Human Immunodeficiency Virus Positive Subjects Research Articles

Evaluation of Thyroid and Lipid Profile of Hiv Patients Seen in a Faith-Based Health Facility in Anambra State, Nigeria

Background: Human Immunodeficiency Virus (HIV) and thyroid function have been described. Prevalence pattern and atherogenic status significantly differ from HIV-negative control in several studies. Unfortunately, few studies have determined the prevalence of thyroid function and lipids among Nigerians living with HIV. Objective: This study is to evaluate thyroid hormones and lipid profiles in HIV-positive subjects attending a faith-based health facility in Anambra State Nigeria. Materials and methods: The serum concentration of Thyroid Stimulating Hormone (TSH), free Triiodothyronine (fT3), triiodothyronine (T3), free Thyroxine (fT4), Thyroxine (T4), Total Cholesterol [TC], Triglyceride [TG], High-Density Lipoprotein [HDL], Low-Density Lipoprotein [LDL] and Very Low-Density Lipoprotein [VLDL] was determined in 95 HIV positive subjects which include 48 patients who were on HAART- group 1 and 47 not on HAART- group 2; and compared to 30 HIV negative controls – group 3. Results: The level of TSH and fT3 was significantly (p < 0.05) higher in group 1 participants than in group 2 and the group 3 participants. The level of T4 was significantly higher in group 2 than in group 1 and group 3 participants. The level of T3 was significantly lower in Control participants in comparison to both HAART and non-HAART participants. The prevalence of fT4 dysfunction across the groups was significantly different from each other. The total mean of Cholesterol (163.5 ± 22.7), Triglyceride (163.5 ± 22.7), and Very Low-Density Lipoprotein (14.2 ± 2.4) of the HIV-positive participants were significantly (p < 0.05) lower than that of the HIV negative participants. Conclusion: The results obtained from this study indicate that serum levels of thyroid hormones may be used as baseline periodic markers during antiretroviral therapy and many people living with HIV may benefit from supplementation if appropriate.

Evaluation of Serum Cytokines Biomakers in HIV-Infected Subjects Before and After Commencement of Haart in Federal Teaching Hospital Gombe

The Human Immunodeficiency Virus (HIV) infection causes the acquired immunodeficiency syndrome (AIDS), which is a systemic disorder characterized by severe impairment and progressive damage of both cellular and humoral immune responses. The aim of this study is to evaluate the effect of long administration of HAART on haematological indices, immunological biomarkers, Biochemical and some cytokines in HIV infected subjects   at federal teaching hospital Gombe.  This is a cross sectional study carried out from May to December 2021 on 132 HIV infected adults. The design entails collecting pre and post blood sample after treatment with highly anti-retroviral treatment (HAART) for more than six months. Out of the 132 subjects studied, 66 were HIV sero-positive and these were the test group, while the remaining 66 were HIV Sero-negative drawn from client visiting blood bank of FTH Gombe to make voluntary donation and HIV Testing Unit (HTS) for Marital and Medical Certificate of Fitness Screening and served as control group. All the subjects were between the ages of 15 - 65 years and are aged matched with the control group. Demographic data was collected using structured questionnaire.  The protocol entails collecting 9mls of venous blood from those who were seropositive for HIV 1 &2 before commencement of HAART. This sample is designed pre- treatment sample and these individuals were followed up for 6 months and a second sample collection was done some were lost to follow up and so the attrition was compensated by also collecting blood samples from other HIV individual who had been on HAART for several years. 4ml was dispensed into EDTA bottle for Full blood count using ELIZA analyzer. P<0.05 was considered as significant.The result of the analysis indicated that the mean±se of Interleukines-2 (IL-2) (pg/ml) and Interleukines -6 (IL-6) (pg/ml) parameters for the control group are 65.43 ± 3.37and 34.74 ± 1.20 respectively. The mean±se of the treatment naïve for IL-2 and IL-6 are 101.61 ± 16.47 and 14.63 ± 1.65 respectively. Also, the mean±se of the treatment/HAART for Interleukines-2 (IL-2) (pg/ml) and Interleukines -6 (IL-6) (pg/ml) are 67.43 ± 1.40 and 10.80 ± 0.45 respectively. The IL-2 significantly higher among treatment Naïve HIV infected participants when compared with treatment and control group with (p-value < 0.05). The result is also shown in table 2.0 Above.From this work it is clear that all the cases in this regard, confirm the fact that Long-term HAART remarkably drops the viral load and inflammation in HIV positive  subjects and shows  that  a  low-level  inflammation  continues  which probably leads to  chronic inflammatory  state, morbidity  and mortality in this group of subjects among HIV positive patients in this part of Northern Nigeria despite the reported side effects

