Thesis (DTech (Chemistry))--Cape Peninsula University of Technology, 2016. / Bimetallic silver-platinum (Ag-Pt) nanoparticles (NPs) were synthesized via simultaneous reduction of varying mole fractions of metal precursors H2PtCl6.6H2O and AgNO3 by sodium citrate. Kinetics rates of were as follows; Ag NPs (0.079 s-1), Ag-Pt NPs 1:1 (0.082 s-1) and Pt NPs (0.006 s-1). The UV visible spectrum of Ag NPs exhibited a characteristic absorption band while Pt NPs and Ag-Pt bimetallic NPs exhibited no absorption peaks. Successful formation of both monometallic and bimetallic NPs was confirmed via transmission electron microscopy (TEM); selected area electron diffraction (SAED) and energy dispersive X-ray (EDX) analysis. TEM images depicted core-shell arrangement in the bimetallic (BM) NP ratios (1:1, 1:3 and 3:1) with an average particle size of 21 nm. The particle size trend where monometallic Ag NPs (60 nm) > Pt NPs (2.5 nm) while in the BM ratios Ag-Pt NPs 1:1 (25 nm) > Ag-Pt NPs 1:3 (20.7 nm). X-ray diffraction (XRD) patterns depicted crystallinity in all the synthesized NPs with confirmation of the face centred cubic structure formation. Transducers were fabricated by drop casting the nanoparticless on the glassy carbon electrode (GCE) and their electrochemical properties studied via cyclic voltammetry (CV). High diffusion coefficient (D) and surface coverage reported were Ag NPs (6.70 cm2 s-1, 54.49 mol cm-2 ) and Ag-Pt NPs 1:1 (0.62 cm2 s-11.85 mol cm-2). Electrochemical band gaps ranged from 1.45 to 1.70 eV while the Tauc’s model band gaps of nanoparticles were found in the range of 2.48 to 3.84 eV. These band gaps were found to be inversely proportional to particle size, which was attributed to the quantum confinement effect. Both optical and electrochemical band gap portrayed similar trend as well as an increase in the BM NP relative to monometallics. These nanoparticles band gaps are within semiconductor range for most materials. The electrochemical behaviour and surface characteristics were studied using 0.1 M PBS solution by scan rates variations for the diffusion coefficient determination of modified electrodes which ranged from 0.62 to 6.10 x 10-5 cm2 s-1. Laviron’s approach for parameters such as apparent charge transfer rate constant, ks, and charge transfer coefficient, α, for electron transfer between NPs and GCE were investigated using CV. The values of electron-transfer coefficients ranged from 0.1 to 0.7 while the charge transfer rate constant values ranged from 0.74 to 31.13 s-1.

Thesis (MCur)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: Many HIV positive patients are on antiretroviral therapy (ART) to assist in decreasing the replication of the HIV virus within the body. Adherence to this medication is important, as non- adherence can have serious repercussions. Therefore, the patients’ knowledge of ART and their disease is crucial in ensuring good adherence. A range of barriers to patient education were suspected by the researcher in this community of Delft. The high influx of patients into the clinic everyday minimized consultation time and thereby diminished the opportunity for effective patient education. Consequently, adherence to medication which is closely related to the knowledge and understanding of patients about the disease may be affected. The following research question was therefore explored: What is the knowledge of infected HIV/AIDS patients who are receiving antiretroviral treatment about HIV/AIDS and ART? The objectives set were to evaluate the patient’s knowledge of HIV/AIDS, evaluate the knowledge of ART and to determine whether there are statistical differences between the dependant and independent variables within the study. A quantitative descriptive correlational research design was applied and a convenience sample of n= 200 (8.5%) patients was selected from a population of N= 2349 at the Delft Community Health Centre. A multiple choice questionnaire comprising of mainly closed ended questions with multiple responses was used in individual interviews conducted by either the researcher or fieldworker. Reliability and validity was ensured through the consultation of experts in the fields of research methodology, statistics, HIV/AIDS and the Health Research Ethics Committee of Stellenbosch University. Permission