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Outbreak of Measles in vaccinated population in Southeastern Nigeria

*1Shenge, J. A., 2Odaibo, G. N., and 2Olaleye, D. O.

1Department of Biological Sciences, Dominican University, Ibadan, Nigeria

2Department of Virology, College of Medicine, University of Ibadan, Ibadan, Nigeria

*Correspondence to: jadamma@yahoo.com

Abstract:

Background: Outbreaks of respiratory disease, febrile illness and rash occurred in two adjoining rural communities of Imo State, Southeastern, Nigeria, at different times between 2006 and 2020. Laboratory investigation was carried out to determine the aetiological agent of the outbreak.

Methodology: Oropharyngeal swabs were collected from 6 individuals showing symptoms of disease, within 3-4 days of appearance of rash. Venous blood samples were also collected from a total of 41 symptomatic persons, their contacts and individuals with resolved infections. Swabs were inoculated into Vero, HEp-2c, B95a and MDCK cell lines. Sera were analyzed using enzyme-linked immunosorbent assay (ELISA) for immunoglobulin G and M to rubella and measles viruses, while immunofluorescence assay was used to detect Lassa fever virus immunoglobulins. Descriptive data were analyzed using the Statistical Package for the Social Sciences (SPSS). Results: Four of the 6 (66.7%) swab samples showed viral activity or cytopathic effect characterized by clumping of cells in Vero cells while 2 (33.3%) in Hep-2c characterized by rounding up of cells. Thirty-nine (95.1%) sera were positive for measles IgG while 13 (31.7%) were positive for IgM. Thirty-six (87.8%) sera were positive for rubella IgG but none was positive for IgM. None of the sera was positive for Lassa fever virus IgG and IgM. Continue reading “Outbreak of Measles in vaccinated population in Southeastern Nigeria”

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Persistence of cervical human papillomavirus infection among cohort of women in Awka, Nigeria

*1Ezebialu, C. U., 2Ezebialu, I. U., and 2Ezenyeaku, C. C.

1Department of Applied Microbiology and Brewing, Nnamdi Azikiwe University, Awka, Nigeria

2Department of Obstetrics and Gynaecology, College of Medicine, Chukwuemeka Odumegwu Ojukwu University, Awka, Nigeria

*Correspondence to: nenyeume@yahoo.com; 08066528090

Abstract:

Background: Many women are known to contract human papilloma virus (HPV) infection in their lifetime but only a few develop cervical cancer. One of the major factors that contribute to development of cervical cancer is HPV persistence. Several other factors including viral load have been implicated in cervical cancer development. This work therefore intends to investigate the persistence of cervical HPV infection among cohort of women in Awka, Nigeria.

Methodology: A cohort of 58 women with normal Papanicolaou (Pap) test but positive HPV DNA selected from a population of 410 women at baseline were followed up over a period of 6 months from April to October 2015. Cervical specimens collected were subjected to HPV DNA test and viral quantification using TaqMan Real Time PCR and cervical cytology. Risk factors were obtained using semi structured interviewer administered questionnaires. Variables were analysed using descriptive statistics and T-test on IBM SPSS statistics version 21.0 and EPI INFOTM 7.0

Results: At the 6-month follow up, cervical HPV infection persisted in 29 women, representing 50% of the women followed up. Among the 29 women, 7 (24.1%) developed abnormal Pap smear (Low grade Squamous Intraepithelial Lesion). Factors significantly associated with persistence at bivariate analysis of HPV include previous sexually transmitted infection (STI) (p=0.005), HIV positivity (p=0.04), HIV positivity but no anti-retroviral drugs (p=0.014), HPV 16 infection (p<0.0001) and age less than 40 years (p<0.0001). At multinomial logistic regression, only age above 17 years at first sexual intercourse (p=0.003, CI=0.012-0.392) and multiple lifetime sexual partners (p=0.021, CI=0.20-0.726) were statistically significant.

