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”

Active tuberculosis among adult HIV-infected patients accessing antiretroviral therapy in a tertiary health facility in Lafia, northcentral Nigeria

*1Audu, E. S., 2Adiukwu, C., 3Bello, S., 4Abdulmajid, S., 4Anyuabaga, B., 5Ashuku, Y. A., and 6Anazodo, M.

1Department of Medical Microbiology/Special Treatment Clinic, Dalhatu Araf Specialist Hospital, Lafia

2Department of Internal Medicine, Dalhatu Araf Specialist Hospital, Lafia

3Department of Paediatrics/Special Treatment Clinic, Dalhatu Araf Specialist Hospital, Lafia

4Special Treatment Clinic, Dalhatu Araf Specialist Hospital, Lafia

5College of Medicine, Federal University, Lafia

6Research Unit, Dalhatu Araf Specialist Hospital, Lafia

*Correspondence to: [email protected]

Abstract:
Background: Tuberculosis and Human Immunodeficiency Virus (HIV) co-infection is a major problem in Nigeria and other countries that are ravaged by a high burden of both diseases. The World Health Organization (WHO) reports that the risk of developing active tuberculosis (TB) among people living with HIV is 16-27 times that of HIV negative persons. Although antiretroviral therapy (ART) reduces the risk of developing TB, there are factors which predispose those on ART to TB. This study sought to determine the prevalence of TB among adults on ART in our facility and identify the predisposing factors.

Methodology: This was a retrospective study utilizing data from clinical records (folders and electronic) of adult HIV patients who are accessing ART in our facility and have been on ART for at least 6 months. A proforma was used to collect data including demographic, clinical, ART and laboratory information of the patients. The data were entered into SPSS version 23 and analyzed using descriptive statistics and bivariate analysis. Associations were tested using Chi square with 95% confidence level.

Results: A total of 457 patients were studied, aged 18-69 years (mean age 38.3± 10 years), and 72.4% females. Majority were married (81%), unemployed (53.8%), had mean baseline CD4 cell count of 267.4 ± 185 cells/mm3 and a mean duration on ART of 100.9± 39 months. Seventeen point three percent of the patients had a previous history of TB before or within 6 months of commencement of ART. Thirteen (2.8%) of the patients had active TB while on ART. Majority of those who had active TB were females (76.9%), married (76.9%), unemployed (46%), had no previous history of TB (53.8%), baseline CD4 cell count of ≤ 350 cells/mm3 and were on first line ART medication. There was however no significant statistical association of active TB with any of these factors.

Conclusion: Few patients had active TB while on ART in this study. The high frequency of TB in those who had low baseline CD4 cell count and baseline WHO stage shows the importance of early initiation of ART in people living with HIV (PLHIV). There is need for regular screening of PLHIV for TB and innovative approaches to get people with HIV to know their TB status as well as early commencement of ART.

Keywords: Human immunodeficiency virus, Active Tuberculosis, Antiretroviral therapy.

Received Dec 9, 2019; Revised March 15, 2020; Accepted March 18, 2020

Copyright 2020 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=”//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.

Tuberculose active chez des patients adultes infectés par le VIH ayant accès à un traitement antirétroviral dans un établissement de santé tertiaire à Lafia, au centre-nord du Nigéria

*1Audu, E. S., 2Adiukwu, C., 3Bello, S., 4Abdulmajid, S., 4Anyuabaga, B., 5Ashuku, Y. A., et 6Anazodo, M. Continue reading “Active tuberculosis among adult HIV-infected patients accessing antiretroviral therapy in a tertiary health facility in Lafia, northcentral 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