to conduct this study was granted by the Health Research Ethics Committee of Stellenbosch University, the Provincial Regional Head for Primary Health Care Services, as well as the head of the Delft Community Health Centre. Data revealed that the participants were mainly female (n=145/72.5%), and the mean age was 37.5 years. Participants were mostly Xhosa speaking and literate, and the majority (n=112/56%), of the participants had a highest education level between grade 9 and grade 12. Many (n=73/36.5%) of the participants had been living with HIV for more than 5 years, but had been on ART for between 1 to 3 years. Knowledge was assessed by asking questions about various aspects of HIV and ART throughout the study. Scores for the 14 critical questions revealed that (n=0/0%) of the participants had good knowledge, (n=40/20%) of the participants had average knowledge and (n=160/80%) of the participants had poor knowledge. The average score for all participants for all 20 knowledge testing questions was (12.6/63%). The findings showed that the overall knowledge (n=160/80%) is poor. Basic terms and principles of HIV/AIDS and ART were not understood and serious misconceptions regarding the disease were revealed. / AFRIKAANSE OPSOMMING: Baie MIV positiewe pasiënte is op antiretrovirale terapie (ART) om te help met die vermindering van die replisering van die HIV virus in die liggaam. Gebruik van hierdie medikasie is belangrik omdat versuiming van inname ernstige gevolge kan hê. Dus, is die pasiënte se kennis van ART en hul siekte van deurslaggewende belang om volgehoue inname te verseker. ’n Reeks van hindernisse om pasiënte te onderrig, is deur die navorser in die Delftgemeenskap vermoed. Die hoë toestroming van pasiënte na die kliniek elke dag het die konsultasietyd tot die minimum beperk en daardeur die geleentheid vir effektiewe pasiëntonderrig laat verminder. Gevolglik, kan die nakoming om die medikasie te neem wat ’n noue verband toon met die kennis en begrip wat pasiënte het oor die siekte, geaffekteer word. Die volgende navorsingsvraag is gevolglik ondersoek: Wat is die kennis van geïnfekteerde HIV/VIGS pasiënte wat antiretrovirale behandeling ontvang oor HIV/VIGS en ART? Die doelwitte wat gestel is, is om die pasiënt se kennis van HIV/VIGS te evalueer, die kennis van ART te evalueer en te bepaal of daar ’n statistiese verwantskap tussen onafhanklike en afhanklike veranderlikes binne die studie is. ’n Kwantitatiewe beskrywende korrelerende navorsingsontwerp is toegepas en ’n gerieflikheidsmonster van n= 200 (8.5%) pasiënte is geselekteer uit ’n bevolking van N = 2349 by die Delftgemeenskap Gesondheidssentrum. ’n Veelkeusige vraelys wat hoofsaaklik uit geslote vrae met veelkeusige response bestaan het, is gebruik in individuele onderhoude wat deur of die navorser of veldwerker gevoer is. Betroubaarheid en geldigheid is verseker deur oorlegpleging met spesialiste op die gebied van navorsingsmetodologie, statistiek, HIV/VIGS en die Gesondheidsnavorsing se Etiese Komitee van die Universiteit van Stellenbosch. Toestemming om die navorsing te doen, is gegee deur die Gesondheidsnavorsing se Etiese Komitee van Stellenbosch Universiteit, die Provinsiale Streekshoof vir Primêre Gesondheidsdienste, asook die hoof van die Delftgemeenskap Gesondheidssentrum. Data het bewys dat die deelnemers hoofsaaklik vroulik is (n=145/72.5%) en die gemiddelde ouderdom 37.5 jaar. Deelnemers is meestal Xhosasprekend en geletterd en die meerderheid (n=112/56%) van die deelnemers se hoogste opleidingsvlak is tussen graad 9 en graad 12. Baie (n=73/36.5%) van die deelnemers het met HIV geleef vir 5 jaar, maar was op ART vir tussen 1 tot 3 jaar. Kennis is geassesseer deur vrae te stel oor verskeie aspekte van HIV en ART dwarsdeur die ondersoek. Puntetelling vir die 14 kritiese vrae het aan die lig gebring dat (n=0/0%) van die deelnemers goeie kennis het, (n=40/20%) van die deelnemers beskik oor gemiddelde kennis en (n=160/80%) van die deelnemers se kennis is gering. Die gemiddelde puntetelling vir al die deelnemers van al 20 kennisvrae wat getoets is, is (12.6/63%). Die bevindinge bewys dat die algehele kennis (n= 160/80%) gering is. Basiese terminologie en beginsels van HIV/VIGS en ART word nie begryp nie en ernstige wanopvattinge aangaande die siekte is geopenbaar.

