Ugandan researchers stand out at HIV conference in Sydney
Jul 25, 2007
<b>HIGHLIGHTS on Day 2 at IAS 2007. </b>Uganda’s Apollo Basenero’s research on when and how to switch patients from first line to second line Anti Retroviral Therapy (ART), won him the Recherches sur le SIDA (ANRS)/IAS Prize.
Hilary Bainemigisha
HIGHLIGHTS on Day 2 at IAS 2007. Uganda’s Apollo Basenero’s research on when and how to switch patients from first line to second line Anti Retroviral Therapy (ART), won him the Recherches sur le SIDA (ANRS)/IAS Prize.
The prize recognises young researchers, who demonstrate excellence in research related to the scale up of prevention and treatment in resource-limited settings.
Basenero’s award-winning research was about evaluating the use of a consensus meeting of care providers at Infectious Disease Institute (IDI), Mulago hospital, to determine which patient should switch from first line to second line ARV therapy. He said these weekly switch meetings of clinic staff do not use virologic monitoring because it is expensive.
The decisions are based on clinical and immunologic monitoring alone and, therefore, even when done by an experienced HIV team, may lead to unnecessary ART change in up to 35% of patients.
He suggested that viral load testing should be an essential part of monitoring in spite of the resource-limited setting.
Basenero is a medical officer at the IDI, Makerere University and has been the coordinator of the ‘Switch meeting’ for two years.
Research in HIV childcare shows that treating infants with anti-retrovirals after they show signs of illness or a weakened immune system, means losing about half of them.
The National Institute of Allergy and Infectious Diseases and the National Institutes of Health, US, recommend that all children born of HIV-positive mothers, should be given ART until it is confirmed that they are HIV-negative.
Uganda was fourth out of 133 countries in the number of abstracts received from researchers in 133 countries.
The US sent in most (360), Nigeria and Australia the host came second with 192. Ugandan researchers sent in 167 research abstracts, a good number of which went through to be used in sessions and exhibitions. We were followed by Brazil (145), Nepal (119), Canada (93), Spain (86), Italy (83), France (82), UK (73), Thailand (68) and Kenya (61).
Quotes
-It is not a question if people in Africa will get TB, but when — By Renee Ridzon, of the Bill & Melinda Gates Foundation while calling for urgent new research in TB.
-We condemn all restrictions imposed on people living with HIV and ask all governments which require HIV test for immigration purposes to stop it forthwith — Keynote speech by Prof Dr Michel Kazatchkine, executive director of the Global Fund for AIDS, TB and Malaria
Day’s events
The main plenary session: The main topic was about understanding the origin, development and deadliness of HIV, ARV roll-out and research issues in the developing world, how HIV makes you sick and the effect of HIV on aging.
Poster exhibitions
These were dominated by Ugandan researchers. Bonnie Wandera’s exhibition was about the impact of malnutrition on survival and immunological response in HIV-infected patients starting ART.
From his research at the Infectious Diseases Institute, Makerere University, Adult Infectious Diseases Clinic, Kampala, and Makerere University Medical School, Department of Medicine, he concluded that people who start ARVs when they are not well-fed (body mass index lower than normal) have less chances of survival, but if they did after 12 months of ART, their immune response improves.
He recommends nutritional supplementation to enable then survive the first ART bombardment.
Another exhibition was by James Ssenfuka on the success of clean delivery kits in HIV prevention efforts.
His study found that the delivery kits (referred to as maama kits) used by Uganda Programme for Human and Holistic development (UPHOLD) in Gulu district Internally Displaced Peoples camps increased survival opportunities for babies born to HIV-positive mothers.
Ssenfuka concluded that facilities for clean delivery have been a big challenge. Clean delivery kits create an opportunity for dosing the infant with nevirapine. He recommended that the use of clean delivery kits in poor settings should be scaled up as it increases opportunities for prevention-of-mother-to-child-transmission. Ssenfuka also said use of incentives like “maama kitsâ€, mosquito nets can have an impact on uptake of reproductive health services.