Prevalence of tuberculosis among HIV positive patients on anti-retroviral therapy with special emphasis on pattern of adverse events of first-line anti-tubercular drug

Background: Survival rates have been improved with concomitant use of anti-tubercular drugs in HIV subjects with tuberculosis. The use of anti-tubercular drugs combined with ART can lead to more drug interactions, non-compliance, toxicity, and adverse effects. Aim: To assess the pattern, severity, and prevalence of adverse drug reactions of first-line anti-tubercular drugs in HIV (Human Immunodeficiency Virus) positive subjects with tuberculosis. Methods: The present prospective, observational study included 391 subjects out of 19522 subjects who were diagnosed HIV Positive and scheduled for Anti-Retroviral therapy at the ART Centre. 102 subjects were enrolled as tuberculosis confirmation of HIV-TB Co-Infection disease during the study period. All the subjects were evaluated for adverse drug events including blurred vision, jaundice, neuropathy, skin infection, itching, blood urea, hepatotoxicity, tingling, numbness, pain, pancreatitis, diarrhea, skin rashes, and anemia. Results: The most prevalent side-effect noted was neuropathy reported in 26.13% (n=10) study participants followed by skin rashes reported in 21.05% (n=8) study subjects. Jaundice, vomiting, and body weakness were all reported in 15.78% (n=6) of study subjects each. Diarrhea, headache, hepatotoxicity, insomnia, mental confusion, and anorexia were all reported in 10.52% (n=4) of study participants each.

Single nucleotide polymorphisms in the V3 region of glycoprotein 120 among Human immunodeficiency Virus positive subjects in Nigeria.

Single nucleotide polymorphisms in the V3 region of glycoprotein 120 among Human immunodeficiency Virus positive subjects in Nigeria.

Evaluation of Activated Partial Thromboplastin Time and Prothrombin Time in HIV and TB Patients in Owerri Metropolis

Background: Human immunodeficiency Virus (HIV) and Tuberculosis (TB) are the leading infectious diseases with high morbidity and mortality in the developing countries; it has been known to be associated with some coagulation abnormalities especially as the disease progresses.
 Aim: The study aimed at evaluating the effect of HIV- Tuberculosis co- infection on some haemostatic parameters (APTT & PT). It was carried out at Federal Medical Centre Owerri, Imo state.
 Materials and Methods: Sixty (60) subjects were sampled comprising fifteen (15) HIV positive subjects, fifteen (15) TB positive subjects, fifteen (15) HIV-TB co-infected subjects and fifteen (15) HIV and TB negative subjects (Control). Activated Partial Thromboplastin Time (APTT) and Prothrombin Time (PT) were analyzed using standard techniques.
 Results: The results showed that HIV positive subjects showed a significant values of PT (15.45±1.44sec, P < 0.05) when compared with control subjects (12.45 + 1.23) and a non-statistically significant values of Activated Partial Thromboplastin Time (APTT) (33.33± 6.27sec, P > 0.05) when compared with the control subjects (29.05+2.19). TB subjects showed statistical significant values of PT (15.84±0.98scc, P < 0.05) when compared with control subjects (12.45 + 1.23) and non- statistical significant values of APTT (33.55+5.26 sec P > 0.05) when compared with the control subjects (29.05+2.19 sec). Both the PT and APTT of HIV- tuberculosis Co-infected subjects showed significant values (17.03±1.46sec; 37.59±4.69sec, P < 0.05) compared with the control subjects (12.45+ 1.23sec; 29.05+2.19). One way analysis of variance showed no significant difference of a PT of TB patient (15.84+0.98) compared to PT of HIV patients (15.45+1.44 sec). PT of HIV- TB co-infected subjects higher values (P< 0.05) when compared with HIV patients but not significantly (P> 0.05) higher than compared with TB patients. Also there is a significant increase in APTT of TB patients (P<0.05) when compared with HIV patients. APTT of HIV-TB Co-¬infected subjects were not significantly elevated when compared with HIV and TB patients (P> 0.05).
 Conclusion: HIV infections have been shown to affect both the Activated partial thromboplastin time and prothrombin time. There is significant alteration in coagulation parameters (particularly PT and APTT) on tuberculosis, lesions as a result of the mycobacterial infection can induce pro- coagulant tissue factor expression which can lead to coagulation defects.