Thesis (MSc in Medical Science)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: Background: Para-aminosalicylic acid (PAS) is one of the first effective anti-tuberculosis agents and has become one of the principal second-line drugs to treat patients with an extended resistance spectrum. Despite being one of the oldest anti-tuberculosis drugs, little data is available regarding its pharmacokinetics, drug interactions, genetic factors and dosing regimens, especially for the relative new granular slow release PAS (GSR-PAS) preparation. Objectives The aim of the study was to investigate the pharmacokinetics, tolerability and safety of a single 8 g once- or 4 g twice-daily GSR-PAS dose in a multidrug- or extensively drug resistant tuberculosis (M/XDR-TB) population, in which some subjects were also co-infected with the human immunodeficiency virus (HIV). An additional objective was to investigate the potential covariates (i.e. genetic factors and drug interactions) that can alter the pharmacokinetics of PAS. Study design and methodology A randomised, two-period, open-label cross-over study was conducted in 32 adults (≥18 years old) with M/XDR-TB admitted at Brooklyn Chest Hospital, Cape Town, South Africa and treated for drug resistant tuberculosis with a multidrug regimen containing GSR-PAS. The subjects were randomised to follow a single 8 g once-daily GSR-PAS regimen or a 4 g twice-daily GSR-PAS regimen for 8 days. On the eighth day blood samples were obtained at 0, 1, 2, 3, 4, 6, 8, 12 and 24 hours. After the 24-hour sample (Day 9) the regimens were crossed-over. The tolerability and safety of the two regimens were determined using Visual Analogue Scales and interviews. PAS plasma concentrations were determined by a developed HPLC-MS/MS method. N-acetyltransferase (NAT1 and NAT2) genotyping was performed. The data of this study together with unpublished data of a previous study in a very similar population were used in a pharmacometric analysis to determine the PK parameters and any subject covariates. Results and Discussion In comparison to the 4 g twice-daily GSR-PAS dose, the single 8 g once-daily GSR-PAS dose generated a pharmacokinetic profile with a significantly higher maximum concentration (Cmax), concentration at 12 hours (C12) and area under the curve 0 to 12 hours (AUC12). The concentrations of all subjects on the twice-daily regimen were maintained above a minimum inhibitory concentration (MIC) throughout a 12-hour interval, while the single 8 g dose was able to sustain the PAS plasma concentrations above the MIC in 18 out of 29 subjects (62.1%) for the entire 24-hour dosing interval. Both regimens were reasonably well tolerated but most subjects preferred the twice-daily dosing. The clearance of PAS was increased by 45% in HIV positive subjects prescribed antiretroviral treatment (ART), possibly due to interaction with efavirenz (EFV). No significant associations were found for any of the individual NAT1 or NAT2 genotypes, but a difference between mean concentrations of the different genotypic groups was reported. Conclusions The 8 g once-daily dose has the potential to be included in future regimens. The higher peak concentrations achieved can be expected to increase the bactericidal effect of GSR-PAS without significant loss of bacteriostatic effect, i.e. time over MIC. The 8 g once-daily dose has a reasonable tolerability and is potentially easier to supervise in an outpatient setting. Since antiretrovirals (ARVs) increase PAS clearance and decrease PAS exposure in HIV co-infected subjects on ART, the 8 g once-daily dose will be less suitable for maintaining bacteriostasis in these patients (inadequate PAS exposure). Therefore, PAS and ARV interactions need to be clarified before the 8 g once-daily dose can be recommended for the HIV co-infected patients on ART. / AFRIKAANSE