from the editor.html


    
        
            
                
                    

                

            

            
                From the Editor

                
                    SAJHIVMED
                    has undergone a bit of a facelift since the previous issue. For more
                    than a decade, the layout and formatting had been essentially
                    unchanged, and a revamp was in order to provide a more contemporary
                    profile suitable to a research-driven publication. The new look was
                    shaped by the talented team at the Health & Medical Publishing
                    Group (who produce the SAMJ and several other prominent journals, as well as the South African Medicines Formulary), particularly Siobhan Tillemans and Melissa Raemaekers. Thanks to both, and the entire HMPG team, for their assistance!

                    Along with the new aesthetic, we are pleased to announce a new
                    editorial board to support the Journal’s work. The names on the
                    masthead will be known to many readers, as they represent some of South
                    Africa’s leading researchers and clinicians working in HIV/AIDS.
                    In addition, there are some exciting developments planned to increase
                    the international visibility and accessibility of SAJHIVMED, and I will keep you posted on news as it emerges.

                    This edition of the journal contains several notable items,
                    with a particular focus on laboratory assessments. There is ongoing
                    interest in the new markers that may be used to monitor HIV disease
                    progression and response to antiretroviral therapy; Bipath and
                    colleagues suggest that neopterin levels may be more strongly
                    correlated with standard HIV disease markers (e.g. viral load or CD4
                    cell count) than either C-reactive protein or procalcitonin. In another
                    interesting piece, Gounden et al.
                    investigate a case of how host genetics – here, allelic variation
                    in the genes that promote tumour necrosis factor-alpha – may
                    influence HIV disease progression. Both these studies present
                    intriguing findings that point to the need for further research with a
                    particular view towards their clinical utility. A more practical
                    laboratory assessment comes from Swaziland, where Mlawanda and
                    colleagues examined the variability of CD4 enumeration both within and
                    between labs – a real-world concern that is commonly raised by
                    healthcare providers and patients alike. Although the sample sizes are
                    small, the results are somewhat reassuring, with reasonable agreement
                    in results between labs. Two case series explore common complications
                    of advanced HIV disease, including CMV retinitis (Laher), suggesting
                    reasonable outcomes despite the absence of systemic therapy, and Pneumocystis pneumonia (Shaddock), providing evidence for lung fibrosis in individuals with advanced disease requiring ventilation.

                    This edition also continues SAJHIVMED’s
                    tradition of publishing important guidelines from the Southern African
                    HIV Clinicians’ Society that help to shape programmes and
                    services across the region. Prevention strategies using antiretrovirals
                    have demonstrated efficacy in reducing the sexual transmission of HIV,
                    most notably in the realm of pre-exposure prophylaxis (PrEP). The
                    evidence for PrEP’s efficacy is strongest in research among men
                    who have sex with men (MSM), yet there are currently no tools to guide
                    service providers. Here, Bekker and colleagues present comprehensive
                    guidelines on implementing PrEP among MSM, the first such document of
                    its kind internationally.

                    Landon Myer

                    School of Public Health & Family Medicine

                    University of Cape Town

                    Landon.Myer@uct.ac.za