Conclusion: High risk HPV infection, in addition to other factors peculiar to an individual may influence HPV persistence

Key words: cervical cancer, human papillomavirus, persistence, cytology, risk factors, infection

Received Sept 28, 2020; Revised Jan 14, 2021; Accepted Mar 27, 2021
Copyright 2021 AJCEM Open Access. This article is licensed and distributed under the terms of the Creative Commons Attrition 4.0 International License <a rel=”license” href=”http://creativecommons.org/licenses/by/4.0/”, which permits unrestricted use, distribution and reproduction in any medium, provided credit is given to the original author(s) and the source.

Editor-in-Chief: Prof. S. S. Taiwo

Persistance de l’infection cervicale par le papillomavirus humain parmi une cohorte de femmes à Awka, Nigéria

*1Ezebialu, C.U., 2Ezebialu, I.U., et 2Ezenyeaku, C. C.

1Département de microbiologie appliquée et brassage, Université Nnamdi Azikiwe, Awka, Nigéria

2Département d’obstétrique et de gynécologie, Collège de médecine, Université Chukwuemeka Odumegwu Ojukwu, Awka, Nigéria

*Correspondance à: nenyeume@yahoo.com; 08066528090

Abstrait:

Contexte: De nombreuses femmes sont connues pour contracter une infection au virus du papillome humain (VPH) au cours de leur vie, mais seules quelques-unes développent un cancer du col de l’utérus. L’un des principaux facteurs qui contribuent au développement du cancer du col de l’utérus est la persistance du VPH. Plusieurs autres facteurs, y compris la charge virale, ont été impliqués dans le développement du cancer du col de l’utérus. Ce travail vise donc à étudier la persistance de l’infection cervicale au VPH parmi la cohorte de femmes à Awka, au Nigeria.

Méthodologie: Une cohorte de 58 femmes avec un test de Papanicolaou (Pap) normal mais un ADN HPV positif sélectionné parmi une population de 410 femmes au départ ont été suivis sur une période de 6 mois d’avril à octobre 2015. Les échantillons cervicaux collectés ont été soumis à l’ADN HPV. test et quantification virale à l’aide de la PCR en temps réel TaqMan et de la cytologie cervicale. Les facteurs de risque ont été obtenus à l’aide de questionnaires semi-structurés administrés par les intervieweurs. Les variables ont été analysées à l’aide de statistiques descriptives et d’un test T sur IBM SPSS statistics version 21.0 et EPI INFOTM 7.0

Résultats: Au suivi de 6 mois, l’infection cervicale au VPH persistait chez 29 femmes, soit 50% des femmes suivies. Parmi les 29 femmes, 7 (24,1%) ont développé un test Pap anormal (lésion squameuse intraépithéliale de bas grade). Les facteurs significativement associés à la persistance lors de l’analyse bivariée du VPH comprennent les antécédents d’infection sexuellement transmissible (IST) (p=0,005), la positivité au VIH (p=0,04), la positivité au VIH mais pas d’antirétroviraux (p=0,014), l’infection au VPH 16 (p<0,0001) et moins de 40 ans (p<0,0001). Lors de la régression logistique multinomiale, seuls les âges supérieurs à 17 ans lors du premier rapport sexuel (p=0,003, IC=0,012-0,392) et les multiples partenaires sexuels à vie (p=0,021, IC=0,20-0,726) étaient statistiquement significatifs.

Conclusion: Une infection au VPH à haut risque, en plus d’autres facteurs propres à un individu, peut influencer la persistance du VPH

Mots clés: cancer du col de l’utérus, papillomavirus humain, persistance, cytologie, facteurs de risque, infection

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Persistence of cervical human papillomavirus infection among cohort of women in Awka, Nigeria

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Hepatitis B virus infection among pregnant women on antenatal visits: rapid tests or ELISA?

*1,2Fowotade, A., 2Adetunji, S. O., 2Amadi, E., 2Ishola, I. O., and 3Omoruyi, E. C.

