmonary cystic disease...

..Very little is known about the quality of life of tuberculosis (TB) and HIV co-infected patients. In this study in Ethiopia, we compared the quality of life HIV positive patients with and without TB...

..In Ethiopia, where HIV and tuberculosis (TB) are very common, little is known about the prejudice and misconceptions of rural communities towards People living with HIV/AIDS (PLHA) and TB...

..The relationship between TB/HIV co-infection and common mental disorders (CMD) has been scarcely investigated. In this study, we compared the occurrence of CMD in TB/HIV co-infected and non-co-infected HIV patients in Ethiopia...

..The performance of the WHO recommendations for pediatric antiretroviral treatment (ART) in resource poor settings is insufficiently documented in routine care...

..The active form of vitamin D, 1,25-dihydroxyvitamin D, is a key player in the clearance of pathogens and influences the level of inflammation and macrophage activation...

..Chemotherapy and radiotherapy were only temporarily successful. She died shortly after surgery was performed to remove the tumour...

..Treatment in isolation wards was acceptable, but the quality of clinical documentation was unsatisfactory. Improved clinical documentation is necessary for a basic evaluation of supportive treatment...

..With the increasing numbers of persons living with HIV infection and the increased use of HAART it is expected that in the future more otolaryngological manifestations of IRIS will be detected...

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..ABSTRACT: We describe a patient in which a venous hum, heard during abdominal auscultation, lead to the diagnosis of a vena cava inferior thrombosis...

..Most importantly, more HIV clinical trials need to be conducted in Africa, and African cohorts of patients on antiretroviral therapy need to be established in order to develop recommendations that are evidence based...

..abstract:..

..Using universal precautions for handling blood and body fluids and barrier nursing techniques there is little risk that if a patient with viral haemorrhagic fever arrives in Belgium there will be secondary cases...

..The study shows that despite the availability of highly active antiretroviral therapy many people with HIV infection still take complementary and alternative medicine...

..In contrast to Ebola outbreaks, there was little panic among health care workers and the general public in Durba and all health services remained operational...

..A similar methodology could be used to evaluate and compare health service delivery systems for persons with HIV infection in Africa in order to identify the most efficient models of care...

..In this patient the visceral leishmaniasis was finally cured with meglumine antimoniate, followed by pentacarinat isothianate as maintenance therapy in conjunction with highly active antiretroviral treatment...

..They discuss the availability of several new treatment options such as darunavir, etravirine, integrase, and CCR5 inhibitors for patients with multidrug-resistant viruses...

..The pressure on politicians and international donor agencies to provide ARVs to resource-poor countries should be used to increase overall healthcare budgets and to improve healthcare services in general...

..On the other hand, antiretroviral roll-out programmes should learn from the genesis of the MDR-TB problem; laboratory monitoring should be enhanced and compliance optimized to avoid the acquisition of additional drug resistance in HIV...

..Between 1996 and 1997, many persons with HIV infection in Europe received a suboptimal ARV treatment regimen. Use of ARVs should be improved for intravenous drug users, persons with lower educational level and lower income...

..We believe that this model can make an accurate diagnosis of treatment failure in most patients. However, operational research is needed to assess whether this strategy works in practice...

..The multidisciplinary approach, offered by the Antwerp University Hospital, was widely appreciated by patients and could be used as an example for organizing patient care for other diseases...

..To evaluate the safety and virological response to lopinavir/ritonavir containing second-line therapy after failing a first line nonnucleoside reverse transcriptase inhibitor (NNRTI) based regimen...

..We identified predictors of viral failure and documented genotypic mutations in a subset of patients with viral failure after 12 months on antiretroviral therapy (ART)...

..To investigate the epidemiology and clinical spectrum of fever in HIV-infected returning travelers and migrants...

..Liver diseases are common in patients with HIV due to viral hepatitis B and C co-infections, opportunistic infections or malignancies, antiretroviral drugs and drugs for opportunistic infections...

..To determine the proportion of patients developing active tuberculosis (TB) versus that of patients who experience worsening of TB, after initiating highly active anti retroviral therapy (HAART)...

..The initial clinical and laboratory assessment can help in selecting appropriate investigations and empiric treatments for patients with imported fever...

..Anemia is the most frequent cytopenia in HIV-infected individuals and is often associated with malaria...