OPSOMMING: Agtergrond Para-aminosalisielsuur (PAS) is een van die eerste effektiewe anti-tuberkulose middels en het een van die hoof tweede-lyn middels geword om pasiënte met 'n uitgebreide weerstand spektrum te behandel. Ondanks die feit dat PAS die oudste anti-tuberkulose middel is, is daar baie min data beskikbaar met betrekking tot die farmakokinetika, middel interaksies, genetiese faktore en dosering, veral in die geval van die relatiewe nuwe granulêre stadige vrystelbare PAS voorbereiding (GSV-PAS). Doel Die doel van die studie was om navorsing te doen oor die farmakokinetika, verdraagsaamheid en veiligheid van ʼn enkele 8 g een keer daaglikse en 4 g twee keer daaglikse GSV-PAS dosering in ʼn multi- of uitgebreide weerstandige tuberkulose (M/XDR-TB) populasie, waar sommige proefpersone ook met die Menslike Immuniteitsgebreksvirus (MIV) geko-infekteer is. ʼn Verdere doel van die studie was om te bepaal of potensiële kovariate soos genetika en medisyne interaksies die farmakokinetika van PAS verander. Metodes ʼn Onwillekeurige, twee-periode, oop-etiket oorkruisingstudie was op 32 M/XDR-TB volwassenes (≥ 18 jaar oud) uitgevoer terwyl hulle vir middel weerstandige tuberkulose in Brooklyn Chest hospitaal (Kaapstad, Suid-Afrika) behandel is. Die deelnemers was onwillekeurig ingedeel om ʼn 8 g eenkeer daaglikse GSV-PAS dosering of ʼn 4 g twee keer daaglikse GSV-PAS dosering vir agt dae te volg. Op die agste dag was bloedmonsters op die volgende ure 0, 1, 2, 3, 4, 6, 8, 12, en 24 geneem. Na die 24-uur monster (Dag 9) was die doserings omgekeer. Die verdraagsaamheid en veiligheid van die twee doserings is bepaal deur gebruik te maak van Visueel Analogiese Skale en onderhoude. PAS plasma konsentrasies is bepaal deur 'n ontwikkelde HPLC-MS/MS metode. N-asetieltransferase (NAT1 en NAT2) genotipering is uitgevoer. Die data van hierdie studie saam met ongepubliseerde data van 'n vorige studie is gebruik in farmakometriese analise om die farmakokinetiese parameters en enige kovariate te bepaal. Resultate en Bespreking In vergelyking met die 4 g GSV-PAS twee keer daaglikse dosis, het die enkele 8 g daaglikse dosis, ‘n pharmakokinetiese profiel met ‘n beduidende hoër maksimum konsentrasie (Cmax), 12-uur konsentrasie (C12) en area onder die kurwe van 0 tot 12 uur (AUC12), gegenereer. Die PAS plasma konsentrasies van alle proefpersone, wat op die twee keer daaglikse dosis was, was tydens die 12-uur interval bo die die minimum inhiberende konsentrasie (MIK) gehou. Terwyl die enkele 8 g dosis die PAS plasma konsentrasies vir die duur van die 24 uur interval bo die MIK in 18 van 29 (62%) proefpersone gehandhaaf het. Die meeste proefpersone het die twee-daaglikse dosering verkies, maar beide doserings was redelik goed verdra. Die verwydering van PAS het met 45% toegeneem in HIV positiewe proefpersone wat antiretrovirale behandeling ontvang het, moontlik weens interaksies met efavirenz. Geen beduidende assosiasies vir enige van die individuele NAT1 of NAT2 genotiepes was gevind nie, maar ‘n verskil tussen die gemiddelde konsentrasies van die verskillende genotiepes is gerapporteer. Gevolgtrekking Die 8 g een keer daaglikse dosis het die potensiaal om in toekomstige doserings ingesluit te word. Die hoër piek konsentrasies van die 8 g daaglikse dosis, kan moontlik die bakterisidiese (kiem-dodende) effek van GSV-PAS verhoog, sonder om die beduidende bakteriostatiese (kiem-inhiberende) effek (o.a. tyd oor MIK), te verloor. Die 8 g een keer daaglikse dosis is redelik verdraagsaam en kan potensieël makliker gekontrolleer word in die geval van buite-pasiënte. Serdert antiretrovirale middels (ARVs) PAS verwydering verhoog en gevolglik die PAS plasma konsentrasies verlaag in die MIV ko-infekteerde proefpersone wat op ARVs is, sal die 8 g een keer daaglikse dosis minder geskik wees vir die handhawing van bakteriostasis in hierdie pasiënte (onvoldoende PAS blootstelling). Dus moet daar klarigheid verkry word oor PAS en ARV interaksies voordat die 8 g een keer daaglikse dosis vir MIV ko-infekteerde pasiënte op ARVs aanbeveel kan word.

