Evaluation of HIV-1 P24 antigenemia in HIV seronegative antenatal attendees in two Nigerian hospitals

Pregnant women who a tended antenatal clinics in Asokoro District Hospital. Abuja in Northern Nigeria and Tnivcrsik of Calabar Peaching Hospital. Calabar in Southern Nigeria were recruited tor this study. The subjects were aged 20 years to 40 years old. Samples collected were analysed for P24 antigenemia using the method of Niel based on the principle of Enzyme linked Immunosorbent Assay [RL1SA]. Samples were screened for HIV antibodies using the ELISA technique of imrmmocomb test using the method of Epstein. Serology testing is the routine screening method for HIV in virtually all Nigerian health centers. Two hundred and twenty pregnant women selected for this study were tested sero-negative for HIV-1 antibodies while 30 that had been tested zero positive for HIV-1 antibodies were used as controls for P24 antigenemia testing. The 220 that were seronegative for HIV-1 antibodies were tested for P24 antifiens. Thirty two [14.5%] of the 220 subjects were positive for P24 antigenemia. Out of these 32. twenty three [23] were in the highly reproductive and sexually active age brackets of 20 years to 30 years. Expectedly. 26 [86.7%] of the 30 controls tested positive for P24 antigenemia. Subjects from polygamous marriages had a higher number of P24 anligenemia positivity than those from monogamous marriages [Table 4]. This implies that mother to child transmission of HIV infection is high in sexually active reproductive age bracket and in polygamous marriages. The latter could be due to multiple partnership involvement. Observation is that using HIV-1 serologic technique, there is about 1 in 10 ratio chance of a mother transmission of HIV to her unborn child since the window period is not covered by this technique. Although HIV antibody tests are the most appropriate, rapid and efficient means of detecting infection but P24 antigen assay is an alternative technology for diagnosing early infection before a level of detectable antibodies is reached. P24 antigen is detectable in a predictable manner between 14 to 29 days of infection. We conclude that HIV serologic test, which is used routinely and generally in most Nigerian health centers, is not enough to elucidate HIV serostatus of individuals, especially those who appear to be sero-negative Therefore introduction of P24 antigen assay, to cover greater part of the window period of the infection will not only protect the mother but also the unborn child