Haematological and Immunological Parameters in Patients with Chronic Hepatitis B Infection in Zaria, Nigeria.

Hepatitis B virus (HBV) is one of the major causes of morbidity and mortality worldwide. The aim of this study was to determine the haematological and immunological parameters in patients with chronic HBV infection in Zaria, Nigeria. Twenty individuals with confirmed chronic HBV (CHB) infection constituted the subjects while 20 non-HBV-infected individuals were monitored as controls. The subjects were enrolled purposively from the Gastroenterology Clinic of the Ahmadu Bello University Teaching Hospital Shika, Zaria Nigeria. Four millilitres of blood samples were collected from each study participants. Full blood count was conducted using the Swelab Alfa Haematology Analyzer, while CD4+ T-Cell enumeration was performed using the Sysmex Partec CyFlow® Counter IVD flow cytometer according to the manufacturers' instruction. The mean (and standard deviation) age of the 20 participants with CHB was 32.7 (±10.1) years while that of the 20 HBV negative control participants was 30.0 (±7.8) years. Mann-Whitney test showed no significant difference between the two groups in their total WBC (p=0.6634) and granulocytes (p=0.2386). There was a significant increase in the monocytes count (p=0.0151) and a significant decrease in the lymphocytes count (p=0.0006) of patients with CHB compared to the healthy control. There was no significant difference in the mean CD4+ T-lymphocytes count between subjects and controls (p=0.0633). Unpaired Student t-test showed no significant difference between the two groups in the other haematological parameters. This study showed a significant increase in monocytes and decrease in lymphocytes, a phenomenon that characterize the sustenance of infection by immune evasion mechanism.

Seroprevalence of IgG antibodies to herpes simplex virus type-1 in Nigerian children.

BACKGROUND: Herpes simplex virus type-1 (HSV-1) can cause chronic ulcerative infection in immunosuppressed children leading to latency with subsequent reactivate in the conjunctiva resulting in scarring, thickening of the cornea and blindness. They are also common cause of fatal sporadic encephalitis in 70% of paediatric patients. This cross sectional study determined the prevalence of HSV-1 in children in Kaduna State, Nigeria. METHOD: A total of 377 blood samples were collected from children less than five years old attending some selected hospitals in Kaduna State and analyzed for HSV-1 IgG antibodies employing Enzyme immune assaytechnique by using commercially available ELISA Kits. RESULTS: Sero-prevalence rate of 57.8% (218/377) was obtained. The highest prevalence of HSV-1 infection was obtained in children in age group 49-60 months (85.2%) and lowest in children in age group 13-24 months (44.8%). Further analysis of the result of children less than one year old showed that children 9-16 weeks old were more susceptible to HSV-1 infection. HSV-1 infection was significantly associated with age (X2 = 37.92, df = 4, p = 0.001). Though a higher prevalence was obtained in female children (61.5%) than male children (54.5%), the difference observed in the prevalence was not statistically significant (X2 = 1.84, df = 1, P = 0.105). HSV-1 infection was significantly associated with children who were in school (X2 = 15.28, df = 1, P = 0.001) with a higher prevalence of 74.3%. CONCLUSION: Over half of the children sampled were protected from HSV-1 infection while 42.2% were susceptible to the infection and were at risk of developing severe HSV-1 manifestation which includes keratitis, encephalitis and Keratoconjunctivitis.

The frequency and outcome of neuropathies among HIV/AIDS adults treated at a tertiary hospital in Kaduna State, Nigeria.

AIMS AND OBJECTIVES: Highly active antiretroviral therapy (HAART) has been shown to reduce AIDS- defining illnesses, including neuropathies. However, it has been postulated that an increase in age -, HIV- and HAART- related neurological complications will occur as HIV-infected persons live longer. This study investigated the frequency and outcome of neuropathies in relation to CD4+ cell count and HAART status of hospitalised HIV/AIDS patients in Shika. PATIENTS AND METHODS: Consecutive adult (e"15 years) non pregnant HIV- infected patients treated at Ahmadu Bello University Teaching Hospital Shika-Zaria from January 2006 to May 2013 with neuropathies were studied. Non HIV-infected patients with neurological disorders and HIV-infected patients without neuropathies were excluded. RESULTS: Of 5240 HIV/AIDS patients seen , 11% (566) presented with neuropathy at median CD4+ cell counts of 200 cells / ul, with yearly reduction of the frequency of patients with neuropathy from 3.9% in 2006 to 0.06% in 2013. Male: female ratio was 2:1 and respective mean years were 41.9±10.1: 45.3±17.4 (p<0.00). 253 (45%) were on HAART at presentation. 40 patients died and the mortality was associated with recurrent seizures, CD4+ cell counts d" 100 / ul, male sex, HAART-naivety and presence of co-morbidity and complications. CONCLUSIONS: The progressive reduction in the yearly frequency of neuropathy among HIV/AIDS patients suggests a beneficial effect of HAART on neuropathies. However, late presentation, low CD4+ cell counts and failure of patients to start HAART early were responsible for AIDS-related mortality thus highlighting the importance of early HIV screening and treatment.

CD4+ and CD8+ lymphocytes and clinical features of HIV seropositive Nigerians on presentation.

Eighty of 200 HIV seropositive patients admitted in the medical wards of Ahmadu Bello University Teaching Hospital, Zaria from year 1995 to 1997 were studied on presentation and compared to 40 age and sex matched controls. The main clinical features observed included weight loss, pyrexia, diarrhoea, lymphadenopathy, anaemia and pruritic dermatosis. Sixty-two of the 80 patients (73.2%) presented at stages 3 and 4 of WHO Clinical and Laboratory staging. Thirty (30) percent of these patients died between a period of one to four months after presentation. The main diseases complicating HIV infection at presentation of the 80 patients were Mycobacterium tuberculosis infection (30%), acute bacterial infections (with Salmonella typhi, Streptococcus pneumoniae and Staphylococcus aureus) (24%), candidiasis (14%) and Kaposi sarcoma (2%). Seropositivity for HIV types was found to be HIV-I alone in 43.5% of cases; HIV-II alone in 14% and both HIV-I and II in 42% of cases. Risk factors associated with HIV infection were multiple sexual partners (73%), sexually transmitted disease (70%), and unscreened blood transfusion (1%). HIV positive patients had a mean CD4+ T-cells of 0.24 x 10(9) +/- 0.17 which was significantly lower than the mean of 0.6 +/- 0. 17 x 10(9)/L for controls (P < 0.05 students t-test). Thirty (35%) of the patients had CD4+ counts of less than 0.2 x 10(9)/L (200 cells/microl) at presentation. The mean CD3+ lymphocytes count was 0.51 +/- 0.24 x 10(9)/L for patients and 1.04 +/- 0.71 x 10(9)/L for controls. The mean CD8+ lymphocyte count in patients was 0.29 +/- 0.19 x 10(9)/L and 0.44 x 10(9)/L for controls. Both CD3+ and CD8+ lymphocyte populations were statistically lower in patients than controls (P < 0.05).