Thesis (MSc)--University of Stellenbosch, 2011. / ENGLISH ABSTRACT: The primary aim of the study was to determine the applicability of the theory of planned behaviour (TPB) in predicting adherence to ART among South African patients attending public health clinics. The second aim was to determine the relationship between self-reported adherence and viral load. The results from the hierarchical multiple regression analyses revealed that the linear combination of the variables of the TPB significantly explained 12% of the variance in intentions to adhere to ART. Perceived behavioural control was the only variable that significantly predicted intentions to adhere to ART. The inclusion of perceived stigma was not a useful addition to the model. The results also reflect the relationship between intentions to adhere to treatment and self-reported adherence, which was not significant. The TPB was unable to significantly account for variance in self-reported treatment adherence. When perceived stigma was added to the TPB, the model was still unable to significantly explain variance in self-reported adherence. Nonetheless, attitudes towards treatment were the only variable that significantly accounted for variance in self-reported treatment. It was concluded that interventions aimed at improving adherence among South African patients attending public health clinics, should aim to encourage positive attitudes towards treatment, should aim to increase perceived subjective norms, should increase the patients’ perceptibility that they are able to be adherent and should aim to decrease perceived stigma. Improving adherence to ART can result in increasing the quality of life of patients living with HIV/AIDS. / AFRIKAANSE OPSOMMING: Die primêre doel van die studie was om vas te stel of die teorie van beplande gedrag (TPB soos voorgestel in die studie) antiretrovirale terapie (ART) nakoming onder Suid-Afrikaanse pasiёnte by publieke gesondheidsklinieke kan voorspel. Die sekondêre doel was om die verhouding tussen self-gerapporteerde volgehoue behandeling en virale lading te bereken. Die uitslae van die hiёrargiese veelvuldige regressie analise het getoon dat die linêere kombinasie van die veranderlikes van TPB 12% van die verandering in ART voornemens akkuraat kon voorspel. Waargenome gedragsbeheer was die enigste veranderlike wat ART voornemens akkuraat kon verklaar het. Die insluiting van waargenome stigma was nie beduidend ten opsigte van die model nie. Geen beduidende verband tussen voorneme om met behandeling vol te hou en self-gerapporteerde volgehoue-behandelingsgedrag word uitgebeeld. Waargenome gedragsbeheer kon wel ‘n bydrae lewer om verandering in die voorneme om met behandeling vol te hou verklaar. Die TPB kon egter nie ‘n verduideliking bied vir die verandering in self-gerapporteerde volgehouebehandelingsgedrag nie. Toe waargenome stigma by die TPB gevoeg is, was die model steeds nie daartoe instaat om die verandering in self-gerapporteerde volgehouebehandelingsgedrag te verklaar nie. Nietemin, houdings teenoor behandeling was die enigste veranderlike wat verandering in self-gerapporteerde gedrag verklaar. Daar is tot die gevolgtrekking gekom dat intervensies gerig op die verbetering van volhoubare gedrag onder Suid-Afrikaanse pasiёnte wat openbare gesondheidsklinieke bywoon,positiewe houding teenoor behandeling moet aanmoedig, subjektiewe norme verhoog, die pasiёnte se persepsie dat hulle instaat is om volhoubare gedrag kan toon moet verhoog en ook waargenome stigma moet verminder. Beter ART nakoming kan lei tot ‘n toename in die MIV/VIGS pasiёnt se kwaliteit van lewe.