1Clinical Virology Unit, Department of Medical Microbiology and Parasitology, College of Medicine, University of Ibadan, Nigeria

2Department of Medical Microbiology and Parasitology, University College Hospital, Ibadan, Nigeria

3Institute of Child and Maternal Health, College of Medicine, University of Ibadan, Nigeria

*Correspondence to: temilabike@gmail.com

Abstract:

Background: Hepatitis B virus (HBV) infection is a global public health challenge with over 360 million people infected worldwide, and is one of the leading causes of death worldwide. The hepatitis B surface antigen (HBSAg) is the most important marker for HBV screening, and HBSAg rapid screening test methods are the most widely used compared with the enzyme-linked immunosorbent assay (ELISA) and nucleic acid testing methods. The objectives of this study are to evaluate the comparative efficacy of rapid test kits and ELISA for HBV screening among pregnant women on antenatal visits and to screen for other HBV serological markers among HBsAg positive patients.

Methodology: This is a cross-sectional study of 172 pregnant women who were recruited consecutively on their first antenatal visit at the University College Hospital, Ibadan, Nigeria between November 2018 and February 2019. All participants were screened for HBsAg using both rapid immunochromatographic test (ICT) and ELISA techniques. HBsAg negative samples were further screened for anti-HBeAg/Ab, anti-HBcAg and anti-HBs by ELISA. Socio-demographic data of the participants were obtained using a semi-structured questionnaire, and data were analyzed using EPI INFO 7.2 statistical software. Continue reading “Hepatitis B virus infection among pregnant women on antenatal visits: rapid tests or ELISA?”

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Prevalence of occult hepatitis B virus infection among blood donors in Ouagadougou, Burkina Faso

*1Ky/Ba, A., 2Sanou, M., 3Ouédraogo, A. S., 2Sourabié, I. B., 4Ky, A. Y., 5Sanou, I., 2Ouédraogo/Traoré, R., and 6Sangaré, L.

1Centre Hospitalier Universitaire de Bogodogo, 14 BP 371, Ouagadougou, Burkina Faso

2Centre Hospitalier Universitaire Charles De Gaule, Ouagadougou, Burkina Faso

3Centre Hospitalier Universitaire Souro Sanou, Bobo-Dioulasso, Burkina Faso

4Intrahealth International, Burkina Faso

5Centre Hospitalier Universitaire Blaise Compaoré, Ouagadougou, Burkina Faso

6Centre Hospitalier Universitaire Yalgado Ouedraogo, Ouagadougou, Burkina Faso *Correspondence to: absetou@yahoo.fr

Abstract:

Background: In Burkina Faso, the polymerase chain reaction (PCR) assay is not routinely used in the biological qualification of blood donations and this constitutes a risk factor for the transmission of occult hepatitis B virus (HBV) infection during blood transfusion. The objective of this study is to determine the prevalence of occult B infection (OBI) among blood donors for the purposes of improved blood safety in Burkina Faso.

Methodology: A descriptive cross-sectional study of 300 HBsAg negative blood donors was conducted in the city of Ouagadougou, Burkina Faso from April to October 2020. Anti-HBc antibody was determined using the BOSON® brand rapid tests. HBV DNA was detected in 75 selected donors by real-time PCR (rt PCR) using the 7500 Fast Real Time PCR assay technique. Continue reading “Prevalence of occult hepatitis B virus infection among blood donors in Ouagadougou, Burkina Faso”

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Molecular detection and characterization of bacteria from CSF samples of patients with suspected cerebrospinal meningitis in parts of northern Nigeria using metagenomic DNA extracts

*1,2Peletiri, I. C., 1Ikeh, E. I., 1Ayanbimpe, G. M., and 3Nna, E.

