Clinical neglect of aspergillosis in pulmonary tuberculosis coinfection: a case report of avoidable mortality in a resourceconstrained setting

*[1]Adeyemo, A. T., 1Obadare, T. O., [2]Edward, S. S., 1Ibrahim, A. O., 1Irek, E. O., 1Amupitan, A. A., 2Olorunsogo, O. A., 1Anuforo, A. C., 2,3Obiajunwa, P. O., and 1,4Aboderin, A. O.

     1Department of Medical Microbiology and Parasitology, Obafemi Awolowo University Teaching  Hospitals Complex, Ile-Ife, Nigeria                                                                                

2Department of Paediatrics, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria

3Department of Paediatrics, Obafemi Awolowo University, Ile-Ife, Nigeria                             

4Department of Medical Microbiology and Parasitology, Obafemi Awolowo University, Ile-Ife, Nigeria  

*Correspondence to: [email protected]; ORCiD: //orcid.org/0000000335442530

Abstract:

Background: Pulmonary aspergillosis (PA) is common among patients with tuberculosis (TB). With both infections presenting with similar clinical and radiologic features, diagnosis of PA is often made too late or missed completely due to lack of clinical suspicion and poor diagnostic laboratory capacity for mycotic infections prevalent in our settings. We present a case of preventable mortality caused by delayed diagnosis and treatment of PA in a patient with pulmonary TB (PTB). Continue reading “Clinical neglect of aspergillosis in pulmonary tuberculosis coinfection: a case report of avoidable mortality in a resourceconstrained setting”

Comparative analysis of haematological parameters in HIV patients with co-infections of hepatitis B & C, and HIV-negative patients in Rivers State, Nigeria

*1Erasmus, M. A., 2Akani, N. P.,

2Amadi, L. O., and 2Williams, J. O.
1Rivers State University Teaching Hospital, P.M.B 5064, Port Harcourt, Nigeria

2Department of Microbiology, Faculty of Science, Rivers State University Nkpolu Oroworukwo, P.M.B 5080, Port Harcourt, Nigeria

*Correspondence to: [email protected]; [email protected]; 08038213334; 08033102655

Abstract:

Background: Human immunodeficiency virus (HIV) has continued to be a threat to global health with several deaths
recorded despite the introduction of highly active antiretroviral therapy (HAART). Co-infection of hepatitis B and C is
now one of the leading causes of death among HIV-infected patients due to some haematological abnormalities and
immunological impairment. This study was conducted to compare some haematological parameters of HIV-infected
patients with hepatitis B and C co-infections from three hospitals in Rivers State, Nigeria

Methodology: This was a comparative cross-sectional study of randomly recruited HIV-patients from antiretroviral
therapy (ART) clinic and HIV-negative patients from medical out-patient department (MOPD) of three different
hospitals in Rivers State, Nigeria. Socio-demographic information of each participant was obtained with a structured
questionnaire. Four millilitres of blood were collected from each participant by venipuncture; 2 ml each were dispensed
into ethylene diamine tetra acetic acid (EDTA) and plain bottles for estimation of full blood count (FBC), cluster of
differentiation 4 (CD4), HIV, hepatitis B virus (HBV) and hepatitis C virus (HCV) serology. Continue reading “Comparative analysis of haematological parameters in HIV patients with co-infections of hepatitis B & C, and HIV-negative patients in Rivers State, Nigeria”

Co-infections of MERS-CoV with other respiratory viruses in Saudi Arabia

*1Al-Quthami, K., 2Al-Waneen, W. S., and 3Al Johnyi, B. O.

1Regional Laboratory, Makkah, Saudi Arabia

2National Centre of Agricultural Technology, King Abdulaziz City for Science and Technology, Saudi Arabia

3King Abdulaziz University, Saudi Arabia

*Correspondence to: [email protected]

 

Abstract:

Background: The Middle East Respiratory Syndrome (MERS) is a viral respiratory disease caused by a member of the coronaviruses called Middle East Respiratory Syndrome Coronavirus (MERS-CoV). The co-infections of MERS-CoV with other respiratory viruses have been documented in rare cases in the scientific literature. This study was carried out to determine whether confection of MERS-CoV occurs with other respiratory viruses in Saudi Arabia.

