Prevalence of HIV, HBV and HCV Infections among Sickle Cell Disease Patients in Southwestern Nigeria: A Case-Control Study

Aim: This study was designed to determine the prevalence of HBV, HCV and HIV infections among individuals with Sickle Cell Disease (SCD) in Ibadan, southwestern Nigeria. Methodology: In this case-control study, 1017 patients with SCD and 1017 age and gender matched controls were enrolled from 6 health facilities and some communities in Ibadan, southwestern Nigeria. Blood samples were tested for the presence of HIV, HBV and HCV infections. Structured questionnaire was used to capture participants’ information and data analyzed using descriptive statistics, McNemar Chi-square/Fishers exact test. Results: Blood transfusion was significantly more common among SCD cases [566 (55.7%)] than controls [54 (5.3%)], while history of vaccination was higher in the control group (p = 0.001). The overall prevalence of HIV [2 (0.2%) vs 11 (1.1%)], HBV [58 (5.7) vs 66 (6.5%)] and HCV [10 (1.0) vs 22 (2.2%)] was lower among SCD cases than controls, respectively, although significantly different only in HCV infection (p = 0.048). All three infections were significantly higher in adults than in children. Co-infection was found only in four of the participants, all of whom were SCD patients. Conclusion: The prevalence of HIV, HBV and HCV infection among SCD patients indicates an improvement in the transfusion safety measures in the region. The prevalence of HBV and HCV found in this study is still relatively high when compared with reports from some other regions. There is a need for continued surveillance and subsidized cost of drugs for treatment of these infections, especially for SCD patients who already have a compromised immunity.

Hepatitis E Virus Infection in HIV Positive ART Naive and Experienced Individuals in Nigeria

Background: Studies have shown Hepatitis E Virus to be a causative agent of acute and chronic hepatitis in severely immunocompromised patients such as organ transplant recipients and person with HIV infection. This study was designed to determine the burden of HEV infection among HIV positive individuals in Nigeria and the effect of HIV treatment on the burden of HEV infection among this group of patients. Methods: Aliquot of plasma samples collected for laboratory investigations such as CD4 enumeration, blood chemistry (AST, ALT, Creatine, Urea) were used to determine the presence of HEV IgG and IgM antibodies using commercially available ELISA. Samples analysed in the study were collected from 180 HIV positive individuals (90 ART naive and 90 ART experienced) attending the ART clinic at the University College Hospital, Ibadan, Nigeria. Results: Twenty two of the 180 (12.2%) samples were positive for either HEV IgG (20/180) or IgM (2/180). The rate of HEV IgG was higher among ART naive individuals and the two IgM positive persons were ART naive. There was no significant difference in the mean CD4 count and mean ALT between HEV seronegative and seropositive individuals (P = 0.8 and 0.2 respectively). Conclusions: The results of this study suggest the need to test for HEV infection in HIV positive individuals for the early diagnosis and proper management since HEV is known to be fulminant in the presence of underlying liver disease that is common among HIV infected persons. In addition, the use of ART may reduce the incidence of HEV infection in HIV positive persons.

HIV Infection among Newly Diagnosed TB Patients in Southwestern Nigeria: A Multi-DOTS Center Study

Backgroud: The burden of TB and HIV infection is estimated to be about 512/100,000 and 3,000,000 people respectively. However, accurate data on TB/HIV co-morbidity in different parts of Nigeria were not available due to limited access to HIV Counseling and Testing (HCT) by individuals with TB infection. This study was designed to determine the true rate of HIV infection among newly diagnosed TB patients by providing comprehensive HCT services in 43 DOTS centers in Oyo State, Southwestern Nigeria. Methods: All patients meeting the case definition for TB suspects who presented at each of the 43 DOTS Centres were counselled and those who consented tested for presence of HIV antibodies using HIV 1/2 Determine, Unigold and Stat-Pak rapid test kits in a serial algorithm. Results: A total of 13,109 TB positive patients were enrolled for the study, out of which 1605 (12.3%) tested positive for HIV antibodies. HIV infection was higher among female (15.5%) than male (9.5%) TB patients (p 0.05). The rates also varied among the age groups, ranging from 4.3% in the 10 - 19 years to 18.0% in the 40 - 49 years age group. A relatively high rate (10.5%) of HIV infection was found among children less than ten years of age. Conclusion: The results of this work show the true burden of TB/HIV in any region in Nigeria for the first time. Higher rate of TB/HIV co-infection among female patients and children are significant and important factors that should be considered in the planning of intervention measures in Nigeria and other TB and HIV endemic countries in Africa.