Anaemia and its response to treatment with recombinant human erythropoietin in chronic kidney disease patients.

BACKGROUND: The introduction of erythropoietin has transformed the management of anaemia in CKD, with considerable benefits which includes enhanced quality of life, increased exercise capacity and improved cardiac function. There is paucity of data on the beneficial effects of this treatment from this environment. OBJECTIVE: The aim of this work was to study the pattern and response of anaemia and its response to treatment with recombinant human erythropoietin(r-HuEpo) in CKD patients in Nigeria. METHODS: This was a prospective study in which 20 CKD patients who satisfied the inclusion criteria were recruited consecutively. Subcutaneous r-HuEpo was administered to each of the study patients, starting with a weekly dose of 50 iu per kg and titrated according to haemoglobin (Hb) response, which was monitored fortnightly throughout the study period with the aim of achieving a target Hb of 11g per dl. RESULTS: The patients studied were anaemic with mean Hb of 7.36(1.05) g/dl. The anemia was normocytic normochromic in 85% of the patients. All the patients responded to treatment with r-HuEpo with the mean Hb rising from 6.74(0.70)g per dl to 11.64(0.37) g/dl and 7.64(1.19) to 11.98(0.45) g/dl in those on maintenance haemodialysis and pre-dialysis patients respectively. The patients reached the target Hb of 11g/dl within 8 weeks in predialytic CKD patients and within 10 weeks in those on maintenance haemodialysis. CONCLUSION: Anaemia is mostly normocytic normochromic in CKD patients in our environment and r-HuEpo therapy is effective in correcting the anaemia.

Human immunodeficiency virus and hepatitis B virus co-infection among patients in Kano Nigeria.

BACKGROUND: Human immunodeficiency virus and hepatitis B virus are widespread in the developing countries and patients with dual infection of HIV and HBV are increasingly being diagnosed among hospital patients. Reports have indicated that hepatitis will contribute significantly to morbidity and mortality in HIV infected patients because of increased use and accessibility of highly active antiretroviral therapy (HAART). The objective of this study is to determine the prevalence of HIV and HBV co-infection in patients in Kano Nigeria and to highlight the reciprocal interactions between the HIVand HBV. METHODS: Three hundred patients consisting of 152 males and 148 females were recruited into the study at the Aminu Kano Teaching Hospital Kano, Nigeria between February 2002 and March 2003. RESULTS: Out of a total of three hundred HIV positive patients, two hundred and eleven (70.3%) were HBV positive. Of the 152 males that are HIV positive, 102 (67.1%) were HBVpositive while out of 148 females that are HIVpositive, 109 (73.6%) were HBV positive. CONCLUSION: A co-infection rate of 70.5% was observed in this study. Since HIV infected patients with HBV co-infection respond less to HAART additional concern and care must be taken in order to minimize the complications associated with the increasing use of HAART The testing of HIV positive patients for HBV will help in the choice of therapy in these patients's.