..Here, we aimed to determine the clinical spectrum, predictors and outcomes of paradoxical tuberculosis-immune reconstitution inflammatory syndrome (TB-IRIS) in a resource-limited setting...

..HIV-related immune-suppression increases the risk of malaria (infection, disease and treatment failure) and probably the circulating parasite biomass, favoring the emergence of drug resistance parasites...

..All four pathogens should be systematically considered because early diagnosis should avoid unnecessary investigations and treatment and allow early intervention in case of primary HIV infection...

..We investigated whether a positive urinary TB lipoarabinomannan (LAM) antigen enzyme-linked immunosorbent assay test before ART initiation was associated with development of paradoxical TB-IRIS...

..HIV-1-negative children with malaria have reversible lymphocyte and CD4 count decreases. We assessed the impact of malaria parasitemia on the absolute CD4 count in both HIV-1-infected and non-HIV-infected adults...

..In conclusion, with systematic TB screening (including culture and chest X-ray), the incidence of ART-associated TB is relatively low in settings with high HIV and TB prevalence...

..We conducted an autopsy study to describe and compare the clinical and autopsy causes of death and contributory findings in hospitalized HIV-infected and HIV-uninfected patients in Uganda...

..A pruritic papular eruption (PPE) is a common skin manifestation observed in 12-46% of persons with HIV infection living in tropical countries...

..Information on epidemiology and prognosis of imported fever is scarce and almost exclusively limited to hospital settings...

..In addition, the substantial relapse rate despite standard primaquine therapy supports the use of a higher dose of primaquine to eradicate P. vivax and P. ovale malaria effectively...

..To develop an algorithm for optimal use of viral load testing in patients with suspected first-line antiretroviral treatment (ART) failure...

..The authors evaluate the performance of the expert system Global Infectious Diseases and Epidemiology Network (GIDEON) in diagnosing febrile illnesses occurring after a stay in the tropics...

..A similar methodology could be used by other health services to evaluate and compare different models of care...

..Integrating the CES-D10 or a similar instrument into patient preparation for ART is recommended in order to identify those who may benefit from further mental health investigations, specific therapy, or closer follow-up during early ART...

..To understand reasons for lost-to-follow-up (LTFU) from a community-based antiretroviral therapy program in Uganda...

..The levels of T-cell immune activation and exhaustion after long-term, suppressive ART and their correlation with CD4 T-cell count reconstitution among ART-treated patients in African cohorts have not been extensively evaluated...

..Our data suggest that, in settings with limited access to CD4 count testing, it might be useful to target this test to patients in WHO stage 3 whose staging is based on weight loss alone, to avoid unnecessary treatment...

..These findings open a major perspective for the development of patient-specific immunotherapy for HIV-1 disease...

..Tuberculosis-HIV (TB-HIV) coinfection remains an important cause of mortality in antiretroviral therapy (ART) programs. In a cohort of TB-HIV-coinfected patients starting ART, we examined the incidence and predictors of early mortality...

..The lack of an alternate explanation led us to suspect that Lopinavir/Ritonavir was potentially responsible for the edema...

..At level of service provision, provider initiated HIV testing including target group tailored counseling should be promoted...

..To determine the autopsy acceptance rate and reasons for decline at Mulago Hospital, Kampala, Uganda...

..Risk factors for this cancer have been identified but not studied systematically in Uganda. Identification of these factors would enable establishment of preventive measures...

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..We assessed the influence that HIV-1 immune suppression has on the efficacy of antimalarial treatment in adults with uncomplicated malaria...

..Functional adrenal insufficiency (FAI) is associated with increased mortality and is defined as subnormal cortisol production during acute severe illness...

..We review various aspects of TB preventive treatment in countries with a high prevalence of HIV-TB co-infection and limited resources but with increasing access to ARV treatment...

..Retention of patients in ART care is a major challenge in sub-Saharan programs. Retention is also one of the key indicators to evaluate the success of ART programs...

..8% The total median waiting time to see providers significantly decreased from 291 to 94 min. Our findings suggest that EMR and same day patient tracing can significantly reduce missed appointments, and LTFU and improve clinic efficiency...

..We introduced HIV Counselling and Testing (HCT) for hospitalised children and their caretakers in Mulago teaching hospital in Uganda to assess its feasibility...