Tom Lutalo followed HIV in rural Rakai district adults for 12 years to discover that while there were significant declines in overall prevalence, significant increase in incidence amongst men aged 20-29 years was noticed. He recommended counselling programmes to address this reverse.
Damalie Nakanjako displayed research on the burden of TB among HIV-infected patients at Mulago and Mbarara hospitals and found it high. She recommends integration of TB screening into HIV/AIDS care programmes both at enrollment and follow-up, especially before initiation of ART to reduce TB deaths among HIV/AIDS patients.
Other research exhibition from non-Ugandans included:
-The need to treat sexually transmitted diseases for better HIV prevention
-How to activate immunity in people living with HIV
-How the world has responded to HIV prevention among injection drug users
Oral abstract session Immaculate Nankya monitored HIV type, fitness and load in the vaginal tract right from the time it enters the body and during disease progression and concluded that in the absence of treatment, HIV-1 fitness and load increases with disease progression, decreasing CD4 counts, and increasing HIV-1 genetic diversity.
Her results suggest that HIV-1 diversity is higher in vaginal tract than in blood at seroconversion, but that the former undergoes a genetic bottleneck whereas the viral population in blood increases in genetic diversity.
Day’s tour
The delegates toured the Sydney Sexual Health Centre to study the centre’s activities with a special focus on access and health promotion activities directed at priority populations.
The centre provides confidential and comprehensive services for sexual care, screening, vaccination and management of sexually transmissible infections including HIV, hepatitis B and C.
The service is free and caters for men who have sex with men, sex workers, injecting drug users, people living with HIV and young people
Special Session
Presented new data and international ART guidelines, the new ARVs discovered, targeted and new compounds, how to treat women and the impact of vaginal microbes on infections after birth among HIV infected and uninfected women. One of the presenters, Motshedisi Sebitloane from South Africa, concluded that HIV infected women carry more infectious vaginal microbes during pregnancy, which subsequently lead to increased afterbirth sepsis.
Poster discussions
-Pre-exposure prophylaxis (taking ARVs for prevention) for HIV-discordant couples willing to conceive a child, for victims of sexual assault and accidental exposure.
-The new ethical issues: Suppressing HIV replication in infected individuals to protect their uninfected partners, who are deemed to have consented and how informed they were, and care and treatment in vaccine trials.
HIGHLIGHTS on Day 2 at IAS 2007. Uganda’s Apollo Basenero’s research on when and how to switch patients from first line to second line Anti Retroviral Therapy (ART), won him the Recherches sur le SIDA (ANRS)/IAS Prize.
The prize recognises young researchers, who demonstrate excellence in research related to the scale up of prevention and treatment in resource-limited settings.
Basenero’s award-winning research was about evaluating the use of a consensus meeting of care providers at Infectious Disease Institute (IDI), Mulago hospital, to determine which patient should switch from first line to second line ARV therapy. He said these weekly switch meetings of clinic staff do not use virologic monitoring because it is expensive.
The decisions are based on clinical and immunologic monitoring alone and, therefore, even when done by an experienced HIV team, may lead to unnecessary ART change in up to 35% of patients.
He suggested that viral load testing should be an essential part of monitoring in spite of the resource-limited setting.
Basenero is a medical officer at the IDI, Makerere University and has been the coordinator of the ‘Switch meeting’ for two years.
Research in HIV childcare shows that treating infants with anti-retrovirals after they show signs of illness or a weakened immune system, means losing about half of them.
The National Institute of Allergy and Infectious Diseases and the National Institutes of Health, US, recommend that all children born of HIV-positive mothers, should be given ART until it is confirmed that they are HIV-negative.
Uganda was fourth out of 133 countries in the number of abstracts received from researchers in 133 countries.
The US sent in most (360), Nigeria and Australia the host came second with 192. Ugandan researchers sent in 167 research abstracts, a good number of which went through to be used in sessions and exhibitions. We were followed by Brazil (145), Nepal (119), Canada (93), Spain (86), Italy (83), France (82), UK (73), Thailand (68) and Kenya (61).
Quotes
-It is not a question if people in Africa will get TB, but when — By Renee Ridzon, of the Bill & Melinda Gates Foundation while calling for urgent new research in TB.