1Department of Medical Microbiology, Faculty of Clinical Sciences, College of Health Sciences, University of Jos, Nigeria

2Medical Microbiology & Parasitology Laboratories, National Hospital, Abuja, FCT, Nigeria

3Safety Molecular Pathology Laboratory, The Molecular Pathology Institute, Enugu, Enugu State, Nigeria

*Correspondence to: kumochris@hotmail.com

Abstract:

Background: The most commonly used approaches for detection and characterization of bacterial pathogens of meningitis in developing countries include culture, Gram stain, and latex agglutination. The positivity rate of culture is relatively low due to suboptimal storage and transportation conditions, culture practice, and/or antibiotic treatment administered before specimens are collected. Specimens that yield no growth in culture can still be analyzed using molecular methods, and metagenomic DNA (mDNA) extracted directly from clinical samples (CSF) can be used. We aimed to detect and characterize three major bacterial causes of cerebrospinal meningitis (CSM); Neisseria meningitidis, Haemophilus influenzae, and Streptococcus pneumoniae using mDNA extracted directly from CSF samples.

Methodology: Metagenomic DNA templates were prepared directly from CSF specimens collected from 210 patients with suspected CSM. A multiplex Real Time PCR (mRT-PCR) using the ABI StepOne Plus Machine and Taqman Probe chemistry was used in the molecular detection, while serogroup/serotype-specific singleplex RT-PCR was used to characterize all positives samples. Continue reading “Molecular detection and characterization of bacteria from CSF samples of patients with suspected cerebrospinal meningitis in parts of northern Nigeria using metagenomic DNA extracts”

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A retrospective study of antibiotic resistance patterns of bacterial pathogens isolated from patients in two Lebanese hospitals for two consecutive years (2018 and 2019)

1Sakr, S., 2Abboud, M., 3Tawbeh, K., 1Hamam, B., and *1Sheet, I.

1Department of Biological and Chemical Sciences, School of Arts and Sciences, Lebanese International University, Lebanon

2Haroun Hospital, Beirut, Lebanon

3Department of Mathematics and Physics, School of Arts and Sciences,
Lebanese International University, Lebanon
*Correspondence to: imtithal.sheet@liu.edu.lb

Abstract:
Background: Misuse of antibiotics is the leading factor promoting emergence of bacterial resistance, a situation that has become a serious public health challenge. Among the leading bacteria that have developed resistance to antibiotics are Staphylococcus aureus, Enterococcus faecalis, Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa, which have caused infections in patients, resulting in considerable mortality. The objective of this retrospective study was to assess antibiotic resistance rates of bacterial pathogens isolated from clinical specimens in two Lebanese hospitals between the years 2018 and 2019.

Methodology: Bacteria isolated from routine clinical specimens collected from hospitalized patients in two hospitals, Haroun and Bekaa, in Lebanon for 2018 and 2019, were analyzed. Bacteria isolation and identification were carried out at the laboratory of each hospital using conventional microbiological methods. Antimicrobial susceptibility testings (AST) of each bacterial isolate to antibiotics were performed by the disc diffusion test and interpreted using EUCAST, CLSI or WHO/AST guidelines. Comparisons of the mean resistance rates of each isolate to individual antibiotics by year of isolation were done using the Z-test and p< 0.05 was considered statistically significant. Continue reading “A retrospective study of antibiotic resistance patterns of bacterial pathogens isolated from patients in two Lebanese hospitals for two consecutive years (2018 and 2019)”

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Bioinformatic analysis of multi-drug resistant class 1 integron-coded protein of Citrobacter freundii

Popoola, O. D., and *Thomas, B. T.

Department of Microbiology, Olabisi Onabanjo University, Ago Iwoye, Ogun State, Nigeria

*Correspondence to: benthoa2013@gmail.com; +2348064011412; ORCID: http://orcid.org/0000-0003-0675-5749

Abstract:

Background: The understanding of the secondary structure of the class 1 integron coded protein is necessary to decipher potential drug target and also to infer evolutionary ancestry at the proteomic level. This study was therefore aimed at determining the secondary structure of class 1 integron-coded protein and also to provide information on their evolutionary ancestry.

