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HIV PROGRAM OVERVIEW
HIV Research | HIV Care and Treatment

Introduction Continued

Prior to the first HIV cohort study, two HIV activities were ongoing in the Kericho HIV program: the Prevention of Mother to Child Transmission (PMTCT) of HIV program and the first phase of a Boston University-KEMRI-WRP Kericho collaboration evaluating the impact of HIV and malaria on James Finlay Plantation tea pluckers’ labor productivity. The WRP’s PMTCT program started in 2001 in three sites in Kericho District. Since then, it has grown to include 55 sites and has screened over 42,000 women, with around 2,200 infected pregnant women infected being given single dose nevirapine (NVP) and about 1,500 infants being given NVP syrup. 

Beginning in 2001 with support from the U.S. National Institutes of Health through the International Studies in Health and Economic Development grant program (ISHED I), a team from the Boston University –KEMRI-WRP Kericho studied the impact of HIV/AIDS-related morbidity on labor productivity.  The ISHED I study was a retrospective cohort study that compared the amount of tea plucked by 54 tea pluckers who had died of AIDS-related causes or been discharged on medical grounds due to AIDS (index subjects) between 1997 and 2002 during the three years prior to termination of service with that of pluckers who were not known to have died of HIV/AIDS. This study concluded in December 2004 and the second part of the study is now in progress.

The HIV and malaria cohort study opened to recruitment in June 2003 and served as the foundation study for the program’s upcoming HIV vaccine clinical studies. The HIV and malaria cohort study was a 3-year prospective, bi-annual follow-up study of approximately 2800 adults working on the James Finlay Plantation. The study was concluded in December 2006. 

Recognizing the critical importance of assuring that comprehensive HIV/AIDS care and treatment is available in the larger Kericho community and southern Rift Valley Province where HIV vaccine research would be ongoing, the USAMRU-K HIV Program took on the ambitious task of opening up HIV/AIDS care and treatment clinics in March 2004 in the Kericho District. As one of the United States Government implementing partners at the US Embassy in Nairobi for the President’s Emergency Plan For AIDS Relief, the USAMRU-K oversees two primary HIV care and treatment programs in Kenya: the South Rift Valley HIV Program (which started in the Kericho District but now covers 6 districts in the southern Rift Valley Province); and, the Kenya Department of Defense- KDOD (which covers 5 military bases throughout Kenya).

The “Optimal Combination Therapy after Nevirapine Exposure (OCTANE)” study is a phase III study comprising two randomized clinical trials (RCT) being conducted concurrently. Both trials compare the virologic response to non-nucleoside reverse transcriptase inhibitor (NNRTI)-based (Arm 1A) versus protease inhibitor (PI)-based (Arm 1B) antiretroviral treatment (ART) in HIV-infected treatment-naïve women. The study systematically evaluates the hypothesis that single dose nevirapine induces a clinically significant resistance to nevirapine-based triple therapy in women who progress to need full antiretroviral therapy for AIDS.

The United States Military HIV Research Program’s (USMHRP) first HIV vaccine study to be conducted in Kenya opened in Kericho in April 2006 and is fully enrolled. This study is a phase I/II clinical trial to evaluate the safety and immunogenicity of a multiclade HIV-1 DNA plasmid vaccine boosted by a multiclade HIV-1 recombinant adenovirus-5 vector vaccine in HIV uninfected adult volunteers in East Africa.

 
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