Cardiovascular Diseases Associated Inflammatory Biomarker Levels in a Small Cohort of HIV-1 Infected Patients Deintensificated from Abacavir/Lamivudine/ Dolutegravir to Lamivudine Plus Dolutegravir Running Head: Risk of Cardiovascular Diseases and Abacavir Use

Following the successful introduction of combined Antiretroviral Therapy (cART), a dramatic decrease in viral burden and opportunistic infections along with a consistent increase in life expectancy has been observed in Human Immunodeficiency Virus (HIV) infected patients [1]. This deep change in the HIV disease evolution has determined that HIV positive subjects were effectively monitored for several alterations of many tissue and organs due to HIV chronic disease and antiretroviral treatment for example, cardiovascular system, bone, adipose tissues, kidney and central nervous system represent the major target of these structural and functional damages during HIV infection. In particular, Cardiovascular Diseases (CVD) were considered important clinical complications in the HIV patient and represent a leading cause of death among HIV-positive patients, accounting for approximately 11% of the total deaths in this population [2]; the risk of CVD is higher in HIV positive individuals compared with HIV negative people, and particularly the reported Myocardial Infarction (MI) incidence in cohort study ranges from 3 to 11 cases per 1000 patients a year in HIV- positive individuals against 2 to 7 cases per 1000 patients-years in HIV-negative population [3,4]. Although initial studies indicated a higher prevalence of traditional CVD risk factors in HIV infected population [5,6] as a possible cause, the molecular mechanisms of increased CVD risk in HIV still remain incompletely defined and should be probably attributable to a combination of multiple factors, including both direct and indirect effects of HIV infection on metabolism. Evidence from experimental and observational studies [7,8] in recent years suggested a more important role of HIV itself in contributing to CVD. Endothelial dysfunction due to gp120, Tat and Nef proteins have been identified as a critical link between infection, inflammation, immune activation, atherosclerosis and cardiovascular system. Moreover, ART may play a role in the exacerbation of risk factors for CVD [9]; since the presentation of findings from the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study in 2008 demonstrating a 90% increased risk of MI in HIV- positive individuals receiving ART regimens including Abacavir (ABC), subsequent studies, conducted by FDA [10], GlaxoSmithKline [11] and independent researchers [12], to investigate this risk have yielded conflicting results. Although more recent studies have shown an effective increased risk of CVD associated with use of ABC, many results did not reach statistical significance [13-17]. The absence of a demonstrated underlying biological mechanism for such a risk added interest and confusion about the question, as well as the higher prevalence of risk factors for CVD, such as renal impairment and substance abuse among abacavir recipients; in addition, a recent meta analysis suggests that Relative Risk (RR) for MI is increased within a 6 months exposure to ABC (RR=1.61; 95% confidence interval: 1.48–1.75) and in cART-naive population [18]. While the published evidence remains conflicting and a plausible biological mechanism for this potential association has not yet been identified, in the following study we have tried to verify whether, after introduction of ABC and its discontinuation in the contest of HAART deintensification, common metabolic markers CVD related such as glucose, LDL, HDL, total cholesterol and triglycerides and inflammatory biomarkers such as IL-6 and D-dimer could change in a small cohort of HIV-1 infected patients.

Interleukin 3 as an Erythropoietic Marker in Human Immunodeficiency Virus and Hepatitis B Positive Patients in South East Nigeria

Aim: To evaluate the interleukin 3 levels in some Hepatitis B virus and Human immunodeficiency virus (HIV) positive subjects.
 Study Design: Cross sectional study.
 Place and Duration of Study: Haematology Department, University of Nigeria Teaching Hospital Enugu, Nigeria, between June and September, 2019.
 Methodology: A total of 86 subjects were recruited for this study; 40 were positive for the human immunodeficiency virus, 30 were Hepatitis B positive and 16 healthy subjects that served as controls. The controls had tested negative to Hepatitis B Virus, Human immunodeficiency Virus and hepatitis C virus infections. Whole blood samples were collected from the Human immunodeficiency Virus positive and control samples. Haemoglobin concentration was analysed using the Orphěe Mythic 22 automated analyzer. Serum samples collected from all 86 subjects were used to assay Interleukin 3 using the Enzyme Linked Immunosorbent assay based Finetest human interleukin 3 kit.
 Results: A highly significant decrease in interleukin 3 levels was observed in Hepatitis B Virus and Human immunodeficiency virus positive subjects when compared with the apparently healthy control subjects, (P = 0.000 < 0.05). Average hemoglobin levels were also lower in the Human immunodeficiency virus subjects compared with the controls.
 Conclusion: A reduction of the interleukin 3 may be part of the synergistic factors responsible for the anaemia usually seen in the viral infections.

