In an antiretroviral treatment program employing comprehensive monitoring, the probability of switching to second-line therapy was limited. Regular pickup of medication was a predictor of survival and was also strongly predictive of patient retention.

The response to treatment and risk factors for early mortality following initiation of combination antiretrovirals(ARVs) in a cohort of African patients are described in a retrospective cohort design. Medical history, laboratory parameters, and mortality data were reviewed for patients initiating ARVs in 12 clinical centers in Mozambique, Tanzania, and Malawi. Among 3456 HIV-1-infected patients who received ARVs for more than 6 months, at baseline 72% had WHO clinical stages 3/4, 7% had a viral load 400 copies/ml, and 38% had a CD4 cell count >200/microl. One year later, 78% had undetectable virus loads and 79% had CD4 cell counts >200 cells/mm3. In the first year of HAART 260 deaths occurred (97 per 1000 person/years) with mortality peaking in the first 3 months. The highest mortality was observed in patients with low BMI, low hemoglobin levels, and CD4 values <200 cells/microl at baseline. Mortality rates following initiation of HAART are higher in patients in resource-limited areas, particularly in the first 90 days following treatment initiation.HAART initiated at higher CD4 cell count levels, especially among malnourished and/or anemic patients, will carry significant public health impact.

We conducted a retrospective cohort study of HIV-infected pregnant women and their infants enrolled in the DREAM programme for prevention of HIV mother-to-child transmission (MTCT) in Mozambique. All women delivering between May 2002 and December 2005 were offered participation. The programme consisted of the provision of highly active anti-retroviral therapy (HAART) to pregnant women until 6 months postpartum, and formula, clean water, nutritional supplementation, and continuing HAART to mothers if necessary.In Mozambique 1,259 HIV-positive pregnant women were offered participation: 212 (14.4%; CL95% 12.6-16.2) refused, 54 (3.7%; CL95% 2.5-4.9) dropped out during pregnancy, and eight women died. The remaining 985 women participated, giving birth to 958 infants, including 21 sets of twins. An additional 28 babies were stillborn. Spontaneous abortions occurred in 20 cases. Discontinuation of anti-retroviral (ARV) therapy by mothers was 3.7% (54/1,464) before delivery, 1.5% in the first month (23/ 1,464), and 1.5% (22/1,464) between the first and sixth months after delivery. Overall drop-out rates were 5.2% (CL95% 4.6-5.8). Approximately 80% of pregnant women completed the treatment protocol.

The electrical resistivity (ER) of Flexinol nickel-titanium shape memory alloys (SMA) has been measured in the range from −15 to 105 • C. The investigated Flexinol wires have two diameters, 150 and 375 µm. The experimental results show new temperatures of phase transformation (TTR) evidencing the unexpected presence of the R-phase. The transformations from austenite to martensite, from austenite to R-phase, and vice versa are simultaneous. In the range [20 to 110 • C] the hysteresis is almost negligible, whereas in the range [−15 to 105 • C] the accommodation process of the hysteresis is observed.

This study evaluates the effectiveness of a holistic model for treating people living with AIDS in Africa; the model aims to improve knowledge about AIDS prevention and care, increase trust in the health centre, impact behaviour, and promote a high level of adherence to HAART. The study took place in the context of the DREAM (Drug Resource Enhancement against AIDS and Malnutrition) programme in Mozambique, designed by the Community of Sant'Egidio to treat HIV patients in Africa. It provides patients with free anti-retroviral drugs, laboratory tests (including viral load), home care and nutritional support. This is a prospective study involving 531 patients over a 12-month period. The patients, predominantly poor and with a low level of education, demonstrated a good level of knowledge about AIDS (more than 90% know how it is transmitted) and trust in the treatment, with a relatively small percentage turning to traditional healers. Overall the patients had a low level of engaging in risky sexual behaviour and a very good level of adherence to HAART (69.5% of the 531 subjects had a pill count higher than 95%). The positive results of the programme's educational initiatives were confirmed with the patients' good clinical results.