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Five weeks after commencing highly active antiretroviral therapy, a 12-year-old boy with advanced human immunodeficiency virus infection presented with acute cerebellar dysfunction and hemiparesis. Progressive multifocal leukoencephalopathy was diagnosed by cerebrospinal fluid polymerase chain reaction for JC virus and magnetic resonance imaging of the(More)
SETTING Rifampicin may reduce plasma efavirenz concentrations by inducing the expression of the cytochrome P450 2B6, which metabolizes efavirenz. However, there is no data in pediatric patient populations. METHODS We measured plasma efavirenz concentrations in 15 children during and after rifampicin-based antitubercular treatment. They were receiving(More)
BACKGROUND Antiretroviral therapy (ART) dramatically improves outcomes for children in Africa; however excellent adherence is required for treatment success. This study describes the utility of different measures of adherence in detecting lapses in infants and young children in Cape Town, South Africa. METHODS In a prospective cohort of 122 HIV-infected(More)
OBJECTIVE To describe the frequency, risk factors, and clinical features of bacillus Calmette-Guérin (BCG) complications in HIV-infected children treated with highly active antiretroviral therapy (HAART). METHODS A retrospective study of children started on HAART between August 2002 and November 2004 was completed. RESULTS Six percent (21/352; 95% CI(More)
INTRODUCTION Between 2009 and 2010, South Africa experienced a major measles outbreak, with more than 18 000 confirmed cases reported to the National Institute of Communicable Diseases. METHODS We studied measles admissions during the outbreak to Red Cross War Memorial Children's Hospital, Cape Town, between 1 November 2009 and 31 July 2010. Factors(More)
In a study of 38 hips showing only minor abnormality on the AP radiograph, it was found that the most reliable sign of an early slip was blurring of the junction between the metaphysis and the growth plate. The diagnosis could not be made on the AP film alone in 11% of cases and it is recommended that a routine lateral radiograph is obtained when slipped(More)
Currently, <10% of all HIV-infected children who need anti-retroviral therapy in sub-Saharan Africa are actually receiving therapy. Many constraints prevent these children from gaining access to appropriate care, including the magnitude of the paediatric epidemic, competing interests of adult care, health system inadequacies, technical challenges and(More)
OBJECTIVE Rifampicin dramatically reduces plasma lopinavir concentrations (coformulated with ritonavir in a 4:1 ratio). A study in healthy adult volunteers showed that this reduction could be ameliorated if additional ritonavir is given. We evaluated the effect of additional ritonavir on plasma lopinavir concentrations in HIV-infected children receiving(More)
PURPOSE OF REVIEW With recent changes in global pediatric HIV policy to initiate treatment immediately after early infant diagnosis, there will be greater demand for feasible antiretroviral sequencing strategies that will support children through adulthood. This review will discuss HIV treatment (antiretroviral therapy) failure, regimen switching, and(More)