Katherine L. Fielding

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BACKGROUND Episodes of viremia are common in African antiretroviral therapy (ART) programs. We sought to describe viremia, resuppression, and accumulation of resistance during first-line combination ART (cART) in South Africa. METHODS Retrospective analysis of a cohort receiving zidovudine, lamivudine, and either efavirenz or nevirapine with human(More)
BACKGROUND We aimed to assess whether interferon-γ release assays (IGRAs) can predict the development of active tuberculosis and whether the predictive ability of these tests is better than that of the tuberculin skin test (TST). METHODS Longitudinal studies of the predictive value for active tuberculosis of in-house or commercial IGRAs were identified(More)
OBJECTIVE Hepatotoxicity is a significant complication of antiretroviral therapy (ART). We assessed the incidence of and risk factors for hepatotoxicity among HIV-infected individuals on ART in South Africa. DESIGN We conducted a retrospective cohort study in a workplace HIV care program in South Africa which uses a first-line regimen of efavirenz,(More)
SETTING National Health Laboratory Services tuberculosis (TB) laboratory, South Africa. OBJECTIVES To compare Mycobacterium Growth Indicator Tube (MGIT) with Löwenstein-Jensen (LJ) medium with regard to Mycobacterium tuberculosis yield, time to positive culture and contamination, and to assess MGIT cost-effectiveness. DESIGN Sputum from gold miners was(More)
We hypothesized that rapid presentation may be a general feature of tuberculosis (TB) associated with human immunodeficiency virus (HIV) that limits the impact of HIV on the point prevalence of TB. To investigate this, we performed a cross-sectional HIV and TB disease survey with retrospective and prospective follow-up. HIV prevalence among 1,773(More)
CONTEXT Tuberculosis preventive therapy reduces tuberculosis incidence among human immunodeficiency virus (HIV)-infected individuals in clinical trials, but implementation has been limited and there are no data on effectiveness under routine conditions. OBJECTIVE To determine the effect on tuberculosis incidence of a clinic providing isoniazid preventive(More)
BACKGROUND Coinfection with hepatitis B virus (HBV) and human immunodeficiency virus (HIV) is common in Africa; however, the impact of HBV infection on the outcomes of antiretroviral therapy programs is unclear. We evaluated the impact of chronic hepatitis B on HIV virologic response, changes in CD4 cell count, hepatotoxicity, and mortality among Africans(More)
Little is published about the disclosure of parents' own HIV status to their children in Africa. Research shows that keeping family secrets from children, including those related to a parent's HIV status, can be detrimental to their psychological well-being and to the structure of the family. Further, children with HIV-positive parents have been shown to be(More)
BACKGROUND As ART programmes in African settings expand beyond the pilot stages, adherence to treatment may become an increasing challenge. This qualitative study examines potential barriers to, and facilitators of, adherence to ART in a workplace programme in South Africa. METHODS We conducted key informant interviews with 12 participants: six ART(More)
OBJECTIVE To assess the performance of WHO clinical and CD4 cell count criteria for antiretroviral treatment (ART) failure among HIV-infected adults in a workplace HIV care programme in South Africa. DESIGN Cohort study. METHODS We included initially ART-naive participants who remained on first-line therapy and had an evaluable HIV viral load result at(More)