Prevalence of Hepatitis B Surface Antigen and Antibodies to Hepatitis C in the General Population of Benue State, Central Nigeria.

There have been various estimates of the prevalence of hepatitis B and C infections in Nigeria. Recent studies have shown the prevalence to be lower than previously reported. The different populations studied might be responsible for this. It is important to have a real population data that would inform the policies to be adopted for eradication. We set out to determine the prevalence, risk factors, and pattern of hepatitis B and C in Benue State, Central Nigeria. Four thousand and five (4,005) subjects, aged 1 year and older, were selected through a multistage random sampling to represent all parts of the state. Trained health workers administered a validated questionnaire. Rapid test kits were standardized and used in determining the prevalence of the respective viruses. Hepatitis B surface antigen (HBsAg) and antibodies to hepatitis C virus (anti-HCV) were found to be positive in 5% and 1%, respectively, of subjects screened. The prevalence varied from one local government area to another, with HBsAg being 8% in the highest to 2% in the lowest LGC, and anti-HCV being 3% in the highest and 0% in the lowest. Age, previous close contact with a patient, and multiple sex partners were the most important risk factors for hepatitis B virus (HBV) infection, whereas age and previous blood transfusion were the most important risk factors for hepatitis C virus (HCV) infection. HBV immunization may be having an impact in reducing the prevalence of the virus. Nigeria appears to be moving from high endemicity to the intermediate one.

A plausible causal link between antiretroviral therapy and increased blood pressure in a sub-Saharan African setting: A propensity score-matched analysis.

BACKGROUND: The transition from association to causation could represent a fundamental step for taking preventive action against hypertension and its complications, especially among HIV-infected persons on antiretroviral therapy in sub-Saharan African countries. METHODS: 406 consecutive HIV-infected adults attending a tertiary HIV clinic in semi-urban Nigeria were prospectively recruited between August and November 2014. These participants were stratified by antiretroviral treatment status. A propensity score matching model was fitted to examine the causal average treatment effects on the treated (ATT) of antiretroviral therapy on blood pressure. Propensity score matching entailed using nearest neighbour matching with a calliper width of 0.2 to achieve similarity in the baseline characteristics between participants naïve and exposed to antiretroviral therapy. RESULTS: Matching HIV-infected patients naïve and exposed to antiretroviral therapy on the propensity score yielded a total of 303 participants - 229 antiretroviral-exposed and 74 antiretroviral-naïve - matched without any residual differences in the baseline characteristics between both groups of patients. In this propensity score-matched sample, the estimated ATT for the effects of antiretroviral therapy on systolic (7.85mmHg, 95% CI 3.72 to 15.68) and diastolic blood pressure (7.45mmHg, 95% CI 4.99 to 13.61) were statistically significant (P<0.001 for each). CONCLUSIONS: There is a high probability that the epidemiological association between antiretroviral therapy and increased blood pressure be causal in nature among people living with HIV in sub-Saharan African settings. HIV-infected patients commencing antiretroviral treatment in these settings may require regular hypertension screening and other cardiovascular risk assessments.

Pattern of glomerular filtration rate abnormalities in type 2 diabetes mellitus in Jos, Nigeria.

BACKGROUND: Diabetes mellitus is one of the leading causes of end- stage renal disease in Nigeria. OBJECTIVES: To describe the pattern of glomerular filtration rate abnormalities and its clinical correlates in Nigerians with type 2 diabetes mellitus. METHODS: Glomerular filtration rate as determined by the endogenous creatinine clearance was measured in 90 patients with type 2 diabetes mellitus and 60 controls at the Jos University Teaching Hospital, Jos. RESULTS: Twelve subjects (13.3% ) in the diabetic group had hyperfiltration (GFR > 125 ml/min) compared to 3 (5% ) in the control group, although the mean glomerular filtration rates were similar in the two groups (96.19 +/- 29.14 ml/min and 88.38 +/- 24.13 ml/min respectively, p > 0.05). All the subjects with hyperfiltration had been diabetic for less than 5 years. Only one of the diabetics had renal insufficiency (GFR < 50 ml/min). CONCLUSIONS: This study demonstrates that hyperfiltration is common in patients with type 2 diabetes mellitus and that it occurs early in the course of the disease.