The seroprevalence of hepatitis C virus antibodies among transfused patients with haematological disorders.

AIMS AND OBJECTIVES: This study was undertaken to determine the prevalence of hepatitis C virus antibodies (anti- HCV) among transfused patients with haematological disorders. and correlate this with the units of blood or blood products received PATIENTS AND METHODS: This was a cross sectional study. Patients with haematological disorders who had received two or more units of blood or blood products and healthy blood donors who had not received blood transfusion were screened for ant-HCV using Enzyme Linked Immunosorbent Assay (ELISA) kits. RESULTS: A total of 480 subjects comprising 146 patients with haematological disorders and 334 blood donor controls were recruited for this study. The patients comprised 78 (53.4%) males and 68 (46.6%) females with age range from 14-65 years and a mean of 39.5. The prevalence of anti-HCV was 6 (4.1%) among transfused patients and 7 (2.1%) among untransfused blood donors. The risk of anti- HCV positivity among patients was higher with increasing units of received blood or blood products. A significant statistical association was observed between the number of pints of blood or blood products received and anti-HCV positivity among patients p=0.008 CONCLUSION: This study suggests that patients who had received blood or blood products are at higher risk of HCV infection than the untransfused individuals. The risk of infection is higher with increasing units of blood or blood products received by transfused patients.

Current sickle cell disease management practices in Nigeria.

BACKGROUND: Although Nigeria has the highest burden of sickle cell disease (SCD) worldwide, there is still variable and poor utilisation of standard-of-care practices for SCD patients in the country. METHODS: This was a questionnaire survey of doctors in some dedicated SCD clinics in Nigeria in order to document the facilities available and common management practices. RESULTS: There were responses from 18 clinics based in 11 institutions. The number of patients being followed in each centre ranged from 15 to approximately 11 000. All clinics provided malaria prophylaxis and folic acid routinely to their patients. Only eight clinics prescribe penicillin prophylaxis. Eight prescribe hydroxyurea to patients who can afford it when indicated. All of the centres except three have electronic cell counters, but all had access to haemoglobin electrophoresis. Three had high-performance liquid chromatography machines installed but none was being routinely used. One institution had a functioning molecular biology laboratory. There is no official newborn screening programme in the country. All had access to microbiology and chemistry laboratories. Nine institutions had CT, six had MRI and three had transcranial Doppler facilities. CONCLUSION: The care available for SCD in Nigeria is still suboptimal and there is an urgent need for concerted effort to tackle the problem, but to make a significant impact on the burden of the disease would require more focus at the primary care level. Some steps to achieving this are outlined.

Seropositive status disclosure to partners and safer sexual behaviours among people living with HIV: An issue in prevention and treatment.

AIMS AND OBJECTIVES: The objective of this study was to determine the rate of disclosure to sexual partners and consequent safer sexual practices among people living with HIV (PLHIV). MATERIALS AND METHODS: This was a cross-sectional study. A semi-structured interviewer administered questionnaire was used to collect demographic data of age, gender, marital status as well as HIV status disclosureand consistent condom use. This information was collected from consenting consecutive antiretroviral-therapynaive PLHIV accessing care at the Lagos State University Teaching Hospital (LASUTH), southwest Nigeria. Collected data were analysed using statistical package for social sciences (version 10.0, spss) and group comparisons were done with chi square tests. RESULTS: A total of 443 respondents were interviewed. The age of the respondents ranged from 18 to 75 years with a mean of 46.5±9. Majority 268 (60.5%) of respondents were females while 175 (39.5%) were males. The disclosure rate to sexual partners was 43 (9.7%) among studied PLHIV. Consistent condom use was highest (12.7%) among PLHIV who had disclosed to sexual partners while inconsistent use was highest (93.3%) among the undisclosed.p=0.26 CONCLUSION: This study reveals that there is a low sexual partner disclosure rate among studied PLHIV. Seropositive status disclosure to sexual partners was associated with consistent condom use.

Condom use among antiretroviral therapy naive people living with HIV at a tertiary health care hospital in Lagos, Nigeria: implication for prevention of new infections.

BACKGROUND: The consistent use of male latex condom significantly reduces the risk of HIV infection among men and women. OBJECTIVE: This study was designed to assess the prevalence and pattern of male and female condom use among antiretroviral therapy naïve people living with HIV (PLHIV) in Lagos, Nigeria. METHODS: This was a cross-sectional descriptive study. Interviewer administered questionnaires were used to collect demographic data of age, gender, marital status, rate, pattern of and reasons for not using condoms among PLHIV. RESULTS: Four hundred and forty three respondents were interviewed with age rangefrom 14 to 75 years and a mean of 35 ± 9 years. There were 175 (39.5%) males and 268 (60.5%) females in the study. Overall, 71 (16.0%) of respondents used condom consistently. Only 55 (12.4%) of the respondents were aware of female condom while 9 (2%) used it. CONCLUSION: This study reveals that there is a low consistent use of male condoms and a very low awareness and use of female condoms among studied PLHIV.

Risk factors and seroprevalence of hepatitis C virus antibody among blood donors in Lagos.

