Willingness to participate in South African HIV vaccine trials - concerns of medical professionals in the Western Cape

Objectives. To evaluate the willingness of medical doctors working at a tertiary hospital to participate in HIV vaccine trials, their perceptions ofpatients' willingness to participate, and the major reasons underlying these views.Design. A self-administered, anonymous postal survey conducted in two rounds between May and July 2001.Setting. A tertiary care hospital in the Western Cape. Subjects. All medical doctors listed on the hospital's staff directory.Outcome measures. Willingness to participate in, and to recruit patients into, HIV vaccine trials, and the reasons for this.Results and conclusions. Of the 289 individuals surveyed, 80% stated either that they would not be willing to participate in HIV vaccine trials or that they were unsure about their participation. Meanwhile, 37% stated that they would be willing to recruit patients into vaccine trials. The most common concerns with trial participation were the possibility of vaccine-induced infection and the possibility of testing positive for antibodies to HIV. The surprisingly low level of willingness to participate in trials in this sample of medical professionals highlights the importance of preparatory work to overcome substantial barriers to HIV vaccine trial participation

Detection of human papillomavirus DNA with in situ hybridisation in oral squamous carcinoma in a rural black population

No Abstract

The characteristics of juvenile myasthenia gravis among South Africans

OBJECTIVES: To report the characteristics of juvenile-onset (<20 years) myasthenia gravis (MG) in Africa. SUBJECTS AND METHOD: Six South African centres collected data which included acetylcholine receptor-antibody (AChR-ab) status, delay before diagnosis, MG Foundation of America grade at onset, maximum severity and severity at last visit, therapies, outcomes and complications. RESULTS: We report on 190 individuals with a 4-year median follow-up (interquartile range (IQR) 1 - 8). The median age at symptom onset was 7 years (IQR 4 - 14). Ocular MG (26%) occurred among younger children (mean 5.1 years) compared with those developing generalised MG (74%) (mean 10.2 years) (p=0.0004). Remissions were obtained in 45% of generalised and 50% of ocular MG patients, of whom the majority received immunosuppressive treatment, mainly prednisone. Children with post-pubertal onset had more severe MG, but deaths were infrequent. Thymectomies were performed in 43% of those with generalised MG who suffered greater maximum disease severity (p=0.002); there was a trend towards more remissions in the thymectomy group compared with the non-thymectomy group (p=0.057). There was no racial variation with respect to AChR-ab status, maximum severity, or use of immunosuppression. However, 23% of children of African genetic ancestry developed partial or complete ophthalmoplegia as a complication of generalised MG (p=0.002). CONCLUSION: Younger children developed ocular MG and older children generalised MG. Persistent ophthalmoplegia developing as a MG complication is not uncommon among juveniles of African genetic ancestry. A successful approach to the management of this complication that causes significant morbidity is, as yet, unclear.http://www.samj.org.z

Simian immunodeficiency viruses (SIVs) from eastern and southern Africa : detection of a SIVagm variant from a chacma baboon

Simian immunodeficiency viruses (SIVs) have been shown to infect many old world African primate species. Thus far, no work has been published on southern African primates. In this study we investigated the genetic diversity between SIV strains from Kenyan and South African vervets (Cercopithecus aethiops pygerythrus). We amplified and sequenced a 1113 bp region of the env gene. Phylogenetic analysis of these sequences showed that all strains clustered with members of the vervet subgroup of SIVagm. The SIVs from South African vervets differed by 7% from each other and by 8–14% from the Kenyan SIV strains, while the Kenyan SIV strains differed by 10–21% from SIVagm of other east African vervets. We also isolated and sequenced, for the first time, a SIV strain from a healthy chacma baboon (Papio ursinus), caught in South Africa. Phylogenetic analysis of the env region showed the virus to be closely related to the South African vervet SIV strains, while analysis of its pol region confirmed the virus to be a SIVagm variant

Identification of env subtypes in fourteen HIV type 1 isolates from South Africa

All subtypes of HIV-1 have been identified in Africa. The envelope glycoprotein of the HIV-1 is the most variable region of the virus, with the third variable region, including the V3 loop, a major target of vaccine research. This paper reports the identification of the HIV-1 subtypes present in 14 viral strains, isolated between 1984 and 1992 in South Africa. HIV-1 strains were isolated routinely at Tygerberg hospital in the Western Cape region, with genomic DNA isolated from virus-infected cultures. After presenting the distance calculations and describing the tree constructions and bootstrap analysis, the authors emphasize the need for ongoing molecular epidemiological analysis of HIV-1 subtypes to track the current epidemic in South Africa. More rapid methods will facilitate subtyping to monitor the circulation and spread of HIV-1 subpopulations in the country.This article was co-written by Prof Janse van Rensburg before she joined the University of Pretoria

Prevalence of EBV in oral squamous cell carcinomas in young patients

BACKGROUND: Recent studies reported a difference in the age distribution of oral squamous cell carcinoma (OSCC) between black and white South Africans with OSCC more prevalent in black patients under the age of 50 compared to whites. MATERIALS AND METHODS: Paraffin embedded blocks of OSCC were divided into two groups: one with a mean age of 56.2 years and the second group all younger than 40 years of age. A control group of 30 non-neoplastic intraoral lesions were selected. A standard PCR reaction was used to amplify the BAM H1 W-fragment of the EBV. RESULTS: EBV DNA was demonstrated in 11/45 (24%) cases from the first group and in 11/45 (24%) cases from the second group. EBV DNA was present in 11/30 (37%) cases from the control group. CONCLUSIONS: This study showed that the prevalence of EBV in OSCC was not influenced by the age of the patient.This article was co-written by Prof Janse van Rensburg and Prof Van Heerden before they joined the University of Pretoria

Correlation between p53 gene mutation, p53 protein labeling and PCNA expression in oral squamous cell carcinomas

The prevalence of oral squamous cell carcinoma (OSCC) among the black community in South Africa is unacceptably high. The association between p53 protein, and PCNA overexpression and the presence of p53 gene mutations was evaluated. Materials and Methods: One hundred and ten formalin-fixed, paraffin-embedded blocks of OSCC were selected for immunohistochemical studies for p53 protein and PCNA expression using the DO-7 and PC10 monoclonal antibodies, respectively. DNA was extracted from fifty-five block and exons 5 to 9 of the p53 gene were amplified with nested primers, thereafter sequencing was performed to confirm the presence of mutations detected by single stranded conformational polymorphism. Results: Fifty-six cases (51%) showed p53 expression, while fourteen mutations (25%) were detected. A significant difference was found between the PCNA index in p53 positive and p53 negative rumors while the mean PCNA index for the tumors with p53 mutations was not significantly different from the tumors without mutations. Conclusions: No association between p53 protein overexpression and p53 gene mutations could be demonstrated.The article was co-written by Prof Janse van Rensburg before she joined the University of Pretoria

HIV type 1 V3 region subtyping in KwaZulu-Natal, a high-seroprevalence South African region

No abstract available.This article was co-written by prof Janse van Rensburg before she joined the University of Pretoria