Opportunistic Intestinal Protozoan Infections and Immunological Status of HIV/AIDS Patients in Jalingo Local Government, Taraba State

The Human Immunodeficiency Virus (HIV) is a virus that attacks the immune system. Opportunistic intestinal protozoans are among the major contributors to the global intestinal parasite load. This study investigated the danger and complication due to intestinal protozoans’ infection among HIV/AIDS patients in Jalingo metropolis. The study also compared the prevalence of opportunistic intestinal protozoa infection and CD⁴⁺ T-Cell count between HIV/AIDS and non HIV patients. The procedure of wet mount technique and faecal concentration methods were employed. The CD⁴⁺ count of patients were determined using the Partee Cyflow Counter, which determines the percentage of CD⁴⁺ cells of individuals. The prevalence of opportunic intestinal protozoan parasites was higher among female positives, 68 (l9.60%) than the male, 50 (16.50%) with no significant difference (p>0.05). The infection based on age groups revealed that the age group 10-15 years had the highest prevalence of 27 (48.21%) while the age group 41-45 years had the least prevalence of 2 (2.63%). The prevalence of intestinal parasites was highly significant among the study participants with CD⁴⁺ count <200 cells/μl. <i>Cryptosporidium spp</i> was significantly associated with HIV positive subjects who had CD⁴⁺ count of less than 200 cell/μl. The prevalence of intestinal parasites was highly significant among the study participants with CD⁴⁺ count <200 cells/ul. The implications of these findings are discussed and solution proposed to curb opportunistic infections among HIV/AIDS patients.

Cryptococcus neoformans seropositivity and some haematological parameters in HIV seropositive subjects

BackgroundCryptococcus neoformans is an opportunistic fungal pathogen that causes meningitis worldwide and may be fatal in immunocompromised subjects. In Nigeria, cases have been reported with prevalence between 4 and 13.1% in Human Immunodeficiency virus (HIV) patients depending on the study subjects. This study was designed to assess the prevalence of cryptococcosis, CD4+T cell counts and possible effect on haematological parameters in HIV seropositive subject in Nnewi, South-Eastern Nigeria. MethodA total of four hundred and twenty-nine (429) subjects were recruited for the study. Of these, two hundred and ninety (290) were HIV positive and one hundred and thirty-nine (139) were HIV seronegative subjects recruited from the voluntary counseling and testing (VCT) unit and HIV care clinic at Nnamdi Azikiwe University Teaching Hospital Nnewi, Anambra State, Nigeria. Their ages were between 18–80 years. One hundred and thirty nine (139) apparently healthy HIV seronegative subjects were recruited as controls. Blood samples were taken for C. neoformans by Antigen lateral flow assay (CrAgLFA), HIV testing, CD4+T cell, platelet and Full blood count (FBC). ResultsOur results show that of the two hundred and ninety (290) who were HIV positive subjects investigated for cryptococcosis, 4 (1.4%) tested positive for CrAg of whom 1(25%) were male and 3(75%) were female. All those with cryptococcosis had their CD4 count below 200 cells/μL, three of them were on ART and one was not. There were significant differences in the CD4 counts (P<0.05) between those infected and not infected with C. neoformans. None of the control group tested positive to cryptococcosis. ConclusionWidespread use of anti-retroviral therapy may have reduced C. neoformans infection. However, the threat remains and there may be a possibility that women may be a more vulnerable population.

