From the Editor

SAJHIVMED has undergone a bit of a facelift since the previous issue. For more than a decade, the layout and formatting had been essentially unchanged, and a revamp was in order to provide a more contemporary profile suitable to a research-driven publication. The new look was shaped by the talented team at the Health & Medical Publishing Group (who produce the SAMJ and several other prominent journals, as well as the South African Medicines Formulary), particularly Siobhan Tillemans and Melissa Raemaekers. Thanks to both, and the entire HMPG team, for their assistance!

Along with the new aesthetic, we are pleased to announce a new editorial board to support the Journal’s work. The names on the masthead will be known to many readers, as they represent some of South Africa’s leading researchers and clinicians working in HIV/AIDS. In addition, there are some exciting developments planned to increase the international visibility and accessibility of SAJHIVMED, and I will keep you posted on news as it emerges.

This edition of the journal contains several notable items, with a particular focus on laboratory assessments. There is ongoing interest in the new markers that may be used to monitor HIV disease progression and response to antiretroviral therapy; Bipath and colleagues suggest that neopterin levels may be more strongly correlated with standard HIV disease markers (e.g. viral load or CD4 cell count) than either C-reactive protein or procalcitonin. In another interesting piece, Gounden et al. investigate a case of how host genetics – here, allelic variation in the genes that promote tumour necrosis factor-alpha – may influence HIV disease progression. Both these studies present intriguing findings that point to the need for further research with a particular view towards their clinical utility. A more practical laboratory assessment comes from Swaziland, where Mlawanda and colleagues examined the variability of CD4 enumeration both within and between labs – a real-world concern that is commonly raised by healthcare providers and patients alike. Although the sample sizes are small, the results are somewhat reassuring, with reasonable agreement in results between labs. Two case series explore common complications of advanced HIV disease, including CMV retinitis (Laher), suggesting reasonable outcomes despite the absence of systemic therapy, and Pneumocystis pneumonia (Shaddock), providing evidence for lung fibrosis in individuals with advanced disease requiring ventilation.

This edition also continues SAJHIVMED’s tradition of publishing important guidelines from the Southern African HIV Clinicians’ Society that help to shape programmes and services across the region. Prevention strategies using antiretrovirals have demonstrated efficacy in reducing the sexual transmission of HIV, most notably in the realm of pre-exposure prophylaxis (PrEP). The evidence for PrEP’s efficacy is strongest in research among men who have sex with men (MSM), yet there are currently no tools to guide service providers. Here, Bekker and colleagues present comprehensive guidelines on implementing PrEP among MSM, the first such document of its kind internationally.

Landon Myer

School of Public Health & Family Medicine

University of Cape Town

Landon.Myer@uct.ac.za