School of Clinical Medicine (ETDs)

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Browsing School of Clinical Medicine (ETDs) by Author "Brozin, Daniel"

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    A Review of HIV-Positive Patients at Chris Hani Baragwaneth Hospital on Third Line Antiretroviral Therapy
    (University of the Witwatersrand, Johannesburg, 2024) Brozin, Daniel; Van Blydenstein, Sarah Alexandra; Venter, Michelle
    In South Africa’s battle against the Human Immunodeficiency Virus/Acquired Immune Deficiency Virus (HIV/AIDS) epidemic, the ability of patients to readily access antiretroviral therapy (ART), has led to a significant reduction in mortality due to AIDS associated diseases. As per the Joint United Nations Program on HIV/AIDS (UNAIDS), there are approximately 7.5 million people in Sub-Saharan Africa with HIV/AIDS. Of this subset, approximately 7 million people are aware of their status, with 5.5 million people currently on ART, and approximately 5 million people with an undetectable viral load. As we have more patients who are on first-line ART for a longer period, we are experiencing an increasing rate of treatment failure, with patents having to undergo regime switches, often to Protease Inhibitor (PI) based second line regimens, As a result of more patients being on PI-based regimens for longer periods of time, a subset of patients with virological failure on second-line treatment has emerged. These patients require more costly and clinically challenging third-line therapy regimens (1) . As one spends a longer period of time on a particular regime, in the setting of non-compliance, which will create a ‘non-suppressed state‘ or low level viraemia, the inevitability of an accumulation of mutations to standard ART will increase. Studies done investigating the reasons for treatment failure in the South African context have provided many explanations concerning the above-mentioned issu