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CD4 cells profile of HAART naive HIV seropositive clients in Kogi State University Teaching Hospital, Anyigba, Kogi State. Nigeria

OJ Alabi, SPO Akogu, M Akpa, V Ukeje, PO Okpanachi, OG Agama, S Gideon, B Adegboro

 

Abstract

CD4 lymphocyte cells are the primary targets of Human immune-deficiency virus (HIV). Enumeration of CD4 T lymphocytes in the peripheral blood is used in the assessment of disease clinical stage, risk of  opportunistic infections, evaluation of prognosis and guide decision on the commencement of  antiretroviral therapy. The objective was to determine CD4 cells profile of HIV sero-positive naïve  patients in Kogi State University Teaching Hospital( KSUTH) Anyigba. A total of 404 HIV sero-positive Highly Active Anti Retro Viral Treatment ( HAART) naïve patients comprising 147(36.4%) males and  257 (63.6%) females were examined. Approval was obtained from ethical committee of Kogi State University Teaching Hospital (KSUTH), Anyigba. Written and verbal informed consent was taken from all patients. The overall mean age of patients was 33.0 ± 12.7 years and female-male ratio was  1.7:1. Majority of patients were in the clinical stage two 121(30.5%) and three 200(50.4%). Patients had overall mean CD4 cells count of 381.8 ± 240.8 cells /mm3. Patients CD4 cells count varied statistically with the HIV clinical staging (F =4.512 & P value=0.004) and statistically insignificant with gender (P value = 0.7562 & t Test= 0.3106) and tuberculosis status (P value=0.223 & F=  1.505).Conclusion: This study showed HIV sero-positive HAART naive patients presented in KSUTH with mean age of 33 years. Majority of patients presented in disease clinical stage two and three with a mean CD4 cells counts of 381.8 cells/mm3 . This study recommend the need to reduce stigmatization, discrimination and promote early access to treatment , care and support services.

Keywords: HIV/AIDS, CD4, Patient/clients, KSUTH, Nigeria.

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CD4 cells profile of HAART naive HIV seropositive clients in Kogi State University Teaching Hospital, Anyigba, Kogi State. Nigeria

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Candiduria among HIV- Infected Patients Attending a Tertiary Hospital in Benin City

NO Esebelahie, IB Enweani, FO Newton-Esebelahie, R Omoregie

 

Abstract

Background: Candiduria is a common finding. However, in  immunocompromised patients like HIV-infected individuals, it has high risk of morbidity and mortality as it could be a pointer to systemic candidiasis. Unfortunately, there are no clear criteria for differentiating between colonization and infection or between upper or lower urinary tract infections.

Objective: This study focused on determining the spectrum of Candida species implicated in candiduria among HIV-infected individuals and their
susceptibility to fluconazole and voriconazole in a tertiary hospital.

Methods: A total of 300 subjects comprising of 200 HIV patients and 100 non-HIV individuals were used for this study. Clean catch midstream were collected from each individual and processed using standard  microbiological techniques. Emergent Candida isolates were identified with CHROMagar Candida and sugar fermentation tests.

Results: The overall prevalence of candiduria among HIV patients was 13.5%. HAART-naive patients had a significantly higher prevalence  (OR=4.165, 95%CI=1.602, 10.828; P=0.0038) than their counterpart on highly active antiretroviral therapy (HAART). Female gender was a  significant risk factor for acquiring candiduria. Age had no significant effect on the prevalence of candiduria in this study. A CD4+ count <200 cells/µl was a significant risk factor for acquiring candiduria only among  HAART-naive patients (OR=11.711; 95%CI=3.943, 34.780; P= 0.0001). The three species of Candida recovered from this study were C. albicans, C. krusei and C.parapsilosis. C. albicans (64.52%, 83.36%) and C. krusei (66.67%, 100.00%) were resistant to fluconazole and voriconazole  respectively.

Conclusion: There is a significant relationship between  antiretroviral therapy, CD4+ counts, and the prevalence of candiduria among the study population.

Keywords:HAART, HAART-naive, candiduria, CD4+ counts, Candida,  prevalence.