AIMS AND OBJECTIVES: This study was undertaken (i) to determine the seroprevalence of antibodies to Hepatitis C virus (anti -HCV) among blood donors (ii) to document the incidence of known risk factors for HCV infection among blood donors. PATIENTS AND METHODS: This is a cross sectional prospective study among apparently normal blood donors. Subjects were recruited from three different hospitals in Lagos metropolis. All recruited donors were evaluated for HCV infection- associated risk factors by questionnaire interviews. Sera samples from recruited donors were tested for anti-HCV using third generation Murex (Murex Biotech, South Africa) and fourth generation Dialab Enzyme Linked Immunosorbent Assay (ELISA) kits (Dialab. Austria). RESULTS: A total of three hundred and thirty four blood donors were screened, of which seven (2.1 %) were positive for anti-HCV. The blood donors comprised 15 (4.5 %) females and 319 (95.5 %) males. There was an association between anti-HCV positivity and history of multiple sex partners and previous sexually transmitted infections (X2-15.9; p < 0.05) Majority of blood donors were family replacement 317 (94.9 %) with anti-HCV prevalence of 2.2 % (7/317) while 5.1 % (17/334) were voluntary non remunerated with anti-HCV prevalence of 0% (p >0.05) CONCLUSION: Prevalence of anti-HCV among blood donors in Lagos (2.1%) is low as in most previous reports from Nigeria and some other parts of Africa.

Hepatitis C virus co infection in HIV positive patients.

BACKGROUND: Hepatitis C virus (HCV) co infection is reported common in HIV positive individuals and also responsible for increasing morbidity and mortality among them. OBJECTIVE: This study was undertaken to determine the prevalence of antibodies to HCV (anti- HCV) among HIV positive patients. METHODS: This cross sectional study was carried out among HIV positive patients and HIV negative blood donors. HIV infection was diagnosed in patients using Determine HIV- 1/2 rapid kits and Elisa based immunocombfirm, while Dialab Elisa kits were used for screening blood donors for HIV and also assaying anti HCV in all subjects. RESULTS: Anti-HCV was detected in 14.7% of patients and 1.1% of HIV negative blood donors. HIV/HCV co-infection rate was highest in the 30-39 years age group (P > 0.05). CONCLUSION: Findings demonstrate a high prevalence with 13 fold higher risk of HCV co infection among HIV-positive patients.

Seroepidemiology of hepatitis-B surface antigenaemia in HIV positive patients.

BACKGROUND: Hepatitis B virus (HBV) co-infection with HIV is a potential and significant cause of mortality and morbidity in HIV-positive patients. OBJECTIVE: This study was undertaken to determine the prevalence of hepatitis B surface antigen (HBsAg) among HIV positive patients and to identify the risk groups for HIV/ HBV co-infection among these patients. METHODS: The diagnosis of HIV infection was made using Determine register mark or target rapid screening kits and reactive samples were confirmed by enzyme linked immunosorbent assay (ELISA). The marker for HBV was HBsAg which was detected using an ELISA technique. RESULTS: HBsAg was repeatedly detected in 29 (28.4%) of HIV-positive patients. Ninety-eight percent of the subjects were confirmed positive for HIV-1 and 1.9%for HIV-2. There were 32(31.4%) males and 70(68.6%) females aged 20 to 75 years (mean+/-SD: 40+/-11.7) .HIV/ HBV co-infection rate was highest in the age group 31-40 years.More males [12 (37.58%)] than female subjects 17/70 (24.3%) were HIV/HBV co-infected, (p>0.05). CONCLUSION: There is a high prevalence of HBsAg in HIV positive patients.

Seroepidemiology of Hepatitis-B Surface Antigenaemia in HIV Positive Patients

BACKGROUND: Hepatitis B virus (HBV) co-infection with HIV is a potential and significant cause of mortality and morbidity in HIV-positive patients. OBJECTIVE: This study was undertaken to determine the prevalence of hepatitis B surface antigen (HBsAg) among HIV positive patients and to identify the risk groups for HIV/ HBV co-infection among these patients. METHODS: The diagnosis of HIV infection was made using Determiner rapid screening kits and reactive samples were confirmed by enzyme linked immunosorbent assay (ELISA). The marker for HBV was HBsAg which was detected using an ELISA technique. RESULTS: HBsAg was repeatedly detected in 29 (28.4) of HIV-positive patients. Ninety-eight percent of the subjects were confirmed positive for HIV-1 and 1.9for HIV-2. There were 32(31.4) males and 70(68.6) females aged 20 to 75 years (mean +SD: 40+.11.7) .HIV/ HBV co-infection rate was highest in the age group 31-40 years.More males [12 (37.58)] than female subjects 17/70 (24.3) were HIV/HBV co-infected; (p 0.05). CONCLUSION: There is a high prevalence of HBsAg in HIV positive patients

Primary lymphoma of the testis in remission for more than ten years: a case report.

BACKGROUND: Primary testicular lymphoma is a unique, rare and aggressive extra nodal non-Hodgkins Lymphoma (NHL). It is the most common testicular tumour in males between 60 and 80 years old OBJECTIVE: To report a case of primary testicular lymphoma in a young man who has done very well on surgery and chemotherapy. METHODS: The patient a Nigerian male civil servant who was single and aged 31 years presented to us with a history of a progressive painful right scrotal swelling of two years duration and associated painful right groin swelling for one year. A working diagnosis of right hydrocele with differential diagnosis of lymphangioma was made. Investigations were essentially normal and patient was scheduled for hydrocelectomy but findings at operations were different. RESULTS: At surgery, there was grossly enlarged hard right testis with thickened spermatic cord. Right radical inguinal orchidectomy with excision of the right spermatic cord and a regional lymph node was carried out. Histology revealed intermediate grade nodular NHL of the right testis. He was treated with systemic combination chemotherapy and has since been in complete remission for over 10 years. CONCLUSION: Primary testicular lymphoma is a rare and unique neoplasm of the testis and is most commonly seen in men over the age of 60, but should be considered in the differential diagnosis of testicular tumours in younger age groups. It is curable in early stage with appropriate multimodalities of management.