Serum concentration of acute phase protein and lipid profile in HIV-1 seropositive patients and its relationship to the progression of the disease.

AIMS AND OBJECTIVES: To evaluate the effect of HIV-1 infection and its progression on lipid profiles, acute-phase proteins and to determine which of the parameters may serve as an early indicator of the progression of HIV infection. MATERIALS AND METHODS: A cross-sectional study was conducted on sixty-two HIV-1 infected subjects attending HIV clinic, the patients consisted of 29 males and 33 females aged between 20-60 years (mean age 31+/- 7 years) who were screened for HIV-1 by ELISA test. Absolute CD4+ T lymphocyte was counted and HIV infected individuals were classified according to the Centre for Disease Control and Prevention (CDC) Criteria; CD4+ counts e"500/mm3 (asymptomatic), CD4+ counts 200-499/mm3 (symptomatic) and CD4+ counts d"199/mm3 (symptomatic) with full blown AIDS. Serum concentrations of total protein, albumin, gamma globulin, acute-phase protein, and lipid profile were determined. RESULTS: There was significantly increased gamma globulin fraction of the serum protein in HIV patients with CD4+ counts of e"500/mm3, 200-499/mm3 and d"199/mm3 when compared with the controls. Serum triglyceride was significantly increased in HIV patients with CD4+ counts of d"199/mm3 only, whereas a significantly decreased serum HDL-cholesterol in HIV patients with CD4+ counts of 200-499/mm3 and d"199/mm3 was found when compared with the controls. Haptoglobin, C-reactive protein and a1-acid glycoprotein were significantly increased in HIV patients with CD4+ counts of 200-499/mm3 and d"199/mm3 when compared with the controls. However, albumin was significantly reduced in HIV patients with CD4+ counts of d"199/mm3 when compared with the controls. There was direct correlation between HDL-cholesterol and the CD4+ counts, on the other hand, an inverse correlation between C-reactive protein, haptoglobin and a1-acid glycoprotein against CD4+ counts was found. CONCLUSION: A decreased HDL-cholesterol had direct correlation with the CD4+ counts in all the stages of HIV infection; however, increased haptoglobin and C-reactive protein had inverse correlation with the CD4+ counts in all the stages of HIV infection. Therefore HDL-cholesterol, C-reactive protein and haptoglobin may serve as indicators of disease progression in HIV infection.

Tuberculosis treatment outcomes in State Hospital, Osogbo, southwestern Nigeria: a four year review.

BACKGROUND: A retrospective review of all cases of tuberculosis (TB) enrolled in the directly observed treatment-short course chemotherapy (DOT-SCC) between June 2000 and June 2004 at a General Hospital in Southwestern Nigeria was undertaken. The aim is to determine treatment outcomes and ascertain the effectiveness of the programme for TB control. METHODOLOGY: Case registers of all TB patients enrolled were reviewed and data obtained analyzed by statistical methods. RESULTS: A total of 879 TB patients (467 males, 412 females; M: F ratio 1.13:1) aged 1 to 80 years (mean age 33.0 +/- 14.0 years) were enrolled. The disease was pulmonary in 98.4% and extrapulmonary in 1.6%. Seven hundred and thirty four (83.6%) patients complied with the DOTS-SCC regimen, 127 (14.4%) defaulted while 18 (2%) transferred out. The overall treatment success rate was 76.3% while 3.8% had treatment failures. Outcome was not significantly affected by types of TB lesion (P = 0.1103), patient category (P = 0.4968), age (P = 0.7198), gender (P = 0.1726) or smear positivity (P = 0.5497). CONCLUSION: Although the currently advocated DOT-SCC regimen achieved a high success rate in this locality, it fell below the 85% recommended target. There is need to step up health education campaign on compliance with therapy and aggressively follow up defaulters to forestall the emergence of multidrug resistant M. tuberculosis.

Infant feeding and lactational amenorrhea in Sagamu, Nigeria.

Five hundred and twenty educated, breastfeeding women in Sagamu, Nigeria, were observed prospectively in order to describe their infant feeding practices and to determine whether any predictors of the return of menses could be identified. The women remained amenorrheic for seven months. Compared with similarly selected women in other countries, they regularly fed their infants with supplements from a very early age, yet breastfeeding frequency and duration did not decline dramatically. Semi-solid food was introduced at about four months and such supplementation, as well as earlier supplementation with milk/milk-based feedings, was associated with the return of menses. The median duration of abstinence was about four months but the mean may have been much longer. No woman became pregnant until her infant was weaned.