..Improved patient flow, patient and provider satisfaction and reduced waiting times allowed for service delivery to more patients using the same staff following the implementation of triage...

..Our series confirms the clinical effectiveness of raltegravir in HIV-2-infected patients when given with other antiretrovirals to which the virus is susceptible...

..We compared 25-hydroxyvitamin D plasma [25-(OH)D] concentration in paired samples before and after 12 months of HAART. 25-(OH)D levels are presented using two different cut-offs: <20 ng/ml and <30 ng/ml...

..The object of this study was to assess the effect of this educational board game on the uptake of knowledge...

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..Nonetheless, there was a declining trend in the rate of use of the service...

..Compared with the plasma concentration, the breast milk concentration was between 68 and 90% for nevirapine, 6 and 24% for nelfinavir and 90 and 540% for indinavir...

..In this paper we review current KS treatments available worldwide and discuss the implications of the increased access to antiretrovirals for KS treatment strategies in resource-limited settings...

..Telemedicine is a way to support physicians working in resource-poor settings, providing remote consultations and continuing medical education on HIV/AIDS care...

..The data suggest that neither pre-nor post-exposure levels of intracellular beta-chemokines are correlated with the subsequent control of disease progression...

..We describe an HIV-infected patient presenting with multiple TBA who recovered completely with a combination of HAART and anti-tuberculous treatment...

..Moreover, this technology can easily be applied in laboratories in developing countries...

..SP need adequate counseling training to tackle SRH-related issues. A better integration between HIV care programs and SRH care settings is needed to improve effective service provision...

..rifampicin lowers nevirapine plasma concentrations by inducing cytochrome P450. However, few data are available on this interaction during the lead-in period of nevirapine treatment...

..Together with the need for more research to identify optimal ART regimens for resource-poor settings, research regarding optimal chemoprophylaxis against opportunistic infections should also remain high on the agenda...

..The findings show that mild cases of MHF have to be expected during an outbreak and point out the difficulty to base patient management decisions on clinical case definitions alone...

..To investigate the characteristics of imported Katayama fever (acute schistosomiasis) as well as evolution and outcome under treatment...

..Such factors should be considered in clinical interventions to promote "positive prevention."..

..To evaluate a 5-year HIV care programme (2003-2007) in the Sihanouk Hospital Center of HOPE, Phnom Penh, Cambodia...

..The decreased capacity of T-cells to respond to these cytokines could contribute to the HIV-related immune dysfunction...

..She developed fever, large abscesses and pleural and peritoneal effusions. Systemic symptoms decreased during corticosteroid treatment, but abscesses only disappeared 8 months after the start of the anti-TB treatment...

..Additional antimosquito measures should be generalised, encompassing highly exposed personnel, container content and handling buildings, animal cages, wheel bays, and the boundary between the sorting and the reception of luggage...

..to deficient type-1 responses through decreased IL-12 production in AIDS infection, whereas enhanced CD40-mediated IL-12 production in less advanced stages might contribute to increased levels of various cytokines in early disease..

..Some avenues for future research and intervention are explored. Beyond the obvious need to find the reservoir and study the natural history, public health strategies for a more timely and efficient response are urgently needed...

..Selected SRH-issues predicted condom use. Sexual risk reduction and positive prevention should be discussed in the context of family planning and integrate SRH perspectives in routine HIV care...

..Since the incidence of opportunistic infections has dramatically decreased with the use of highly active antiretroviral treatments, other causes of fever including immune restoration disease, neoplasm and drug-fever should be considered...

..VI1035 and VI1197 may be the result of successful "second-generation" recombinations of HIV-1 strains CRF02.AG with, respectively, subtype C (VI1035) and G (VI1197) strains in a dually infected individual...

..Service providers should pay attention to the identified predictors of condom use and adopt comprehensive and gender-related approaches for preventive interventions with people living with HIV...

..Ambulatory treatment is safe in treatment-naive malaria patients with parasitemia <1% who do not vomit and who do not exhibit any criteria of severe malaria...

..03). Overall, the recovery of CD4 cell count after five years of HAART is good, although therapy interruptions have an important negative impact...

..abstract:..

..Structural interventions should at the same time address and reduce HIV-related stigma and socio-economic needs of young people living with HIV...