Prevalence of Intestinal Parasitic Infections in Relation to the HIV Status of Patients Attending the Care Units in Three Divisions in the Centre Region of Cameroon

Background: Depression of the immune system caused by the human immunodeficiency virus (HIV) promotes the onset of opportunistic infections including intestinal parasites. Objectives: In this study, we are comparing the prevalence of these parasitic infections among individuals infected with HIV (HIV+) and non-infected (HIV-) enrolled in four HIV care units in the Centre Region of Cameroon. Methods: A cross-sectional study was conducted and stool samples were collected from 283 HIV positive subjects and 245 seronegative subjects. These samples were processed using direct wet mount, formol-ether concentration, Kato-Katz procedure, modified Ziehl-Neelsen staining, and Baermann techniques to identify both common and opportunistic intestinal parasites. Logistic regression analyses were used to assess the association between HIV infection and socio-demographics factors as well as infection with intestinal parasites. Results: A total of 123 (23.4%) individuals were found infected with at least one protozoan parasite species, and nine (1.7%) with intestinal worms. Overall, infection rates were 27.9% and 22.4% among HIV+ and HIV- subjects, respectively. The frequencies of Cryptosporidium spp. and Entamoeba histolytica/dispar were significantly more important among HIV+ subjects (P < 0.0455). Pentatrichomonas hominis and Entamoeba coli were significantly more prevalent among HIV- subjects (P < 0.0210). Heterogeneity was observed in the distribution of intestinal parasites, according to socio-demographic parameters. In addition, Cryptosporidium spp. was significantly associated with the decrease in CD4 cell count (P = 0.0035). The frequencies of infections with Cryptosporidium spp., Isospora belli, and Iodamoeba buetschlii were significantly more important in HIV positive patients not taking antiretroviral (P < 0.0226). Conclusions: Cryptosporidium spp., Entamoeba histolytica/dispar, and Blastocystis spp. were the intestinal pathogens more often found among HIV infected individuals. HIV positive subjects were significantly more infected with intestinal parasites than seronegatives in intermediate and rural settings, among individuals aged more than 45 years and among unemployed individuals.

Abstract 4002: Uptake of cervical cancer screening among HIV positive women at a tertiary healthcare center in Nigeria

Abstract BACKGROUND: Cervical cancer currently ranks the commonest gynecological cancer in Nigeria. This could be attributed to poor performance of screening strategies due to economic and patient factors. HIV (human immunodeficiency virus) infection is associated with increased risk of cervical cancer and there is lack of sufficient data on cervical cancer screening among HIV positive patients in our setting. Inefficient cervical cancer screening is related to late diagnosis and increased mortality associated with cervical cancer in our setting. AIM: This study was to assess the uptake and attitude of HIV positive women in relation to cervical cancer screening. METHODOLOGY: This was a cross-sectional study of women diagnosed with HIV that presented for care at the department of obstetrics and gynecology of Federal Medical Centre Abeokuta. A total of 52 women were recruited from July, 2017 to June, 2018. Knowledge of Pap smear, HPV DNA test and colposcopy were tested among the participants. A pretested questionnaire was given to respondents to assess factors associated with uptake of cervical cancer screening and SPSS version 23 was used for cross tabulation and to perform logistic regression of the factors associated with cervical screening among the subjects. RESULTS: The mean age of the subjects was 36.5±6.8 years. Out a total of 52 respondents, only 15 (29%) were aware of at least one method of cervical cancer screening. Women with tertiary level of educational status comprised 11(78%) of the subjects that are aware of cervical cancer screening. Only 6 (12%) of the HIV positive subjects were aware of the increased risk of cervical cancer associated with HIV infection. Among the 15(29%) of subjects that are aware of cervical cancer screening, 9(17%) were screened because of symptoms and signs of lower genital tract condition. Women between 40 and 50 years of age (OR= 2.41), presence of gynecological symptoms (OR= 2.97), educational attainment (OR=2.54), duration of HIV diagnosis &amp;gt;5yrs (OR=2.99), were strong predictors of uptake of cervical cancer screening in our setting. CONCLUSION: The knowledge and uptake of cervical cancer screening was very poor among HIV positive patients in our setting despite the increased risk associated with HIV infection, incorporation of cervical cancer screening among health education and intervention to improve its uptake by the agencies involved in HIV care will lead to improved uptake and ultimately decrease mortality associated with cervical cancer REFERENCES 1. Zayyan MS, Akpa M, Dawotola DA, Oguntayo AO, Kolawole AO. Quality of life in patients with advanced cervical cancer in Nigeria. Sahel Med J 2018;21:61-9 Note: This abstract was not presented at the meeting. Citation Format: Chibuike F. Chukwunyere, David O. Awonuga. Uptake of cervical cancer screening among HIV positive women at a tertiary healthcare center in Nigeria [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 4002.