Methodology: Five different sequences of Citrobacter freundii with the following accession numbers; KP902625.1, KP902624.1, KP902623.1, KP901093.1 and KP902609.1 were obtained using nucleotide BLAST (http://blast. ncbi.nlm.nih.gov/Blast.cgi) and subjected to evolutionary analysis, pairwise distance calculation, secondary structure and neutrality test using MEGA explorer, Kimura 2 parameter, SOPMA tool and Tajima’s test respectively. Continue reading “Bioinformatic analysis of multi-drug resistant class 1 integron-coded protein of Citrobacter freundii”

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Antibacterial activity and time kill kinetics of Amlodipine, Thioridazine and Promethazine against pathogenic clinical bacterial isolates

*1Akinjogunla, O. J., 2Umo, A. N., 3Alozie, M. F., 2Oshosanya, G. O., and 1Saturday, G. I.

1Department of Microbiology, University of Uyo, P.M.B. 1017, Uyo, Akwa Ibom State, Nigeria

2Department of Medical Microbiology and Parasitology, Faculty of Clinical Sciences, University of Uyo, Uyo, Akwa Ibom State, Nigeria

3Department of Pharmaceutical Microbiology and Biotechnology, Faculty of Pharmacy, University of Uyo, Uyo, Akwa Ibom State, Nigeria
*Correspondence to: papajyde2000@yahoo.com

Abstract:
Background: The emergence of multi-drug resistant bacterial strains worldwide has necessitated the scientific search for novel, potent, and affordable antimicrobial agents including medicinal plants and non-antibiotic drugs for therapy of infectious diseases. The objective of this study is to assess in vitro antibacterial activities and time kill kinetics of some non-antibiotic drugs against pathogenic clinical bacterial isolates.

Methodology: In vitro antibacterial activities including minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC) and time kill kinetics of Amlodipine (AML), Thioridazine (THI) and Promethazine (PRO) against Staphylococcus aureus, coagulase negative staphylococci (CoNS), Streptococcus spp, Escherichia coli, Enterobacter spp, Klebsiella pneumoniae and Pseudomonas aeruginosa clinical isolates were determined using disc diffusion, broth microdilution and plate count techniques.

Results: The mean growth inhibition zones by the disc diffusion assay of AML, THI and PRO against the isolates were ≤15.1±1.0 mm with MIC and MBC values ranging from 12.5 to 50μg/ml and 25 to 100μg/ml respectively. The time-kill assay revealed bactericidal effect of AML, THI and PRO on Gram positive bacteria evidenced by mean log reductions in viable bacterial cell counts ranging from 0.13 Log10 to 2.41 Log10 CFU/ml for S. aureus, 0.88 Log10 to 2.08 Log10 CFU/ml for Streptococcus spp, and 0.26 Log10 to 2.34 Log10 CFU/ml for CoNS after ≤30hrs post inoculation at 1xMIC. The range of log reduction in viable cell counts of Gram-negative bacteria exposed to AML, THI and PRO were E. coli (0.11 to 3.23 Log10 CFU/ml), P. aeruginosa (0.52 to 2.56 Log10 CFU/ml), K. pneumoniae (0.85 to 3.0 Log10 CFU/ml) and Enterobacter spp (0.38 to 2.08 Log10 CFU/ml) after ≤30 hrs post inoculation at 1x MIC.

Conclusion: These findings demonstrate in vitro antibacterial efficacies and time kill kinetics of AML, THI and PRO against pathogenic clinical bacterial isolates, which indicate that these non-antibiotic drugs may be useful therapeutic alternatives in the bid to reduce the burden of infectious diseases associated with antibiotic resistant pathogens.