Methods: Nasopharyngeal swabs samples of 57 MERS-CoV positive outpatients were collected using flocked swabs. Nucleic acid was extracted from each sample using commercial NucliSens easyMAG system. Amplification was performed by multiplex RT-PCR using Fast Track Diagnostics Respiratory Pathogen 33. Data were analyzed with SPSS software version 19 and comparison of variables was done with Fisher Exact test, with p value <0.05 considered significant.

Results: Six of the total 57 MERS-COV patients (35 males, 22 females) were positive for co-infection of MERS CoV with other respiratory viruses, giving a prevalence rate of 10.5%, with 14.5% (5/35) in males and 4.5% (1/22) in females (OR=3.500, 95% CI=0.3806-32.188, p=0.3889). The prevalence of co-infections was significantly higher among non-Saudis (23.8%, 5/21) than Saudis (2.8%, 1/36) (OR=0.09143, 95% CI=0.009855-0.8485, p=0.0217), and among the age group 18-34 years (25%, 3/12) than other age groups (X2=3.649, p=0.1613). Human rhinovirus (HRV) was found in 2 of the 6 (33.3%) patients with co-infection while the other viruses were found in each of the remaining 4 patients.

Conclusion: Our study confirms that MERS-CoV co-infects with other respiratory viruses in Saudi Arabia.

Keywords: MERS-CoV, URTI,  Co-infection, Coronavirus Continue reading “Co-infections of MERS-CoV with other respiratory viruses in Saudi Arabia”

Cytomegalovirus co-infection with HIV in children and adolescents on antiretroviral therapy in Abuja, Nigeria

Cytomegalovirus co-infection with HIV in children and adolescents on antiretroviral therapy in Abuja, Nigeria

1*Okechukwu, A. A., and 2Thairu, Y.
1Deparment of Paediatrics, University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria
2Department of Microbiology, University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria
Correspondence to: [email protected]; +2348036719906

Abstract:
Background: Cytomegalovirus (CMV) co-infection with human immunodeficiency virus (HIV) is known to accelerate HIV disease progression. It has the potential of being a killer disease or a silent lifetime companion in HIV patients. There is dearth of information on CMV prevalence among HIV infected children and adolescents in our environment. We therefore conducted this study to determine its sero-prevalence, and risk factors for co-infection among HIV infected children and adolescents on highly active antiretroviral therapy (HAART) in our center.
Method: A descriptive cross sectional study of HIV-infected children and adolescents aged 2 months to 18 years on HAART was conducted over a 6 month period between October 2017 and March 2018 in our health facility. Blood samples of subjects were screened for CMV IgM using commercial test kits. Biodata of subjects, CD4 cell count, and viral load were collected into a designed proforma, and statistical analysis was done with SPSS version 22.0.
Result: A total of 161 HIV-infected children and adolescents were recruited, 103 (64.0%) were males, 83 (51.6%) were between the ages of 5 and <10 years, 113 (70.2%) were from lower socio-economic class, and 138 (85.7%) were on 1st line HAART. Of the 17 (10.6%) subjects positive for CMV IgM, 3 (17.6%) were less than 5 years old, 11 (64.7%) were between the ages of 5-10 years, and none was older than 15 years. Univariate analysis showed significant differences in the mean age, weight, length/height, and systolic blood pressure between CMV IgM positive and negative patients (p<0.05), but no significant difference in gender, socioeconomic class, types of antiretroviral drugs, CD4 cell count, and viral load (p>0.05). Multivariate analysis however did not show any significant difference in age, weight, length/height, and systolic blood pressure. Conclusion: The prevalence of active CMV infections among HIV infected children and adolescents on HAART in our centre is high. Low CD4 cell count and high viral load were not associated with active CMV disease, and no risk factor for co-infection was also identified. Identifying those with primary/active infection will be necessary for possible treatment with anti-herpes drugs before development of reactivated CMV disease.