A Phenotypic Comparison between HIV Positive and HIV Negative Tuberculous Meningitis Patients

Background : Tuberculous meningitis (TBM) is the most common type of meningitis found in humans and the Human Immunodeficiency Virus (HIV) is a major risk factor of TBM. This study aimed to identify phenotype differences, such as clinical manifestations, cerebrospinal fluid (CSF) findings, and chest x-ray results between HIV positive and HIV negative TBM patients. Methods : This was a comparative analytical study of 123 TBM patients. The patients were divided into two groups based on their HIV status, and their phenotypes were compared. A retrospective cross sectional designed study was carried out in case report form using a TBM cohort and Rifampicin dose finding study in the neurological ward at the Dr. Hasan Sadikin General Hospital Bandung, between January 2015 and August 2016. Categorical data was analysed using Chi square tests and the alternative Fisher’s Exact test and Mann-Whitney test was used for numerical data. P-values were significant if p < 0.05. Results : Of the phenotypic parameters, only the CSF results had statistical difference. HIV positive subjects had higher CSF to blood glucose ratios (0.42 vs. 0.18; p = 0.001) and fewer leukocyte cells (41 vs. 199; p < 0.001). Conclusions : CSF findings of TBM patients’ revealed differences between HIV positive and negative patients, whilst clinical manifestations and chest x-ray results showed no differences.

Knee extension and flexion strength asymmetry in Human Immunodeficiency Virus positive subjects: a cross-sectional study

BackgroundHuman Immunodeficiency Virus positive subjects present impairment in muscle function, neural activation, balance, and gait. In other populations, all of these factors have been associated with muscle strength asymmetry. ObjectiveTo investigate the existence of muscle strength asymmetry between dominant and non-dominant lower limbs and to determine the hamstrings-to-quadriceps strength ratio in Human Immunodeficiency Virus positive subjects. MethodsIn this cross-sectional study, 48 subjects were included (22 men and 26 women; mean age 44.6 years), all of them under highly active antiretroviral therapy. They performed isokinetic strength efforts at speeds of 60°/s and 180°/s for knee extension and flexion in concentric-concentric mode. ResultsPeak torque was higher (p<0.01) at 60°/s for quadriceps (193, SD=57 vs. 173, SD=55% body mass) and hamstrings (97, SD=36 vs. 90, SD=37% body mass) in dominant compared to non-dominant. Similarly, peak torque was higher at 180°/s (quadriceps 128, SD=44 vs. 112, SD=42; hamstrings 64, SD=24 vs. 57, SD=26% body mass) in dominant. Average power was also higher for all muscle groups and speeds, comparing dominant with non-dominant. The hamstrings-to-quadriceps ratio at 60°/s was 0.50 for dominant and 0.52 for non-dominant, and at 180°/s, it was 0.51 for both limbs, with no significant difference between them. The percentage of subjects with strength asymmetry ranged from 46 to 58%, depending upon muscle group and speed analyzed. ConclusionHuman Immunodeficiency Virus positive subjects present muscle strength asymmetry between lower limbs, assessed through isokinetic dynamometry.

THU-206 - Rate and predictive factors of spontaneous hepatitis C virus clearance after acute infection in human immunodeficiency virus-positive subjects

THU-206 - Rate and predictive factors of spontaneous hepatitis C virus clearance after acute infection in human immunodeficiency virus-positive subjects

Sero - Prevalence of &amp;lt;i&amp;gt;Helicobacter Pylori&amp;lt;/i&amp;gt; in HIV Positive Patients and HIV Negative Controls in St. Paul’s General Specialized Hospital, Addis Ababa, Ethiopia