Keywords: Amlodipine, Thioridazine, Promethazine, Time-Kill, Kinetics, MIC, MBC, bacteria

Received April 8, 2020; Revised July 12, 2020; Accepted July 13, 2020

Copyright 2021 AJCEM Open Access. This article is licensed and distributed under the terms of the Creative Commons Attrition 4.0 International License <a rel=”license” href=”http://creativecommons.org/licenses/by/4.0/”, which permits unrestricted use, distribution and reproduction in any medium, provided credit is given to the original author(s) and the source.

Editor-in-Chief: Prof. S. S. Taiwo

Activité antibactérienne et cinétique de destruction du temps de l’amlodipine, de la thioridazine et de la prométhazine contre les isolats bactériens cliniques pathogènes

*1Akinjogunla, O. J., 2Umo, A. N., 3Alozie, M. F., 2Oshosanya, G. O., et 1Saturday, G. I.

1Département de microbiologie, Université d’Uyo, P.M.B. 1017, Uyo, Akwa Ibom State, Nigéria

2Département de microbiologie médicale et de parasitologie, Faculté des sciences cliniques, Université d’Uyo, Uyo, État d’Akwa Ibom, Nigéria

3Département de microbiologie et biotechnologie pharmaceutiques, Faculté de pharmacie, Université d’Uyo, Uyo, État d’Akwa Ibom, Nigéria *Correspondance à: papajyde2000@yahoo.com

Abstrait:

Contexte: L’émergence de souches bactériennes multirésistantes dans le monde a rendu nécessaire la recherche scientifique d’agents antimicrobiens nouveaux, puissants et abordables, notamment des plantes médicinales et des médicaments non antibiotiques pour le traitement des maladies infectieuses. L’objectif de cette étude est d’évaluer les activités antibactériennes in vitro et la cinétique de destruction temporelle de certains médicaments non antibiotiques contre les isolats bactériens cliniques pathogènes.

Méthodologie: activités antibactériennes in vitro, y compris la concentration minimale inhibitrice (CMI), la concentration bactéricide minimale (MBC) et la cinétique de destruction du temps de l’amlodipine (AML), de la thioridazine (THI) et de la prométhazine (PRO) contre Staphylococcus aureus, les staphylocoques à coagulase négative (CoNS), Streptococcus spp, Escherichia coli, Enterobacter spp, Klebsiella pneumoniae et Pseudomonas aeruginosa ont été déterminés en utilisant des techniques de diffusion sur disque, de microdilution en bouillon et de numération sur plaque.

Résultats: Les zones moyennes d’inhibition de la croissance par le test de diffusion de disque d’AML, THI et PRO contre les isolats étaient ≤15,1±1,0mm avec des valeurs MIC et MBC allant de 12,5 à 50μg/ml et de 25 à 100μg/ml respectivement. Le dosage temporel a révélé un effet bactéricide de la LMA, du THI et du PRO sur les bactéries Gram positives, mis en évidence par des réductions logarithmiques moyennes du nombre de cellules bactériennes viables allant de 0,13 Log10 à 2,41 Log10 CFU/ml pour S. aureus, 0,88 Log10 à 2,08 Log10 CFU/ml pour Streptococcus spp et 0,26 Log10 à 2,34 Log10 CFU/ml pour CoNS après ≤ 30 heures après l’inoculation à 1 x MIC. La plage de réduction logarithmique du nombre de cellules viables de bactéries à Gram négatif exposées à la LMA, au THI et au PRO était E. coli (0,11 à 3,23 Log10 CFU/ml), P. aeruginosa (0,52 à 2,56 Log10 CFU/ml), K. pneumoniae (0,85 à 3,0 Log10 CFU/ml) et Enterobacter spp (0,38 à 2,08 Log10 CFU/ml) après ≤ 30 heures après l’inoculation à 1 x MIC.

Conclusion: Ces résultats démontrent une efficacité antibactérienne in vitro et une cinétique de destruction du temps des LMA, THI et PRO contre les isolats bactériens cliniques pathogènes, ce qui indique que ces médicaments non antibiotiques peuvent être des alternatives thérapeutiques utiles dans le but de réduire le fardeau des maladies infectieuses associées aux antibiotiques pathogènes résistants.

