A review of the epidemiology, prevention and treatment of human immunodeficiency virus infection in Nigeria

In order to amalgamate research findings on HIV/AIDS in Nigeria as well as the trend of the infection in a concise manner, we reviewed published articles on the HIV/AIDS situation in Nigeria. We categorized this review into several subheadings. The HIV prevalence rate has continued to rise steadily from less than 0.1 percent in 1987, to 5.8 percent in 2001, with a slight decrease in 2003 to 5.0 percent. Although the knowledge about HIV and its mode of transmission is widespread, it is however disheartening to note that this did not result into appreciable attitudinal change and behavior modification among Nigerians. Both HIV-1 and HIV-2 have been identified in Nigeria, with HIV-1 being the predominant type. Furthermore, several subtypes like subtypes A, B, C, G and J have been identified in Nigeria, with several recombinant forms like the CRF02_AG; the major ones being A, G and CRF02_AG. HIV-infected patients in Nigeria are also co-infected with other viral and bacterial infections, the commonly reported ones being co infections with hepatitis B and C. Although treatment of infected patients has increased recently, more effort is needed, especially in the area of patients monitoring, to maximize the benefits of ART in Nigeria. Finally, Nigeria has made appreciable efforts in vaccine development and candidate HIV DNA vaccines have been developed utilizing the sequences from predominant subtypes, and these candidates have been shown to be immunogenic in animal models. It is therefore clear that only the integration of prevention and antiretroviral research programmes into a coherent programme that is needed to address the public health needs that HIV/AIDS crisis represents for Nigeria.

The role of triple infection with hepatitis B virus, hepatitis C virus, and human immunodeficiency virus (HIV) type-1 on CD4+ lymphocyte levels in the highly HIV infected population of North-Central Nigeria

We set out to determine the seroprevalence of hepatitis B and C among human immunodeficiency virus type-1 (HIV-1) infected individuals in North-Central Nigeria to define the influence of these infections on CD4+ lymphocytes cells among our patients as access to antiretroviral therapy improves across the Nigerian nation. The CD4+ values of 180 confirmed HIV-1 infected individuals were enumerated using a superior fluorescence-activated cell sorter system. These patients were tested for the presence of hepatitis B surface antigen and anti-hepatitis C virus (HCV) using third generation enzyme-linked immunosorbent assays. Fifty (27.8 percent) patients had active hepatitis B virus (HBV) infection while 33 (18.3 percent) tested positive for anti-HCV antibody. Of these infections, 110 (61.1 percent), 37 (20.6 percent), and 20 (11.1 percent) had HIV only, HBV/HIV-only, and HCV/HIV-only respectively. A HBV/HCV/HIV coinfection prevalence of 7.2 percent (13 patients) was recorded. Patients coinfected with HIV/HBV/HCV appeared to have lower CD4+ counts (mean = 107 cells/æl; AIDS defining) when compared to HBV/HIV-only (mean = 377 cells/æl), HCV/HIV-only (mean = 373 cells/æl) and patients with mono HIV infection (mean = 478 cells/æl). Coinfection with HBV or HCV is relatively common among HIV-infected patients in Nigeria and should be a big consideration in the initiation and choice of therapy.