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Your search found 7 Results

  1. 1
    320653

    Safety of switching to nevirapine-based highly active antiretroviral therapy at elevated CD4 cell counts in a resource-constrained setting [letter]

    Kumarasamy N; Venkatesh KK; Devaleenal B; Palanivel V; Cecelia AJ

    Journal of Acquired Immune Deficiency Syndromes. 2007 Aug 15; 45(5):598-600.

    The World Health Organization recommends the use of generic nevirapine (NVP)/efavirenz (EFV)-based highly active antiretroviral therapy (HAART) regimens as first-line therapy in the management of HIV in resource-limited settings. Initiating NVP-based HAART at elevated CD4 cell counts can lead to liver toxicity. Short-term risk of liver toxicity has been reported in men with CD4 counts greater than 400 cells/mL and in women with CD4 counts greater than 250 cells/mL. Hence, clinicians are advised to monitor the results of liver chemistry tests closely in the first 18 weeks of therapy because of the potential to develop life-threatening hepatic events. Mocroft et al showed that initiating NVP therapy at elevated CD4 levels may be safe for use in antiretroviral-experienced patients. Little is known about short-term adverse consequences and clinical outcome at elevated CD4 cell counts in a resource-limited setting. (author's)
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  2. 2
    316242
    Peer Reviewed

    Reaching the targets for tuberculosis control: the impact of HIV.

    Laserson KF; Wells CD

    Bulletin of the World Health Organization. 2007 May; 85(5):325-420.

    In 1991, the 44th World Health Assembly set two key targets for global tuberculosis (TB) control to be reached by 2000: 70% case detection of acid-fast bacilli smear-positive TB patients under the DOTS strategy recommended by WHO and 85% treatment success of those detected. This paper describes how TB control was scaled up to achieve these targets; it also considers the barriers encountered in reaching the targets, with a particular focus on how HIV infection affects TB control. Strong TB control will be facilitated by scaling-up WHO-recommended TB/HIV collaborative activities and by improving coordination between HIV and TB control programmes; in particular, to ensure control of drug-resistant TB. Required activities include more HIV counselling and testing of TB patients, greater use and acceptance of isoniazid as a preventive treatment in HIV-infected individuals, screening for active TB in HIV-care settings, and provision of universal access to antiretroviral treatment for all HIV-infected individuals eligible for such treatment. Integration of TB and HIV services in all facilities (i.e. in HIV-care settings and in TB clinics), especially at the periphery, is needed to effectively treat those infected with both diseases, to prolong their survival and to maximize limited human resources. Global TB targets can be met, particularly if there is renewed attention to TB/HIV collaborative activities combined with tremendous political commitment and will. (author's)
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  3. 3
    292240

    WHO consultation on technical and operational recommendations for scale-up of laboratory services and monitoring HIV antiretroviral therapy in resource-limited settings.

    World Health Organization [WHO] Consultation on Technical and Operational Recommendations for Scale-Up of Laboratory Services and Monitoring HIV Antiretroviral Therapy in Resource-Limited Settings (2004: Geneva)

    Geneva, Switzerland, WHO, 2005. 42 p.

    The aim of the consultation was to obtain clear and realistic guidelines as to which diagnostic and monitoring schedules were optimal and how they could be delivered in order to assist decision-making on treatment and facilitate the implementation of strategies and necessary actions for scaling up diagnosis and monitoring at the local, regional and global levels, with particular emphasis on resource-constrained settings. It was required that the resulting recommendations would provide useful tools for the rational implementation of scaling-up processes, taking into consideration variations between developing countries in human resources, health structures and socioeconomic contexts. (excerpt)
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  4. 4
    192346

    Sources and prices of selected medicines and diagnostics for people living with HIV / AIDS.

    UNICEF; Joint United Nations Programme on HIV / AIDS [UNAIDS]; Medecins Sans Frontieres. Campaign for Access to Essential Medicines

    Geneva, Switzerland, WHO, 2003 Jun. [88] p.