Mots-clés: Amlodipine, Thioridazine, Prométhazine, Time-Kill, Cinétique, MIC, MBC, bactéries

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Antibacterial activity and time kill kinetics of Amlodipine, Thioridazine and Promethazine against pathogenic clinical bacterial isolates

 

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Differences in haematological parameters and haemoglobin phenotypes in symptomatic and asymptomatic subjects with Plasmodium falciparum infection in parts of Kaduna metropolis, Nigeria

*

1Dikwa, K. B.,

2Maikaje, D. B., 1Yahaya, U. A., and

3Suleiman, A. B.

1Department of Biological Sciences, Nigerian Defence Academy, Kaduna, Nigeria

2Department of Microbiology, Kaduna State University, Kaduna, Nigeria

3Department of Microbiology, Ahmadu Bello University, Zaria, Nigeria
*Correspondence to: kbdikwa@nda.edu.ng

Abstract

Background: Plasmodium falciparum is the leading cause of malaria morbidity and mortality in Nigeria with varied symptoms and haematological consequences. The objective of this study is to assess the differences in haematological parameters and haemoglobin phenotypes in symptomatic P. falciparum infected and apparently healthy asymptomatic individuals in parts of Kaduna metropolis.

Methodology: A total of 1000 subjects; 500 symptomatic and 500 apparently healthy subjects asymptomatic for malaria, were recruited from selected hospitals and National Blood Bank in Kaduna metropolis. Blood samples were collected for thick and thin film microscopy to determine malaria parasitaemia and parasite species identification respectively. Haematological parameters were determined using automated blood analyser (KX-21N, Sysmex, Japan) and haemoglobin phenotypes by alkaline cellulose acetate electrophoresis. Continue reading “Differences in haematological parameters and haemoglobin phenotypes in symptomatic and asymptomatic subjects with Plasmodium falciparum infection in parts of Kaduna metropolis, Nigeria”

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Evidence of virological failure in patients on second-line anti-retroviral therapy in Southwestern Nigeria: an indication for HIV drug resistance testing

*Usman, S. O., Ajayi, O. M., Ebiekura, O., Egbonrelu, N., Ebhojie, G., and Ariyo, A.O
APIN Public Health Initiatives, Abuja, Nigeria

*Correspondence to: senatorhopsy@yahoo.com

Abstract:
Background: In sub-Saharan Africa where genotypic anti-retroviral (ARV) drug resistance testing is rarely performed and poor adherence is blamed for the inability to achieve viral suppression and treatment failure, programmatic approaches to preventing and handling these are essential. This study was aimed at assessing the virological outcomes among HIV patients receiving second-line anti-retroviral therapy (ART) in Southwestern Nigeria.

Methodology: This was a 5-year observational retrospective study of randomly selected people living with HIV (PLWHIV) who have been switched to second-line ART for at least six months before the commencement of the study in multiple comprehensive ART sites across the three levels of care, in Ondo and Ekiti States, Southwestern Nigeria, from January 2015 to December 2019. Quantitative viral load analysis was done using polymerase chain reaction (PCR) assay. Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 24.0.

Results: A total of 249 (71 males and 178 females) subjects eligible for the study were recruited using simple random sampling technique. The mean age (± SD) of the subjects was 44.21 ± 11.45 years. The mean number of years the patients have been on ART regimen was 7.92 ± 2.68 years. The mean number of years the patients were on first line ART regimen before being switched to second line was 4.27 ± 2.63 years. Patients with viral load <1000 RNA copies/ml (suppressed viral load) were 216 (86.7%) out of which 113 (45.4%) had viral load <20 RNA copies/ml while 33 (13.3%) had viral load >1000 RNA copies/ml (unsuppressed viral load or virological failure).