M.Sc. (Chemistry) / Human immunodeficiency virus (HIV) is continuously rewriting medical history as one of the diseases affecting humankind. Current treatments available for HIV, namely antiretrovirals (ARVs), do not completely eradicate the virus from the body, leading to life time commitment. Many ARVs suffer from high toxicities and unpleasant side effects; as a result many patients do not adhere to the treatment. Nanoparticles (NPs) used as drug delivery systems (DDS) hold tremendous potential, since they can easily protect the drug from external environment and enter the human cells to deliver drugs. Therefore, the main objective of this work was to load two ARVs, namely lamivudine (LAM) and efavirenz (EFV), into a biodegradable, biocompatible poly(epsilon-caprolactone) (PCL) polymer based NPs. LAM is a hydrophilic drug suffering from low half life of 5 to 7 hours and many unpleasant side effects. EFV is a hydrophobic drug suffering from low aqueous solubility (4 μg/ml), which leads to a limited oral absorption and low bioavailability (40-45%).

Executive Function is conceptualized in this study as the ability to form (the planning functionality obtained through initiation and working memory), maintain (response selection and the ability to self-regulate and inhibit) and switch (cognitive flexibility, mental tracking, organization and sequencing) mental processes in order to effect a positive outcome. The present research is a quasi-experimental study embedded in the Positivist tradition that sets out to empirically evaluate the Executive Function profile of seropositive adolescents (n = 29) emerging from a low socio-economic background and currently on a managed ART programme when compared to a healthy contrast group (based on age, socio-demographic and educational system). As a quantitative study, Executive Function was operationalized through the use of multiple tests of Executive Function such as the Delis-Kaplan Executive Function Colour Word Interference Test (D-KEFS CWIT), the Wisconsin Card Sorting Test (WCST) and the Trail Making Test Part B (TMT-B). As the study formed part of a larger study that included additional neurocognitive tests, including the WISC-R, selected subtests from the WISC-R were used to validate specific arguments relating to the study. The results showed that HIV positive adolescents were inclined to have poorer Executive Function performance especially under situations of higher cognitive load when compared to the unaffected group. The implications of these results are discussed in this research.

