South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde
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The goal of antiretroviral therapy (ART) is to suppress viral replication to undetectable levels. These low viral load (VL) levels may not be attained in some patients, a situation representing potential virological failure during the course of treatment. ⋯ The model confirms that virological failure, coupled with developing active TB while on cART, increases mortality rates irrespective of patient CD4+ count status. It also suggests that while TB at the time of cART initiation does not increase the risk of viral rebound, development of active TB after cART initiation does increase this risk. These findings highlight the importance of strengthening VL monitoring, which should be performed every 2 months, especially in patients with TB, and addressing unsuppressed VLs appropriately if they are detected.
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Letter by Ntsie on the responses of Van Niekerk (Van Niekerk A. Child health, infant formula funding and South African health professionals: Eliminating conflict of interest. S Afr Med J 2020;110(4):262-264. https://doi.org/10.7196/SAMJ.2020.v110i4.14611) and Khan (Khan N. ⋯ S Afr Med J 2020;110(4):262-264. https://doi.org/10.7196/SAMJ.2020.v110i4.14611) to the article by Lake et al. (Lake L, Kroon M, Sanders D, et al. Child health, infant formula funding and South African health professionals: Eliminating conflict of interest. S Afr Med J 2019;109(12):902-906. https://doi.org/10.7196/SAMJ.2019.v109i12.14336).