Southern African guidelines on the safe, easy and effective use of pre-exposure prophylaxis: 2020

Bekker, Linda‐Gail; Brown, Benjamin; Davey, Dvora Joseph; Gill, Katherine; Moorhouse, Michelle; Delany‐Moretlwe, Sinead; Myer, Landon; Orrell, Catherine; Rebe, Kevin; Venter, François; Wallis, Carole L

doi:10.4102/sajhivmed.v21i1.1152

Cited by 25 publications

(21 citation statements)

References 38 publications

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“…This study evaluated the benefits of tenofovir-silver nanoparticles conjugate on the ultrastructural and cytoarchitectonic properties of the prefrontal cortex in type-2 diabetic rats. Tenofovir disoproxil fumarate (TDF) is commonly used for pre-exposure prophylaxis alone or in combination with other antiretroviral drugs as post-exposure prophylaxis [46,47]. Despite TDF's low CNS-penetration rate, studies have reported its neurotoxic effect and diabetic and neurocognitive implications [11,12,19].…”

Section: Discussionmentioning

confidence: 99%

Tenofovir-silver nanoparticles conjugate ameliorates neurocognitive disorders and protects ultrastructural and cytoarchitectonic properties of the prefrontal cortex in diabetic rats

Lawal

Olojede

Sulaiman

et al. 2022

Bosn J of Basic Med Sci

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Tenofovir disoproxil fumarate (TDF) is the highly recommended antiretroviral drug in human immunodeficiency virus management. Although research has shown the neurological and metabolic disorders associated with TDF administration, the effect of TDF-silver nanoparticles conjugate (TDF-AgNPs) on the disorders has not been fully elucidated. Thus, this study evaluated the neuroprotective effects of TDF-AgNPs on ultrastructural and cytoarchitectonic properties of the prefrontal cortex (PFC) in diabetic rats. Forty-two adult male Sprague-Dawley rats (250 ± 13 g) were randomly divided into non-diabetic groups (1-3) and diabetic groups (4-6), each administered distilled water (0.5 ml/100g, p.o), TDF (26.8 mg/kg/bw, p.o) or TDF-AgNPs (6.7 mg/kg, i.p). After eight weeks of administration, cognitive function, oxidative injury and tissue inflammation were evaluated. Also, PFC ultrastructure was observed using transmission electron microscopy, Nissl staining and immunohistochemistry. Diabetic rats administered TDF exhibited cognitive deficits; and increases in blood glucose, malondialdehyde and interleukin-1 beta (IL-1β) levels, which correlate with decreases in glutathione level, and superoxide dismutase (SOD) and catalase activities. Furthermore, loss of PFC astrocytes and neuronal organelles was observed. Conversely, TDF-AgNPs administration to diabetic rats improved cognitive deficits; and increased glutathione, SOD, and catalase, but reduced PFC malondialdehyde and IL-1β concentrations. Notably, TDF-AgNPs prevented loss of PFC neurons and astrocytic cells, and morphology aberration of neuronal organelles. This study suggests that TDF-AgNPs attenuated cognitive deficits via silver nanoparticles' antioxidant and anti-inflammatory properties, preventing the loss of PFC astrocytes and neurons. The TDF-AgNPs may be utilized to ameliorate the neurological dysfunction caused by prolonged TDF administration.

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Section: Discussionmentioning

confidence: 99%

Tenofovir-silver nanoparticles conjugate ameliorates neurocognitive disorders and protects ultrastructural and cytoarchitectonic properties of the prefrontal cortex in diabetic rats

Lawal

Olojede

Sulaiman

et al. 2022

Bosn J of Basic Med Sci

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“…[6]; (4) pregnancy testing is at no cost in our DoH scenarios since it occurs through the family planning department and only done at initiation; and (5) required tests as per DoH guidelines (Figure 1). We excluded creatinine testing in our DoH and scaled‐DoH scenario analysis since it is not essential for AGYW [21]. A detailed description of items included in each costing category is in Table 1 and Table 2.…”

Section: Methodsmentioning

confidence: 99%

“…† Creatinine test is recommended at PrEP initiation but not essential in well individuals under the age of 40. It should, however, be performed at PrEP initiation and repeated at months 6 and 12 in clients with co‐morbidities, above 40 years, pregnant women or on concomitant medication [21]. ‡ HIV serology test is required at initiation and at least every 3 months.…”

Section: Methodsmentioning

confidence: 99%

Incremental costs of integrated PrEP provision and effective use counselling in community‐based platforms for adolescent girls and young women in South Africa: an observational study

et al. 2022

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Introduction Adolescent girls and young women (AGYW) are a priority population for pre‐exposure prophylaxis (PrEP), a highly effective HIV prevention method. However, effective PrEP use among AGYW has been low. Interventions to support PrEP effective use may improve pill‐taking. Affordability of PrEP programs depends on their cost. We, therefore, evaluated the cost of community‐based PrEP with effective use counselling. Methods Cost data from a randomized controlled trial were used to evaluate the cost of PrEP provision with effective use counselling offered to AGYW through community‐based HIV testing platforms between November 2018 and November 2019. AGYW were randomized to receive (1) group‐based community health club effective use counselling, (2) individualized effective use counselling or (3) community‐based PrEP dispensary. Task shifting of effective use counselling from nurses to trained lay counsellors was implemented in groups 1 and 2. Personnel costs were estimated from time‐and‐motion observations and staff interviews. Expenditure and ingredients‐based approaches were used to estimate costs for medical and non‐medical supplies. Results In total, 603 AGYW initiated PrEP and accrued a total of 1280 months on PrEP. Average cost per person‐month on PrEP with group‐based community health club, individualized effective use counselling and community‐based PrEP dispensary under the Department of Health scenario were similar and high (USD $55.32, $55.65 and $55.46, respectively) due to low PrEP client volume observed in the clinical trial. Increasing client volume (scaled Department of Health scenario) reduced cost per‐person month estimates to USD $15.48, $26.40 and $13.99, respectively. Conclusions As designed, individualized effective use counselling increased the cost of standard‐of‐care PrEP delivery by 89%, group‐based community health effective use counselling increased the cost of standard‐of‐care PrEP delivery by 11%. These estimates can inform cost‐effectiveness and budget impact analysis for PrEP provision with effective use counselling services.

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“…75 As such, all TGD clients should be offered pre-exposure prophylaxis (PrEP). 76 PrEP has no impact on the concentration of oestradiol or testosterone levels and can be safely prescribed in a client on HT. 77 HIV testing and counselling services should address TGD-specific needs, and options, such as HIV self-screening, index testing and partner notification, should be offered.…”

Section: Hivmentioning

confidence: 99%

Southern African HIV Clinicians Society gender-affirming healthcare guideline for South Africa

Tomson

Chris²,

McLachlan³

et al. 2021

South. Afr. j. HIV med.

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Southern African guidelines on the safe, easy and effective use of pre-exposure prophylaxis: 2020

Abstract: No abstract available.

Cited by 25 publications

References 38 publications

Tenofovir-silver nanoparticles conjugate ameliorates neurocognitive disorders and protects ultrastructural and cytoarchitectonic properties of the prefrontal cortex in diabetic rats

Tenofovir-silver nanoparticles conjugate ameliorates neurocognitive disorders and protects ultrastructural and cytoarchitectonic properties of the prefrontal cortex in diabetic rats

Incremental costs of integrated PrEP provision and effective use counselling in community‐based platforms for adolescent girls and young women in South Africa: an observational study

Southern African HIV Clinicians Society gender-affirming healthcare guideline for South Africa

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