Keywords: CMV, HIV, co-infection, anti-retroviral,  children, adolescents

Received June 27, 2019; Revised October 10, 2019; Accepted October 12, 2019

Copyright 2020 AJCEM Open Access. This article is licensed and distributed under the terms of the Creative Commons Attrition 4.0 International License (//creativecommmons.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.

Co-infection par le cytomégalovirus et le VIH chez des enfants et des adolescents sous traitement antirétroviral à Abuja, au Nigéria

1*Okechukwu, A. A., et 2Thairu, Y.
1Département de pédiatrie, Hôpital universitaire de Abuja, Gwagwalada, Abuja, Nigéria 2Département de microbiologie, hôpital universitaire de Abuja, Gwagwalada, Abuja, Nigéria Correspondance à: [email protected]; +2348036719906

Abstrait:

Contexte: On sait que la co-infection par le cytomégalovirus (CMV) et le virus de l’immunodéficience humaine (VIH) accélère la progression de la maladie. Il a le potentiel d’être une maladie mortelle ou un compagnon
silencieux à vie chez les patients VIH. Il existe peu d’informations sur la prévalence du CMV chez les enfants et les adolescents infectés par le VIH dans notre environnement. Nous avons donc mené cette étude pour déterminer sa séroprévalence et les facteurs de risque de co-infection chez les enfants et les adolescents infectés par le VIH sous traitement antirétroviral hautement actif (HAART) dans notre centre. Méthode: Une étude transversale descriptive des enfants et adolescents infectés par le VIH et âgés de 2 mois à 18 ans sous multithérapie a été menée sur une période de 6 mois entre octobre 2017 et mars 2018 dans notre établissement de santé. Des échantillons de sang de sujets ont été testés pour l’IgM de CMV en utilisant des kits de test commerciaux. Les données biologiques des sujets, le nombre de cellules CD4 et la charge virale ont été recueillis dans un formulaire conçu à cet effet et une analyse statistique a été réalisée avec SPSS version 22.0. Résultat: 161 enfants et adolescents infectés par le VIH ont été recrutés, dont 103 (64,0%) étaient des hommes, 83 (51,6%) étaient âgés de 5 à moins de 10 ans, 113 (70,2%) étaient issus de milieux socio-économiques inférieurs. et 138 (85,7%) suivaient la multithérapie de première ligne. Sur les 17 (10,6%) sujets positifs pour l’IgM du CMV, 3 (17,6%) avaient moins de 5 ans, 11 (64,7%) étaient âgés de 5 à 10 ans et aucun n’avait plus de 15 ans. Une analyse univariée a montré des différences significatives dans l’âge moyen, le poids, la taille / taille et la pression artérielle systolique entre les patients positifs et négatifs pour IgM anti-CMV (p<0,05), mais aucune différence significative entre le sexe, la classe socio-économique, les types de médicaments antirétroviraux et les cellules CD4 nombre et charge virale (p>0,05). L’analyse multivariée n’a cependant montré aucune différence significative d’âge, de poids, de taille / taille et de pression artérielle systolique. Conclusion: La prévalence des infections à CMV actives chez les enfants et les adolescents infectés par le VIH sous HAART dans notre centre est élevée. Un faible nombre de cellules CD4 et une charge virale élevée n’étaient pas associés à la maladie à CMV active et aucun facteur de risque de co-infection n’a également été identifié. Identifier les personnes présentant une infection primaire / active sera nécessaire pour un traitement éventuel avec des médicaments anti-herpès avant le développement d’une maladie à CMV réactivée.

