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Background: Despite the increased initiation and uptake of antiretroviral therapy (ART) in South Africa, some people living with HIV (PLHIV) who are on ART still have non-suppressed viral load (VL)., Objectives: This study aimed to determine the prevalence of VL non-suppression among adolescents and youth (aged 12 years - 24 years) living with HIV and on ART in South Africa, as well as the factors associated with it., Method: Data from the 2017 South African national HIV prevalence, incidence, behaviour, and communication survey were analysed. The survey used a multistage-stratified cluster sampling design. A backward stepwise multivariable generalised linear model was used to identify factors associated with VL non-suppression., Results: The study included 340 participants aged 12 years - 24 years, with a median age of 21 (interquartile range [IQR]: 18-23). The proportion of adolescents and youth living with HIV and on ART with non-suppressed VL was 19.2% (95% confidence interval [CI]: 14.4-25.3). Approximately 60% of the participants were not on ART. The odds of VL non-suppression were significantly higher among youth aged 15 years - 19 years (adjusted odds ratio [AOR] = 1.63 [95% CI: 1.24-2.13], p = 0.001) and aged 20 years - 24 years (AOR = 1.22 [95% CI: 1.06-1.41], p = 0.005) compared to adolescents aged 12 years - 14 years. The odds were significantly lower among individuals of other races (AOR = 0.80 [95% CI: 0.69-0.92], p = 0.003) compared to black African people., Conclusion: Findings suggest a need for ART education and counselling as part of treatment support. In addition, the promotion of HIV awareness as part of strengthening the HIV treatment and prevention cascade., Contribution: The article showed the prevalence of VL non-suppression and associated factors among adolescents and youth., Competing Interests: The authors declare that they have no financial or personal relationship(s) that may have inappropriately influenced them in writing this article., (© 2024. The Authors.)

Background: Candida auris is an emerging multidrug-resistant fungal pathogen associated with high mortality., Methods: We investigated the genetic relatedness of clinical C. auris isolates from patients admitted to either public- or private-sector hospitals, which were submitted to a reference laboratory from 2012 to 2015. Patient demographics and clinical details were recorded. We performed antifungal susceptibility testing, sequencing of the hotspot 1 and 2 regions of the FKS1 and FKS2 genes for all isolates with an echinocandin minimum inhibitory concentration (MIC) of ≥1 µg/mL and cluster analysis using multilocus sequence typing., Results: Eighty-five isolates were confirmed as C. auris . The median patient age was 59 years [inter-quartile range (IQR): 48-68 years], with male patients accounting for 68% of cases. Specimen types included urine (29%), blood (27%), central venous catheter tips (25%), irrigation fluid (7%), tissue (5%), respiratory tract specimens (4%) and other (3%). Ninety-seven per cent of isolates were resistant to fluconazole, 7% were resistant to both fluconazole and voriconazole, 8% were resistant to both fluconazole and echinocandins (considered multidrug resistant) and all were susceptible to amphotericin B. Of the 15 randomly selected fluconazole-resistant isolates, 14 isolates had an isavuconazole MIC ≤ 1 µg/mL. No FKS mutations were detected. Multilocus sequence typing (MLST) analysis grouped isolates into two clusters: cluster 1 and cluster 2 comprising 83 and 2 isolates, respectively., Conclusions: Azole-resistant C. auris strains circulating in South African hospitals were related by MLST, but the possibility of nosocomial transmission should be explored using a more discriminatory technique, for example, whole genome sequencing., Competing Interests: For unrelated activities over the last 36 months, Nelesh P. Govender has received a speaker honorarium from Astellas and a travel grant from MSD (Pty)Ltd. For the remaining authors, none were declared., (© 2020. The Authors.)