    This report sets out to provide market information that can be used to help procurement agencies make informed decisions on the source of medicines and serve as the basis for negotiating affordable prices. The aim is to help increase access to medicines for people living with HIV/ AIDS in developing countries. The data provided by the manufacturers serves to highlight the multiplicity of suppliers and the variation in price of some essential HIV/AIDS-related medicines on the international market. Without this information, there is a risk that low-income countries may be paying more than needed to obtain essential medicines. Price variations are highlighted through the tables and graphs included. Provision of price information addresses only one barrier to access to medicines in countries with limited resources and, it is appreciated that many other factors will affect the availability of medicines. Some of the other issues that must be considered in relation to the purchase of medicines for HIV/AIDS and related conditions are health infrastructure, human resources, and supply and distribution systems. (excerpt)
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  5. 5
    192146

    Guidelines for surveillance of HIV drug resistance. Draft.

    World Health Organization [WHO]

    Geneva, Switzerland, WHO, 2003. 79 p.

    The purposes of the HDRST include: 1) to work with the National AIDS Committee to consider the specific public health uses of HIV drug resistance surveillance in the country, and to assess feasibility of surveillance; 2) to develop an appropriate time line for resistance surveillance activities, in coordination with other important implementation plans such as expanding HIV treatment; 3) to assess the country's capacity for HIV drug resistance surveillance, to decide on the populations and groups to be targeted, and to identify additional resources and activities needed; 4) to perform HIV drug resistance threshold surveys to assess when the frequency of resistance in persons newly diagnosed with HIV has reached the 5% threshold indicating a need for resistance surveillance; 5) to implement, when appropriate, HIV drug resistance surveillance; 6) to collaborate with the National AIDS Committee and the national treatment programme; to explore the feasibility of treatment programme monitoring by adding a resistance monitoring component to other year-end programme monitoring activities; 7) after routine surveillance is established, to consider implementing other special studies for in-depth evaluation of certain aspects of drug resistance within the country; 8) to insure implementation of all activities in accordance with international ethical standards designed to promote the well- being and health of individuals and communities; 9) to insure the dissemination of results in order to promote and support the public health of the country. (excerpt)
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  6. 6
    191838
    Peer Reviewed

    Scientific basis of Directly Observed Treatment, Short-course (DOTS).

    Sharma SK; Mohan A

    Journal of the Indian Medical Association. 2003 Mar; 101(3):157.

    The introduction of rifampicin, pyrazinamide and ethambutol ushered in the era of “short course chemotherapy”. Multidrug resistance TB (MDR-TB) is threatening to destabilise the best efforts of TB control. Treatment of MDR-TB is difficult, expensive and toxic and is often unsuccessful. DOTS is an interventional strategy designed to effectively diagnose and treat TB. The fundamental principles in the DOTS strategy are : Polititical will, diagnosis by sputum microscopy, directly observed standardised short-course treatment, adequate supply of good quality drugs, systematic monitoring and accountability. Patients with HIV infection and TB disease respond well to antituberculosis treatment if they are given short-course chemotherapy in the programme of DOTS. (excerpt)
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  7. 7
    185923

    Guidelines for the clinical management of HIV infection in adults.

    World Health Organization [WHO]. Global Programme on AIDS

    [Geneva, Switzerland], WHO, 1991 Dec. [92] p. (WHO/GPA/IDS/HCS/91.6)

    Infections and tumours are the paramount clinical problems confronting health care providers caring for patients with HIV-related disease. Treatment of these infections and tumours is of great importance as it decreases suffering and prolongs life in the absence of effective and non-toxic antiretroviral drugs or immunotherapy against HIV itself. However, clear treatment guidelines are lacking in many parts of the world and health care workers have often not received training in the management of HIV-related disease. To respond to this situation, the WHO Global Programme on AIDS (GPA) has developed guidelines for the clinical management of HIV infection in adults. There are wide variations in the presentation of HIV-related diseases, availability of resources and health infrastructures. It is hoped that the guidelines will provide a model to assist all countries, but especially those in the developing world, to formulate national guidelines in accordance with their own particular needs and resources. Adaptation of these guidelines should take place through national/institutional workshops. The guidelines represent the consensus of a number of clinical experts working in this area, and will be revised from time to time in the light of experience. Comments are welcome and should be sent to the Global Programme on AIDS, World Health Organization, 1211 Geneva 27, Switzerland. (excerpt)
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