Conclusion: About 13% of the patients on second line ART had unsuppressed viral load of more than 1000 RNA copies/ml indicating virological failure. Thus, critical factors such as poor adherence to ART and drug resistance chiefly contributing to virological failure have to be routinely checked.

Keywords: suppression, ART, resistance, virological, failure, Nigeria

Received Apr 26, 2021; Revised Jun 9, 2021; Accepted Jun 13, 2021

Copyright 2021 AJCEM Open Access. This article is licensed and distributed under the terms of the Creative Commons Attrition 4.0 International License <a rel=”license” href=”http://creativecommons.org/licenses/by/4.0/”, which permits unrestricted use, distribution and reproduction in any medium, provided credit is given to the original author(s) and the source.

Editor-in-Chief: Prof. S. S. Taiwo

Preuve d’échec virologique chez les patients sous traitement antirétroviral de deuxième intention dans le sud-ouest du Nigeria: une indication pour le test de résistance aux médicaments contre le VIH

*Usman, S.O., Ajayi, O.M., Ebiekura, O., Egbonrelu, N., Ebhojie, G., et Ariyo, A.O.
Initiatives de santé publique de l’APIN, Abuja, Nigéria

*Correspondance à: senatorhopsy@yahoo.com

Abstrait:
Contexte: En Afrique subsaharienne, où les tests génotypiques de résistance aux antirétroviraux (ARV) sont rarement effectués et où une mauvaise observance est imputée à l’incapacité d’obtenir la suppression virale et l’échec du traitement, des approches programmatiques pour les prévenir et les gérer sont essentielles. Cette étude visait à évaluer les résultats virologiques chez les patients VIH recevant un traitement antirétroviral (TAR) de deuxième intention dans le sud-ouest du Nigeria.

Méthodologie: Il s’agissait d’une étude rétrospective d’observation de 5 ans portant sur des personnes vivant avec le VIH (PVVIH) sélectionnées au hasard et passées à un TAR de deuxième intention pendant au moins six mois avant le début de l’étude dans plusieurs sites de TAR complets aux trois niveaux. de soins, dans les États d’Ondo et d’Ekiti, dans le sud-ouest du Nigéria, de janvier 2015 à décembre 2019. L’analyse quantitative de la charge virale a été effectuée à l’aide d’un test de réaction en chaîne par polymérase (PCR). Les données ont été analysées à l’aide du logiciel Paquet statistique pour les sciences sociales (SPSS) version 24.0.

Résultats: Un total de 249 (71 hommes et 178 femmes) sujets éligibles à l’étude ont été recrutés à l’aide d’une technique d’échantillonnage aléatoire simple. L’âge moyen (± ET) des sujets était de 44,21±11,45 ans. Le nombre moyen d’années pendant lesquelles les patients ont été sous traitement antirétroviral était de 7,92±2,68 ans. Le nombre moyen d’années pendant lesquelles les patients étaient sous traitement antirétroviral de première ligne avant de passer en deuxième ligne était de 4,27 ± 2,63 ans. Les patients avec une charge virale <1000 copies d’ARN/ml (charge virale supprimée) étaient 216 (86,7%) dont 113 (45,4%) avaient une charge virale <20 copies d’ARN/ml tandis que 33 (13,3%) avaient une charge virale >1000 ARN copies/ml (charge virale non supprimée ou échec virologique).

Conclusion: Environ 13 % des patients sous TAR de deuxième ligne avaient une charge virale non supprimée de plus de 1000 copies d’ARN/ml indiquant un échec virologique. Ainsi, les facteurs critiques tels qu’une mauvaise adhésion au TARV et la résistance aux médicaments contribuant principalement à l’échec virologique doivent être systématiquement vérifiés.

Mots clés: suppression, TAR, résistance, virologique, échec, Nigeria.

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Evidence of virological failure in patients on second-line anti-retroviral therapy in Southwestern Nigeria: an indication for HIV drug resistance testing