Must Read. OPEN LETTER: A wake-up call for Health Department heads: Children are dying because of horrendous state of our public hospitals dailymaverick.co.za/article/2022-0…

Withdraw The Suspension - Sign the Petition! chng.it/dgY6B4xP via Change.org South Africa

Flucytosine added to the intensive phase of cryptococcal meningitis treatment improved survival in the ACTA clinical trial - and here we show it also did so in clinical practice setting in 🇿🇦

Findings of the RADIANT-TB trial led by Rulan Griesel and Gary Maartens in Cape Town, presented this week at AIDS2022, evaluating dolutegravir dosing in patients with TB on rifampicin:

1/ Updated HIV chapters 🇿🇦 adult standard treatment guidelines National Department of Health Crypto 1⃣ Retained CD4<100 threshold for bld CrAg screening 2⃣ 5FC+AmBd option added for meningitis 3⃣ Lipo AmB NOT added 4⃣ Non-CNS crypto section removed 5⃣ Re/initiate ART @ 2w if bld CrAg+/ CSF CrAg-

7/ 4⃣ Non-CNS crypto section removed Section removal justified because all bld CrAg+/ CSF CrAg+ need an LP But what about symptomatic non-CNS crypto diagnosed by culture at other sterile sites? Should probably be treated like CNS crypto in HIV but no longer clear in guideline

8/ 5⃣ Re/initiate ART @ 2w post-fluconazole if bld CrAg+/ CSF CrAg- No evidence for this but aligned to Southern African HIV Clinicians Society (SAHCS) and World Health Organization (WHO) guidelines