In 2009 an estimated 33 million people were living with the Human Immunodeficiency Virus (HIV). Of this global population, 35% live in South Africa. Furthermore, sub-Saharan Africa is home to 80% of the world’s population of HIV-1 positive children and adolescents. The most prominent form of transmission of HIV in children in South Africa is from mother to child. Until 2004, South Africans had limited access to ARV treatment at and after birth due to the government legislation. As a consequence, treatment of HIV in children may only have been initiated after clinical presentation of immune deficiency. Therefore, currently, HIV-1 positive adolescents born during the period of restricted ARV-access may have experienced physical and developmental symptoms associated with the virus including neurological deficits, prior to initiating treatment. This study investigated the current psychomotor functioning, such as psychomotor speed, manual dexterity, graphomotor and visual-motor coordination of a group of low socio-economic HIV-1 positive adolescents in Johannesburg, South Africa, who are now on a managed antiretroviral programme and how this compared to a HIV negative contrast group. A Mann-Whitney U Test indicated a significant difference in mean non-dominant hand performance in the Grooved Pegboard Test between the two groups (U = 738, p < .05), with the HIV positive group performing slower than the HIV negative group. An independent samples t-test indicated a significant difference between groups in the Block Design subtest of the WISC-R [t(88) = -2.93, p < .01] where the HIV positive group performed significantly worse than the HIV negative group. Additionally, a Mann-Whitney U Test revealed a significant difference in number of errors made in the WISC-R Mazes subtest between groups (U = 736.50, p < .05), where the HIV negative group made more errors. Another Mann-Whitney U Test revealed a significant difference between groups in the ROCFT Copy score (U = 534.50, p < .01) where the HIV positive group achieved a significantly lower score than the HIV negative group. Lastly, a Mann-Whitney U Test demonstrated significant differences between the groups in the Trail Making Test A time (U = 445.00, p < .01), Trail Making Test B time (U = 509.00, p < .01), the number of errors made on the Trail Making Test B (U = 729.00, p < .05) and the difference between Trail Making Test B – A time (U = 769.50, p < .05) with the HIV positive group performing slower and making more errors in Part B than the contrast group. The findings of the current study imply that HIV-1 vertically-infected adolescents in Johannesburg, South Africa, on a delayed HAART programme appear to have persisting difficulties in complex psychomotor skills where an integration of functions is required. Furthermore, these results indicate an overall poor psychomotor performance in comparison to international normative data, supporting previous findings. Developmental, remedial and therapeutic recommendations were made.

South Africa has the most prominent percentage of individuals living with the Human Immunodeficiency Virus (HIV) in the world, with the most prominent form of transmission of HIV in South Africa being vertical mother-to-child transmission. From 1997 until 2004, South Africa had limited access to ARV treatment at and after birth due to the government legislation. As a consequence, treatment of HIV may only have been initiated after clinical presentation of immune deficiency. A paucity of information therefore exists regarding this population in addition to the specific age demographic of adolescents. Adolescents may be negatively influenced by the cortical thinning associated with HIV, and this study therefore aims to investigate the verbal fluency and vocabulary (in English) of 30 bi- or multilingual seropositive adolescents that are currently on a managed anti-retroviral programme in comparison to an HIV-negative contrast group of 70 bi- or multilingual adolescents in South Africa (matched for age, education, and socioeconomic status). The study found that there were no significant results between the HIV-positive and HIV-negative groups on the measures of vocabulary, semantic naming, or phonemic naming in ‘F’ as determined by their performance on the neuropsychological assessments. Significant results were noted between the HIV-positive and HIV-negative groups on the phonemic naming categories of ‘A’ and ‘S’ however, and negative correlations between performance in these categories and current viral load, and viral load at Highly Active Antiretroviral Therapy (HAART) initiation were also noted. This research formed part of a broader study examining the overall neurocognitive effects of HIV-1 infection in adolescents in South Africa.

Approximately 11.5 million Human Immunodeficiency Virus (HIV)-positive individuals were living in South Africa in 2007, many of whom were infected via mother-to-child transmission. The current study aimed to compare the attentional and concentration functioning of 30 seropositive adolescents on managed anti-retroviral (ARV) programmes, with a comparable group of 71 seronegative adolescents. The results showed that the uncorrected errors on trial 1; self-corrected errors on trial 2; time taken, uncorrected and self-corrected errors on trial 3 of the Stroop Colour-Word Interference Test; and the errors on the Trail Making Test Part B were significantly poorer in the seropositive sample. The results also indicated that the clinical variations in the HIV-positive sample, including the age at which ARVs were commenced; duration of ARV treatment; World Health Organisation (WHO) stage at diagnosis; starting and current CD4+ counts; and starting viral load, but with the exception of the current viral load, impacted significantly on test performance.

