HIV MARCH MAKE UP 01


5

The editorial staff of the Southern African Journal of HIV
Medicine would like to take this opportunity to congratulate
Dr Francois Venter on his election as President of the Southern
African HIV Clinicians Society. I am sure that under Francois’
vigorous leadership the Society will continue to expand and
become even more significant in the field of HIV medicine on
our continent. Francois is an experienced clinician in the field
and is currently working in the public sector. He thus provides
a bridge between the public sector and the private sector and
would be an important catalyst in developing and promoting
public-private sector partnerships.

This issue of the journal provides clinicians with two important
guidelines in the field of antiretroviral (ARV) therapies, namely
the issue of nucleoside reverse transcriptase inhibitor (NRTI)-
associated lactic acidosis and ARV drug resistance. Ironically
the former is associated in most instances with our extremely
adherent patients and the latter with our least adherent
patients. Stavudine, which at the present time is included as a
first-line drug in most regimens in the developing world, is
included for very good reasons: it is effective, inexpensive and
easy to take. Regrettably, however, it has been linked to a
number of conditions associated with mitochondrial toxicities,
lipoatrophy, peripheral neuropathy and lactic acidosis to name
but a few. The time has come when this drug needs to be
replaced in regimens in the developing world. We eagerly
await the registration of tenofovir in South Africa, which will
go a long way towards alleviating the distressing side-effects
of stavudine. Until this happens clinicians need to have a
heightened awareness of lactic acidosis and institute
appropriate laboratory monitoring and prompt management
in order to avoid the not insignificant morbidity and mortality
associated with the condition.

Resistance of HIV to ARV therapies is an issue in both  the
developed and developing world. The difference between these
situations, however, is that in the developed world there are
many more options with regard to both testing and
sequencing of therapy. In the developing world, where options
for drug therapies are limited, the clinicians’ guide published in
this issue will provide immeasurable support for the treating
doctor. 

DES MARTIN
Editor

FROM THE EDITOR

On behalf of the newly elected executive, I would like to extend
my thanks to the 10 500 members of the Southern African HIV
Clinicians Society for all your support. We are going to need it,
as the challenges posed by the epidemic appear to be getting
greater with each passing year. As part of an overall review, the
new executive will be taking an intensive look at our activities
in the light of expanded access to care across the southern
African region. New branches are cropping up across the
region, and a major role for the society is maintaining our
massive database so that, no matter where our members are,
effective communication is possible to ensure that those on
the ground have the information they need to do the best job
possible.

In terms of immediate activities, we will be revamping the
Journal and Transcript, our major method of communication.
The previous president, Professor Des Martin, will remain as
the Journal’s editor and Ms Penny Penhall will continue editing
Transcript, with more scope to stimulate debate and
controversy! The website will also be changing, and will be
freely accessible to all in future, led by Dr Steve Andrews.

Professor Gary Maartens will be co-ordinating the Colleges of
Medicine’s highly successful HIV Management Diploma, and
the Society will be encouraging as many of you to write it as
possible.

The Society’s extremely successful collaboration with the
Foundation for Professional Development is set to continue –

thousands of health
care workers have been
trained through their
courses, and the Society
will continue to ensure
the quality of this
course and its relevance
to the southern African
context. Dr David
Spencer will be leading
the Society’s advocacy
wing, strengthening our
ties with civil society.
Other responsibilities will be allocated as needed. 

I welcome any suggestions going forward, and will be calling
on members to assist us where possible. Finally, much thanks
to the previous executive, as well as Penny Penhall, the
Society’s manager, Pat Solan, responsible for the database, and
Jean Solan, who manages our finances, for making this one of
the biggest medical organisations in the world.

I look forward to meeting many of you through branch
meetings and events and I hope we are able to do great things
in 2006.

FRANCOIS VENTER
President

MESSAGE FROM THE EXECUTIVE

THE SOUTHERN AFRICAN JOURNAL OF HIV MEDICINE                                            MARCH 2006