Mots-clés: CMV, HIV, co-infection, anti-rétroviral, Enfants, les adolescents

CMV and HIV co-infection in children Afr. J. Clin. Exper. Microbiol. 2020; 21 (1): 36 – 44

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Cytomegalovirus co-infection with HIV in children and adolescents on antiretroviral therapy in Abuja, Nigeria

Renal and hepatic profiles in Nigerian multidrug resistant tuberculosis patients with or without HIV co-infection

O Ige, SA Yaqub, VF Edem, OG Arinola

 

Abstract

Tuberculosis (TB) is primarily a lung disease (pulmonary tuberculosis, PTB) but the bacilli can also  develop in other places in the body, such as the bones, liver and kidney as extra pulmonary tuberculosis. Hepatic and renal involvements in PTB patients are mostly secondary to TB chemotherapy that is  potentially hepato- and nephro- toxic. In this study, the biochemical parameters that indicate renal and hepatic involvements were analyzed in the sera of MDR-TB patients with and without HIV co-infection prior to commencement of chemotherapy. Out of 115 MDR-TB patients (76 males and 39 females) recruited for the study, 22 patients (11 males and 11 females) were co-infected with HIV. Serum levels of sodium (Na+), potassium (K+), chloride (Cl-) were analyzed using Easylite (ISE technology),   bicarbonate (HCO3-) was analysed using back titration method, urea and creatinine were determined spectrophotometrically using Diacetlymonoxime (DAM) method and Jaffe’s alkaline picrate method  respectively. Total and direct bilirubin, serum glutamate oxaloacetate transferase (SGOT), serum glutamate pyruvate transferase (SGPT), alkaine phosphatase(ALP), total protein (TP) and albumin (Alb) were determined using Hitachi 912 autoanalyzer. There were no statistical significant differences in the renal and hepatic parameters of TB patients with HIV compared with TB patients without HIV. However, significantly higher proportions (89%) of MDR-TB patients had their SGOT within reference range. The mean values indicate that HIV infection did not significantly alter renal and hepatic profiles in
MDR-TB patients prior to treatment.

 

LES PROFILS RENALS ET HEPATIQUES DANS MULTIRESISTANTE PATIENTS TUBERCULEUX
NIGERIANS AVEC OU SANS CO – INFECTION PAR LE VIH.

La tuberculose est principalement une maladie du poumon (Tuberculeuse pulmonaire TBP) mais les bacilles peuvent être également se développer dans d’autres endroits dans le corps, tels que les os, le foie et les reins comme la tuberculose extra pulmonaire. L’atteinte hépatique et rénale chez les patients atteints de TBP est surtout secondaire a la chimiothérapie de la tuberculose(TB) qui est potentiellement hépato – et néphro – toxique. Dans cette étude, les paramètres biochimiques qui indiquent les  implications rénales et hépatiques ont été analyses dans les sérums des patients atteints de MDR – TB avec ou sans Co – infection par le VIH avant le commencement de la chimiothérapie. Sur les 115 patients atteints de MDR – TB (76 males et femelles), recrutés pour l’étude, 22 patients (11 males et femelles) ont été co – infectes par le VIH. Le niveau sérique de sodium (Na⁺), de potassium (K⁺), le chlorure(C1⁻) ont été analyses en utilisant Easylite(technologie ISE), le bicarbonate (HC0₃⁻) a été analyse en utilisant la méthode de titrage de retour, l’urée et de la créatinine ont été déterminés spectrophotométrie rn utilisant la méthode Diacétyle monoxime(DAM) et la méthode de picrate alcaline de Jaffer respectivement. Bilirubine totale et directe, glutamate oxaloacetate transférase sérique(SGOT), transférase sérique de glutamate pyruvate(SGPT), phosphatase alcaline(ALP), protéines totale(TP) et albumine(Alb) ont été déterminés en utilisant Hitachi 912 autoa nalyseur. Il n’ ya pas de différence statistiquement significative dans les paramètres rénales et hépatiques des patients tuberculeux vivant avec ke VIH par rapport aux patients atteints de tuberculose sans VIH. Néanmoins, les proportions significativement élevées (89%) des patients atteints de MDR – TB ont eu leurs SGOT a porté de référence. Les valeurs moyennes indiquent que l’infection par le VIH n’a pas modifié significativement les profils rénaux et hépatiques chez les patients de TB – MRD.