 

Contexte: La candidurie est un problème commun de sante publique. Cependant, chez les patients immunodéprimés comme les individus infectés par le VIH, elle présente un risque élevé de morbidité puisqu’elle peut évoluer vers la candidose systémique. Malheureusement, il n’existe pas de critères clairs permettant de distinguer la colonisation et l’infection de même que les infections des voies urinaires supérieures et inférieures.

Objectif: Cette étude a porté sur la détermination du spectre d’espèces de Candida impliqués dans la candidurie chez les personnes infectées par le VIH et leur sensibilité au fluconazole et voriconazole dans un hôpital tertiaire.

Methodes : Un total de 300 sujets comprenant 200 patients atteints du VIH et 100 personnes non -VIH ont été utilisés dans cette étude. Les echantillons d’urine ont été collectées auprès de chaque personne par la methode de ‘‘Clean catch midstream’’et traitées en utilisant des techniques microbiologiques standard. Les isolats émergents de Candida ont été identifiés avec CHROMagar Candida et les tests de fermentation de sucre.

Résultats : La prévalence globale du VIH chez les patients atteints de candidurie était de 13,5%. Les patients en naïfs de la multithérapie HAARTavaient une prévalence significativement plus élevée (OR = 4,165, IC à 95% =1,602, 10,828, p = 0,0038 ) par rapport a leurs homologues sous traitement antiretroviral hautement actif (HAART ) . Le sexe feminin etait un facteur de risque important d’acquisition de candidurie. L’age n’avait pas d’effet significat nif sur la prevalence de candidurie dans cette etude. Un compte de CD4 + < 200 cellules / µl ete un facteur de risque important pour l’acquisition de candidurie que chez les patients en multitherapie naifs (OR = 11,711 ; IC a 95% = 3, 943, 34, 780, p = 0,0001). Les trois especes de Candida recuperes de cette etude etaient C. albicans, C. krusei et C.parapsilosis. C. albicans(64,52%, 83,36 %) et C. krusei (66,67%, 100,00 %) etaient resistants respectivement au  fluconazole et voriconazole.

Conclusion: Il existe une relation significative entre le traitement  antiretroviral, CD4 +, et la prevalence de candidurie parmi la population de l’etude..

Mots-cles: multitherapie HAART , naifs , candidurie , CD4 + , Candida , prevalence

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Candiduria among HIV- Infected Patients Attending a Tertiary Hospital in Benin City

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Prevalence and immune status of HIV/HBV co-infected pregnant women

PM Lar, VK Pam, PB Christopher, L Gwamzhi, JD Mawak

 

Abstract

HIV/HBV co-infection places patients at high risk of liver-related morbidity and mortality and the interaction of the two viruses can further complicate treatment. Pregnant women are especially at high risk for increased morbidity and mortality due to infection, and information about HIV/HBV co-infection in pregnant women is scanty. This study examined the occurrence of HBV antibodies in HIV-1 positive pregnant women and the relationship to  Ante-retroviral therapy (ART) and other demographic characteristics. Blood samples were collected from 135 HIV pregnant positive women who were either on ART or Not, from May – June, 2008 at the Jos University Teaching Hospital (JUTH) and the Plateau State Specialist Hospital (PSSH). Presence of hepatitis B surface (HBsAg) antigen in serum was determined using Antec strips (Antec diagnostics UK) and their immunologic status were determined by measuring the CD4+ counts using SL_3 cyFlow counter (Partec, Germany) . Sixteen 16 (11.8%) of the women examined were seropositive for Hepatitis B virus. Occupation was significantly associated with the prevalence of the hepatitis co-infection in the population examined (8.8% of house wives and 5.5% of business women had  co-infection, p<0.05). The immunologic status (CD4+ of most of the HIV/HBV co-infected pregnant women (81.5%) was low (below 300 cells/mm3) although all were on Anti retroviral therapy. The 11.8% prevalence rate reported in this study confirms the endemicity of HBV /HIV co-infection in Nigeria, and this supports the calls for screening for Hepatitis B as a routine in antenatal care.

Keywords: HIV, Hepatitis, Co-infection, CD4, Pregnant women

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Prevalence and immune status of HIVHBV co-infected pregnant women