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Southern African Journal of HIV Medicine
              ISSN: (Online) 2078-6751, (Print) 1608-9693
                                                       Page 1 of 2  Editorial


                                                         Editorial





                                       Greetings to all readers of the Southern African Journal of HIV Medicine (SAJHIVMED) and members
               Author:
               David C. Spencer   1    of the Southern African HIV Clinicians’ Society!

               Affiliation:            This has been a long year and one that will not be forgotten easily. Coronavirus disease 2019
               1 Division of Infectious
               Diseases, Department of   (COVID-19) has reshaped our world.
               Medicine, Helen Joseph
               Hospital, University of   Thank you to our nurses and doctors who stand by the bedside of the sick, placing life and future
               the Witwatersrand,      on the line for others. You have done a great job, and we are proud of you. Thank you too, to
               Johannesburg, South Africa
                                       researchers, laboratory  staff and industry colleagues for your backroom work. Without the
               Corresponding author:   goodwill of all, the sick are easily abandoned. Thankfully, effective vaccines are emerging. But the
               David Spencer,          pandemic is not over. Will low- and middle-income countries (LMICs) access these therapeutics?
               [email protected]  Time will tell. Clearly, this is an issue that we will closely watch.
               How to cite this article:
               Spencer DC. Editorial. S Afr J   Thank  you  to  our authors.  Your  vision  of  human  immunodeficiency  virus  (HIV) in Africa  is
               HIV Med. 2020;21(1), a1199.   important to us: current, authentic and compelling. You have allowed science/truth to do the
               https://doi.org/10.4102/  talking. Thank you for your submissions. Articles are already being allocated to our 2021 edition!
               sajhivmed.v21i1.1199    If you too have HIV-related research based in LMICs, especially in  Africa, please consider
               Copyright:              submitting to the SAJHIVMED.
               © 2020. The Authors.
               Licensee: AOSIS. This work   Thank  you  to  our  reviewers.  Thank  you  for  saying  yes.  For  returning  reviews  on  time and
               is licensed under the   ensuring we meet international publication standards and timelines! You are the backbone of our
               Creative Commons
               Attribution License.    success and we are very much in your debt.

                                       If you are taking a break over the December holidays, we invite our readers to do some catch-up
                                       journal reading. This year we have shared 60 articles with you. The majority were the product of
                                       ‘original’  research.  A  small  number  included  reviews,  case  reports  and  letters.  Five  are  new
                                       guidelines. I will restrict my comments to these. But please do not forget the remaining 55 articles.
                                       These papers reflect this changing epidemic on our doorstep. Stay up to date.

                                       The 2020 Updated ART guideline is essential reading.  This is high-end contemporary science with
                                                                                1
                                       a strong clinical appeal. A lot about dolutegravir. But with many ‘insights’ and ‘tips’ not found
                                       elsewhere. A very special guideline, it deserves your attention.

                                       Dr Jeremy Nel and his co-authors have also given us an African ‘first’, the guidelines for solid-organ
                                       transplantation in persons living with HIV (PLWH).  This is a collaboration of local and international
                                                                             2
                                       HIV clinicians and senior transplant surgeons. Relevant to Africa? Yes. Transplant organs are
                                       needed by HIV-infected and uninfected all over Africa. This article rewards the reader with
                                       accessible immunology and a practical approach to complex patient care.

                                       Human immunodeficiency virus-prevention is addressed in two guidelines. The updated South
                                       African National Guideline for the Prevention of Mother to Child Transmission of Communicable Infections
                                       (2019) and the Southern African Guideline on the safe, easy and effective use of Pre-exposure Prophylaxis
                                                 3,4
                                       (PrEP): 2020.  The former is an update of the 2019 National prevention of mother-to-child
                                       transmission  (PMTCT) guidelines. Its underlying  concern is the relative increase in viral
                                       transmission in the first 18 months of life: 0.7% at birth (2019) but 4.3% at 18 months (2016). (More
                                       recent 18-month data are clearly needed). Quo vadis re. breastfeeding? Children in Africa remain
                                       at risk of HIV  infection.  These guidelines  set out the  rules, the goalposts. Please read and
                                       implement these guidelines.
                                          This is an extraordinary report.  The authors comment, ‘To our knowledge, no PMTCT data of this
                                                                 5
               Read online:               magnitude has been published from a low-income, high HIV-prevalence setting’ before! This is a 14-year
               Read online:
                        Scan this QR      review of the PMTCT in a large cohort of Sowetan women and their children. Over this period 360,751
                        Scan this QR
                        code with your
                        code with your
                        smart phone or
                        smart phone or    pregnant women were managed in 13 clinics in Soweto, South Africa. The proportion of pregnant women
                        mobile device     living with HIV who attended these clinics rose from 14.3% in 2009 to 45% in 2015 (p < 0.001)! Prevalence
                        mobile device
                        to read online.
                        to read online.
                                          rates of HIV in pregnancy during the period were high: 28.9% in 2002, 33.1% in 2009 and 27.4% in 2015.
                                           http://www.sajhivmed.org.za  1  Open Access
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