RESUMO
Aims: To determine the prevalence of HBV co-infection in HIV-infected children and compare the baseline laboratory profile of mono-infected and co-infected patients. Study Design: This was a retrospective cohort study. Place and Duration of Study: AIDS Prevention Initiative in Nigeria (APIN)-supported HIV clinic of Jos University Teaching Hospital, Jos, Nigeria between January 2008 and December 2012. Methodology: We reviewed the clinical records of 452 treatment-naïve children aged 2 months to 15 years confirmed to be HIV positive with Polymerase Chain Reaction (PCR) for children <18 months or Western blot for children ≥18 months. The baseline laboratory tests included: HBsAg, plasma viral load and alanine transaminase (ALT), CD4+T cell count for children ≥5years or CD4+T cell % for children <5years. Results: Three hundred and ninety-four (87.2%) were mono-infected with HIV while 58 (12.8%) were co-infected with HIV and HBV (HIV/HBV). At baseline, the median viral load was 4.6 log copies/mL for mono-infected compared to 4.7 log copies/mL for HIV/HBV (P=.48). The median CD4+T cell count was 366 cells/µL for mono-infected compared to 332 cells/µL for HIV/HBV (P=.64). The median CD4+T cell % was 19% for mono-infected compared to 17% for HIV/HBV (P =.29). The median ALT level for the whole cohort was 23 IU/L for mono-infected compared to 26 IU/L for HIV/HBV (P=.15). However the median ALT level for mono-infected children aged 11-15 years was 28IU/L compared to 43 IU/L for co-infected children of same age (P =.008). Conclusion: A high rate of hepatitis B co-infection was observed in HIV-infected children at our centre; however more severe HIV disease was not observed. Older children co-infected with HBV had significantly higher ALT levels compared to their mono-infected counterparts. Early detection is therefore necessary in order to develop an appropriate treatment plan for children co-infected with HIV and HBV.
RESUMO
Genetic diversity is the hallmark of HIV-1 infection. It differs among geographical regions throughout the world. This study was undertaken to identify the predominant HIV-1 subtypes among infected female sex workers (FSWs) in Nigeria. Methods: Two hundred and fifty FSWs from brothels in Ibadan Nigeria were screened for HIV antibody using ELISA. All reactive samples were further tested by the Western Blot Techniques. Peripheral Blood Mononuclear Cells (PBMCs) were separated from the blood samples of each subject. Fragments of HIV Proviral DNA was amplified and genetic subtypes of HIV-1 was determined by direct sequencing of the env and gag genes of the viral genome followed by phylogenetic analysis . Results: The age of the FSWs ranged from 15 to 55 years old (Mean = 25.8years; SD =3.74). Majority were Nigerians while others (1.6 ) were from neighboring West Africa countries. Four ( 1.6 ) of the FSWs were active for less than one year as sex workers; and the mean length of sex work was 2.80 years ( Range = 1.0 - 15.0 years ). Sixty-four (25.6) of the 250 CSWs were positive for HIV-1 while 7 (2-8) had dual infections to HIV-1 / HIV-2. Among the 34 HIV-1 strains characterized by sequencing; 19 (55-9) were subtype G; 9 (26.5) CRF02_A/G; 3 (8.8) CRF06_cpx while 1 (2.9) each were identified as subtype C; CRF01_A/E and CRF09_cpx respectively. Nineteen (55.9) of the FSWs with subtype G had been active in the sex work for between one to five years. The youngest of the HIV -1 infected FSWs with sexual activity of less than a year had subtype G strain. There is a significant probability that infection with this subtype occurred with a short incubation period (p 0.05). Conclusion: This study showed a wide range of HIV- 1 subtypes among FSWs in Nigeria. The situation poses serious challenge for the design of HIV vaccine candidate for use in Nigeria
Assuntos
HIV-1 , Feminino , Variação Genética , Infecções por HIV , Nigéria , Profissionais do SexoRESUMO
The Prevention of Mother to Child Transmission (PMTCT) programme in the University College Hospital (UCH); Ibadan has been in existence for more than five years and has scaled up to other sites. The study evaluated the service uptake and performance of the programme using national key indicators. Antenatal and delivery records of women enrolled between July 2002 and June 2007 were reviewed. A total of 51952 women attended first antenatal visits and received HIV pre-test counselling. Of these; 51614 (99.5) accepted HIV test and 49134 (95.2) returned for their results. Out of the tested patients; 2152 (4.2) were identified to be HIV positive. Partners of positive patients accepting HIV testing were 361(16.7) with 87 (18.6) testing positive. There were a total of 942 deliveries out of which 39.2of the mothers and 95.2of the babies respectively received ARV prophylaxis. In all; 85.8(788/918) of the mothers opted for formula as the method of infant feeding. Out of the 303 babies eligible for ELISA testing; 68.3reported for the test and 17(8.7) tested positive. There has been progress in the programme; reflected in the increase in the number of new clients accessing the PMTCT service. However; partner testing and follow up of mother-infant pairs remain formidable challenges that deserve special attention