Background. <i>Helicobacter pylori (H. pylori)</i> is recognized as a major human pathogen. Clinical symptoms associated with <i>H. pylori</i> infection have been reported in patients with human immunodeficiency virus (HIV). A high, normal, and a lower sero - prevalence of <i>H. pylori</i> infection in HIV positive patients than negative controls was found in different studies. The aim of this study was to assess the sero - prevalence of <i>H. pylori</i> infection in HIV positive patients and negative controls and determine the impact of CD4 cell count in patients with <i>H. pylori</i> in St. Paul’s General Specialized Hospital in Addis Ababa, Ethiopia. Methods. A comparative cross sectional study was conducted in HIV positive patients and controls with gastrointestinal symptoms using Serology test kit (ACON^® <i>H. pylori</i>, USA). All individuals who came to Voluntary Counselling and Testing and Anti - Retroviral Therapy to the Out Patient Department of the hospital were examined for complaints of dyspepsia and those with the complaint were tested for <i>H. pylori.</i> Results. Of the 106 HIV positive subjects, 68 (64.2%) were positive for anti - <i>H. pylori</i> IgG antibodies; and of the 106 HIV negative controls, 52 (49.1%) were positive for anti - <i>H. pylori</i> IgG antibodies (p=0.037). There was no significant difference of <i>H. pylori</i> seroprevalence between relatively higher and lower CD4 cell counts in the HIV positive cases (p>0.05). Conclusion. A significantly higher seroprevalence of <i>H. pylori</i> was demonstrated in the HIV positive subjects. There was no significant difference in the prevalence of <i>H. pylori</i> between different CD4+ cell counts in the HIV positive study group.

Treatment of W. bancrofti (Wb) in HIV/Wb coinfections in South India.

BackgroundThe disease course of human immunodeficiency virus (HIV) is often altered by existing or newly acquired coincident infections.Methodology/Principal FindingsTo assess the influence of pre-existing Wuchereria bancrofti infection on HIV progression, we performed a case-controlled treatment study of HIV positive individuals with (FIL+) or without (FIL-) W. bancrofti infection. Twenty-eight HIV+/FIL+ and 51 matched HIV+/FIL- subjects were treated with a single dose of diethylcarbamazine and albendazole (DEC/Alb) and followed for a year at regular intervals. Sixteen of the HIV+/FIL+ subjects (54%) and 28 of the HIV+/FIL- controls (57%) were on antiretroviral therapy (ART) during the study. Following treatment, no differences were noted in clinical outcomes between the 2 groups. There also was no significant difference between the groups in the HIV viral load at 12 months as a percentage of baseline viral load (HIV+/FIL+ group had on average 0.97 times the response of the HIV+/FIL- group, 95% CI 0.88, 1.07) between the groups. Furthermore, there were no significant differences found in either the change in viral load at 1, 3, or 6 months or in the change in CD4 count at 3, 6, or 12 months between the 2 groups.Conclusions/SignificanceWe were unable to find a significant effect of W. bancrofti infection or its treatment on HIV clinical course or surrogate markers of HIV disease progression though we recognized that our study was limited by the smaller than predicted sample size and by the use of ART in half of the patients. Treatment of W. bancrofti coinfection in HIV positive subjects (as is usual in mass drug administration campaigns) did not represent an increased risk to the subjects, and should therefore be considered for PLWHA living in W. bancrofti endemic areas.Trial RegistrationClinicalTrials.gov NCT00344279

Altered brain functions in HIV positive patients free of HIV- associated neurocognitive disorders: A MRI study during unilateral hand movements

This paper aimed to investigate the brain activity of human immunodeficiency virus (HIV) positive patients with normal cognition during unilateral hand movement and whether highly active antiretroviral therapy (HAART) could affect the brain function. Functional magnetic resonance imaging (fMRI) was performed for 60 HIV positive (HIV+) subjects and −42 healthy age-matched right-handed control subjects. Each subject was evaluated by the neuropsychological test and examined with fMRI during left and right hand movement tasks. HIV+ subjects showed greater activation in anterior cingulum, precuneus, occipital lobes, ipsilateral postcentral gyrus and contralateral cerebellum compared with control group during right hand movement task. However, during left hand movement no statistically significant difference was detected between these two groups. HAART medication for HIV+ subjects lowered the increased activity to normal level. Meanwhile patients receiving the regimen of zidovudine, lamivudine and efavirenz showed lower activity at bilateral caudate and ipsilateral inferior frontal gyrus in comparison with subjects receiving other HAART regimens. Therefore, HIV+ subjects demonstrated brain asymmetry in motor cortex, with increased activity present during right hand movement but absent during left hand movement. HAART proves effective in HIV+ subjects even with normal cognition and the specific regimen of HAART could prevent cerebral abnormal functions. Meanwhile, this study validates that during motor tasks, fMRI can detect the brain signal changes prior to the occurrences of other HIV- associated dysfunctions.

