Page 9 - SAHCS HIVMed Journal Vol 20 No 1 2019

Page 2 of 6 Editorial

Editor’s comment: This cross-sectional, questionnaire-based, HIV-positive and negative, no data are provided to explain the
descriptive study on attitudes of young male South African cause of the reactive hyperplasia in the HIV-uninfected group.
college students towards medical male circumcision revealed Were other viruses, for example, EBV, CMV, HPV, HHV8 and
that the 351 participants had high levels of knowledge and others implicated?
understanding of the procedure and its benefits. Many of the 5. Moorhouse M, Cohen K. The role of rilpivirine in
students were themselves circumcised viz. 77.6%, and had Southern Africa. South Afr J HIV Med. 2019;20(1):a825.
chosen to have MMC (78.2%). Is this a changing trend in SA? https://doi.org/10.4102/sajhivmed.v20i1.825
3. Edet A, Akinsola HA, Bessong PA. Virologic and
immunologic responses of patients on highly active Editor’s comment: Recommended reading. This is a
antiretroviral therapy in a rural community health centre comprehensive review of the role of rilpivirine (RPV) in the
in Limpopo, South Africa: A retrospective study. South context of ART, pre-exposure (PrEP) and PEP in public sector
Afr J HIV Med. 2019;20(1):a818. https://doi.org/10.4102/ programmes of low-and middle-income countries (LMICs).
sajhivmed.v20i1.818 The authors address regional ART-issues that will impact on
RPV use viz. irregular or unavailable viral load testing, RPV’s
Editor’s comment: Recommended reading – a study that loss of efficacy in the context of high (baseline) viral loads,
ought to be read by all. This retrospective analysis records rifampicin and RPV (tuberculosis therapy), RPV and
data spanning 12 years (2004–2016) and asks the question, dolutegravir (DTG), other drug–drug interactions and long-
‘what are the long-term immunologic (CD4) and virologic acting RPV in future PrEP and PEP programmes. The findings
(viral load) consequences of ART in a rural region of South are quite interesting and relevant.
Africa’. ‘Is (rural) SA on the road to achieving the Joint United
Nations Programme on HIV and AIDS (UNAIDS) 90-90-90 PS: For those who are writing exams later this year or in early
goals?’ ‘Will universal ART in this rural region offer the reward 2020, this is a must-read. But for all of us, this is a nuts-and-
of “Treatment as Prevention,” that is long-term viral bolts review that deserves to be read.
suppression and no further viral transmission?’ The study is
well set-out and very easy to follow. A total of 1247 patients June 2019
were followed. All had to have been on ART for a minimum of 6. Manjengwa PA, Mangold K, Musekiwa A, Kuonza LR.
6 months. The analysis suggests that achieving the 90-90-90 Cognitive and behavioural determinants of multiple sexual
goal is unlikely: viral suppression at < 50 cp/ml after 6 months, partnerships and condom use in South Africa: Results of a
12 months, 24 months, 36 months and 132 months after national survey. South Afr J HIV Med. 2019;20(1):a868.
starting ART is 64%, 70%, 70%, 69% and 94%, respectively. The https://doi.org/10.4102/sajhivmed.v20i1.868
last percentage can be ignored as only 16 patients were
available to be assessed at 12 years. n = 882 (59%) recorded two Editor’s comment: Recommended reading. This is another
or more consecutive viral loads < 50 cp/ml? But only 14% had well-crafted paper. It is a cross-sectional and descriptive
persistent viral load suppression at < 50 cp/ml for the initial report that draws upon the Third National HIV Survey of
54 months of the study. Will rural SA reach the UNAIDS 90-90- 2012. The researchers ask why South Africans continue to
90 goal by 2020? Will viral transmission come to an end any take risks. Two high-risk groups are defined: those with
time soon? The answers are all too obvious after reading this multiple sexual partners (MSPs) and those who do not use
intelligent and readable article. condoms consistently viz. non-condom users (nCU). The
parent survey included 10 034 people. This study employs a
sample of 6061 people who provided information about
PS. If you teach HIV medicine, this is a useful study to have sexual behaviour in the preceding 12 months. Thirteen per
in your repertoire.
cent (n = 744/6061) were MSPs and 53% (n = 3158/6039)
4. Essa R, Maharaj S, Hari K, Motakef S. Tonsil histopathology were nCUs. Respondents in the MSP group indicated that
in HIV-infected versus HIV-uninfected adults. South Afr J ‘perceived benefits’ (adjusted odds ratios, aOR = 2.16) and a
HIV Med. 2019;20(1):a936. https://doi.org/10.4102/ related issue, intergenerational sex (aOR = 2.14), and non-
sajhivmed.v20i1.936 susceptibility to HIV, that is irrational beliefs like ‘it won’t
happen to me’, lay behind their actions. Similar reasoning
Editor’s comment: This is a retrospective histological review defined the responses of the nCUs: perceived benefits (aOR =
covering 10 years (2005–2015) of adult tonsillectomies in the 1.25), non-susceptibility to HIV (aOR = 1.6) and my ‘personal
Department of Otorhinolaryngology (ENT)/Head and Neck belief’ (aOR = 1.35). These irrational and dangerous responses
Surgery at the University of the Witwatersrand in jeopardise attempts to bring the epidemic to an end.
Johannesburg. Although the results are divided into two I recommend this paper for further reading. Is our community
categories, viz. HIV-infected (n = 84) and HIV-uninfected aware of these data? And would that make any difference?
(n = 74), the study is largely descriptive and there is no attempt 7. Sharp J, Wilkinson L, Cox V, Cragg C, Van Cutsem G,
to link findings with patient demographics, CD4 results, viral Grimsrud A. Outcomes of patients enrolled in an
loads and the clinical details of the cases. Statistical and antiretroviral adherence club with recent viral suppression
comparative data are, for the most part, left unexplored. after experiencing elevated viral loads. South Afr J HIV
Although reactive lymphoid hyperplasia was the most Med. 2019;20(1):a905. https://doi.org/10.4102/sajhivmed.
frequent histological finding in both arms viz. 77% in v20i1.905

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