Orientador: Paulo Câmara Marques Pereira / Banca: Maria Tereza Duenhas Monreal / Banca: Lenice do Rosário de Souza / Resumo: A microbiota intestinal normal embora bastante estável pode se alterar em condições patológicas, modificações na composição da dieta, presença de distúrbios gastrointestinais e/ou ingestão de drogas. A associação de infecção com a utilização de medicamentos dificulta a interpretação da participação desses fatores na microbiota intestinal. O objetivo do presente estudo foi avaliar a microbiota intestinal de indivíduos que sofreram acidente ocupacional com materiais biológicos e receberam anti-retrovirais. Foram estudados 23 indivíduos adultos com idade entre 18-45 anos, sendo 13 doadores de sangue, grupo controle (GC) e 10 que sofreram acidente ocupacional com material biológico e realizaram profilaxia anti-retroviral. Foram avaliados a microbiota intestinal, medidas antropométricas, exames laboratoriais (hemograma, função renal, hepática, lipidograma, glicemia, proteínas totais e frações) pré, após a medicação e 30 dias após o término da medicação. A zidovudina mais a lamivudina foi utilizada em 70% dos indivíduos associado ao nelfinavir, 20% ao efavirenz e 10% ao ritonavir. Náuseas, vômitos e diarréia estiveram presentes em 80% no segundo momento do estudo. Sobrepeso em 70%, desnutrição e eutrofia em 10%, dos indivíduos sem alteração durante o estudo. As enzimas AST, ALT, Gama-GT e triglicérides, LOL-colesterol se elevaram no segundo momento e se normalizaram 30 dias após término da medicação. Foi observada redução significativa dos três gêneros de bactérias anaeróbias avaliadas Lacfobacillus , Bifidobacferium e Bacleróides em relação ao grupo controle nos três momentos. O uso de anti-retrovirais provocou impacto significativo na microbiota intestinal dos indivíduos normais em uso de anti-retrovirais, não sendo recuperada 30 dias após o término da medicação. / Abstract: Pathological conditions, changes in diet composition, presence of gastrointestinal disorders and/or ingestion of drugs may alter the normal intestinal microbiota, regardless of its sufficient steadiness. The association of infection with the use of medicine makes the interpretation of the participation of these factors in intestinal microbiota difficult. The objective of the present study was to evaluate the intestinal microbiota from individuais injured by biological materiais in occupational accident, submitied to antiretroviral prophylaxis. 23 adult individuais with ages between 18-45 years old were studied, being 13 blood donors (control group - CG) and 10 individuais injured by biological materiais in occupational accident, submitled to antiretroviral prophylaxis. Intestinal microbiota, anthropometric measures and biochemical examinations (blood count, renal and hepatic functions, glucose and lipids blood levels, total proteins and fractions) were evaluated before, right after and 30 days after the end of medication. Zidovudine plus lamivudine were used in 70% of the individuais associated to nelfinavir, 20% to efavirenz and 10% to ritonavir. Nausea, vomiting and cliarrhea were present in 80% of the individuais at the second part of the study. Overweight was noticed in 70% and malnutrition anel eutrophia were noticed in 10% of the individuais without alterations during the study. AST, ALT, Gamma-GT and triglycerides and LDL-cholesterol enzymes were increased at the second part and normalized 30 days after the end of medication. Significant reduction of the three genera of anaerobic bacteria - Lactobacil/us, Bifidobacterium and Bacteroides - evaluated was observed in reiation to the controi group at the three moments. The use of antiretrovirals caused significant impact in the intestinal microbiota of the normal individuais, without recovery 30 days after the end of medication. / Mestre