Mots – clés : Les reins, le foie, l’électrolyte, la tuberculose, Virus de l’immunodéficience humaine, Co – infection.

Key words: Kidney, Liver, Electrolytes, Tuberculosis, Human Immunodeficiency Virus, Co-infection.

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Renal and hepatic profiles in Nigerian multidrug resistant tuberculosis patients with or without HIV co-infection

Prevalence of HIV/Sputum AFB positivity among patients attending University of Benin Teaching Hospital (UBTH), Benin City, Nigeria

O Iyoha, WO Osarogiagbon

 

Abstract

Human Immunodeficiency Virus (HIV) and Tuberculosis(TB) have synergistic interactions that speedily accelerate decline of the host’s immune system and accentuate the progression of each other. Eight hundred and ninety five patients referred from different units of University of Benin Teaching Hospital, Nigeria were screened for antibodies to HIV-1 and HIV-2 using ELISA and sputum microscopy for acid-fast bacilli. The result showed that, 92(10.3%) were HIV positive with females 68(14.2%) higher than males 24(5.8%) though not statistically significant (p=0.066), 123(13.7%) patients were AFB positive, with males 75(18.1%) significantly higher than females 48(10%) (p=0.046) and 14(1.6%) patients were co-infected. Although the co-infection rate was higher among females 9(1.9%) than males 5(1.2%), there was no significant difference (p=0.450). The age group 40-49 and 50-59 had the highest TB/HIV co-infection (2.5% each).Regular screening for TB in HIV patients and HIV in TB patients would demonstrate the true burden of TB disease amongst HIV infected patients.

Key words: prevalence, TB, HIV, co-infection, Nigeria.

LA PREVALENCE DE LA POSITIVITE DU VIH/EXPECTORATIONS AFB CHEZ LES PATIENTS QUI
FREQUENT L’UNIVERSITE HOPITAL D’ENSEIGNEMENT DE BENIN (UBTH), BENIN CITY, NIGERIA.

Le virus de l’immunodéficience humaine(VIH) et la tuberculose (TB) ont des interactions synergiques qui rapidement accélèrent le déclin du système immunitaire de l’hôte et accentuent la progression de l’un l’autre. Huit cent quatre – vingt quinze patients des différentes unités de l’université hôpital  d’enseignement de Benin, Nigeria, ont été criblés pour les anticorps a VIH – 1 et VIH – 2 en utilisant ELISA microscopique des expectorations pour les bacilles acide – Résistant. Le résultat a montrée que 92 (10,3%) étaient séropositifs avec des femelles 68(14,2%) plus élevé que les males 24(5,8%), mais pas
statiquement significatif, (p=0,066), 123(13,7%) patients étaient AFB positif, avec les males 75(18,1%) significativement plus élevés que les femelles 48 (10%) (p=0,046) et 14 (1,6%) patients ont été Co – infectés. Bien que le taux de la Co – infection était plus élevé parmi les femelles 9(1,9%) que les males 5 (1,2%), il n y avait pas de différence significative (p=0,450). Le groupe d’âges 40 – 49 et 50 – 59 avait la plus forte Co – infection de TB/HIV (2,5%). Le dépistage régulier de la tuberculose chez les patients VIH et VIH chez les patients tuberculeux démontrerait le véritable fardeau de la maladie de la tuberculose chez les patients infectés par le VIH.

Mots Clés : Prevalence, Tuberculose, VIH, Co – infection, Nigeria.

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Prevalence of HIVSputum AFB positivity among patients attending University of Benin Teaching Hospital (UBTH), Benin City, Nigeria

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