Comparative study of plasma zinc and selenium levels amongst Human Immunodeficiency Virus(HIV) positive and negative subjects

The study was a comparative evaluation of plasma levels of selenium and zinc trace elements amongst HIV-positive and HIV-negative apparently healthy, individuals. The comparative cross sectional study comprised two groups of forty HIV positive and HIV negative subjects respectively who were gotten by consecutive clinic recruitment and random sampling respectively. A structured questionnaire was used to retrieve the sociodemographic data after obtaining informed consent from willing participants. Blood samples were collected aseptically into ethylenediaminetetraacetic acid (EDTA) vacutainer bottles and later analyzed by atomic absorption spectrophotometry (AAS). Data analyses were carried out using data analysis software EpiInfo 7 and Microsoft Word Excel 2007. Results were presented as mean ± standard deviation and the student t- test was used to compare means with significance set at P≤0.05. Findings included, instructively, a mean plasma selenium (μg/dl) of 0.0052 ± 0.0024 and 0.0223 ± 0.0054 among HIV negative and positive subjects respectively (p <0.00001). This was in contradistinction to plasma zinc levels where in mean plasma levels(μg/dl) were 122.620 ± 8.571 and 83.35 ± 5.49 for HIV negative and positive subjectsrespectively (p < 0.00001). This may be a pointer to the need for supplementation of certain micronutrients during treatment of HIV infection, as had been noted in some other studies.

Non-AIDS definings malignancies among human immunodeficiency virus-positive subjects: Epidemiology and outcome after two decades of HAART era

Highly active antiretroviral therapy (HAART) for human immunodeficiency virus (HIV) infection has been widely available in industrialized countries since 1996; its widespread use determined a dramatic decline in acquired immunodeficiency syndrome (AIDS)-related mortality, and consequently, a significant decrease of AIDS-defining cancers. However the increased mean age of HIV-infected patients, prolonged exposure to environmental and lifestyle cancer risk factors, and coinfection with oncogenic viruses contributed to the emergence of other malignancies that are considered non-AIDS-defining cancers (NADCs) as a relevant fraction of morbidity and mortality among HIV-infected people twenty years after HAART introduction. The role of immunosuppression in the pathogenesis of NADCs is not well defined, and future researches should investigate the etiology of NADCs. In the last years there is a growing evidence that intensive chemotherapy regimens and radiotherapy could be safely administrated to HIV-positive patients while continuing HAART. This requires a multidisciplinary approach and a close co-operation of oncologists and HIV-physicians in order to best manage compliance of patients to treatment and to face drug-related side effects. Here we review the main epidemiological features, risk factors and clinical behavior of the more common NADCs, such as lung cancer, hepatocellular carcinoma, colorectal cancer and anal cancer, Hodgkin's lymphoma and some cutaneous malignancies, focusing also on the current therapeutic approaches and preventive screening strategies.

English

This study investigated the prevalence and associated factors of proteinuria in treatment naive human immunodeficiency virus (HIV) infected individuals. It also evaluated utility of dipstick urinalysis for the detection of impaired renal function. Two hundred (200) HIV seropositive patients and 72 HIV seronegative subjects were evaluated and tested for proteinuria using dipstick reagent strips. Serum urea and creatinine, haemoglobin, CD4+ T-lymphocyte (CD4+ cell) count and HIV RNA viral load were performed. Cockroft-Gault (CG) equation was used to estimate glomerular filtration rate (eGFR). Dipstick proteinuria was detected in 85 (43%) of the seropositive population compared to 6 (8.3%) in HIV seronegative subjects (odds ratio (OR) 8.3, p < 0.001). One hundred (50%) HIV positive subjects had CD4+ cell < 200 cells at baseline and 63 (31%) had impaired renal function. Although dipstick proteinuria was associated with male gender, severe anaemia, elevated serum urea and creatinine, significantly lower CD4+ cell count and impaired renal function, only the inverse association of dipstick proteinuria and CD4+ cell count remained on logistic regression (OR 0.4, 95% CI: 1.6 to 5.2). We have documented the high prevalence of proteinuria in HIV subjects prior to anti retroviral therapy (ART), and the important role of proteinuria as a significant risk factor for severe immunosuppression. We also show that dipstick proteinuria is not sensitive for the identification of impaired renal function, but has moderate utility in excluding renal insufficiency in subjects negative for proteinuria on dipstick testing. Key words: Proteinuria, estimated glomerular filtration rate, immunosuppression.