-We condemn all restrictions imposed on people living with HIV and ask all governments which require HIV test for immigration purposes to stop it forthwith — Keynote speech by Prof Dr Michel Kazatchkine, executive director of the Global Fund for AIDS, TB and Malaria
Day’s events
The main plenary session: The main topic was about understanding the origin, development and deadliness of HIV, ARV roll-out and research issues in the developing world, how HIV makes you sick and the effect of HIV on aging.
Poster exhibitions
These were dominated by Ugandan researchers. Bonnie Wandera’s exhibition was about the impact of malnutrition on survival and immunological response in HIV-infected patients starting ART.
From his research at the Infectious Diseases Institute, Makerere University, Adult Infectious Diseases Clinic, Kampala, and Makerere University Medical School, Department of Medicine, he concluded that people who start ARVs when they are not well-fed (body mass index lower than normal) have less chances of survival, but if they did after 12 months of ART, their immune response improves.
He recommends nutritional supplementation to enable then survive the first ART bombardment.
Another exhibition was by James Ssenfuka on the success of clean delivery kits in HIV prevention efforts.
His study found that the delivery kits (referred to as maama kits) used by Uganda Programme for Human and Holistic development (UPHOLD) in Gulu district Internally Displaced Peoples camps increased survival opportunities for babies born to HIV-positive mothers.
Ssenfuka concluded that facilities for clean delivery have been a big challenge. Clean delivery kits create an opportunity for dosing the infant with nevirapine. He recommended that the use of clean delivery kits in poor settings should be scaled up as it increases opportunities for prevention-of-mother-to-child-transmission. Ssenfuka also said use of incentives like “maama kitsâ€, mosquito nets can have an impact on uptake of reproductive health services.
Tom Lutalo followed HIV in rural Rakai district adults for 12 years to discover that while there were significant declines in overall prevalence, significant increase in incidence amongst men aged 20-29 years was noticed. He recommended counselling programmes to address this reverse.
Damalie Nakanjako displayed research on the burden of TB among HIV-infected patients at Mulago and Mbarara hospitals and found it high. She recommends integration of TB screening into HIV/AIDS care programmes both at enrollment and follow-up, especially before initiation of ART to reduce TB deaths among HIV/AIDS patients.
Other research exhibition from non-Ugandans included:
-The need to treat sexually transmitted diseases for better HIV prevention
-How to activate immunity in people living with HIV
-How the world has responded to HIV prevention among injection drug users
Oral abstract session Immaculate Nankya monitored HIV type, fitness and load in the vaginal tract right from the time it enters the body and during disease progression and concluded that in the absence of treatment, HIV-1 fitness and load increases with disease progression, decreasing CD4 counts, and increasing HIV-1 genetic diversity.
Her results suggest that HIV-1 diversity is higher in vaginal tract than in blood at seroconversion, but that the former undergoes a genetic bottleneck whereas the viral population in blood increases in genetic diversity.
Day’s tour
The delegates toured the Sydney Sexual Health Centre to study the centre’s activities with a special focus on access and health promotion activities directed at priority populations.
The centre provides confidential and comprehensive services for sexual care, screening, vaccination and management of sexually transmissible infections including HIV, hepatitis B and C.
The service is free and caters for men who have sex with men, sex workers, injecting drug users, people living with HIV and young people
Special Session
Presented new data and international ART guidelines, the new ARVs discovered, targeted and new compounds, how to treat women and the impact of vaginal microbes on infections after birth among HIV infected and uninfected women. One of the presenters, Motshedisi Sebitloane from South Africa, concluded that HIV infected women carry more infectious vaginal microbes during pregnancy, which subsequently lead to increased afterbirth sepsis.
Poster discussions
-Pre-exposure prophylaxis (taking ARVs for prevention) for HIV-discordant couples willing to conceive a child, for victims of sexual assault and accidental exposure.
-The new ethical issues: Suppressing HIV replication in infected individuals to protect their uninfected partners, who are deemed to have consented and how informed they were, and care and treatment in vaccine trials.