Page 9 - HIVMED_v21_i1.indb

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