HIV Seroprevalence Research Articles

Epidemiological Surveillance of Blood Donors in Kinshasa, 2014 - 2018.

The systematic detection of HIV, hepatitis B (HBV) and C (HCV) viruses in any blood donor has been in effect at the University hospital of Kinshasa since 2005. However, no data on the monitoring of blood donors is available today. The purpose of this thesis was to draw up the sero-epidemiological assessment of the afore-mentioned virus during the period 2014 - 2018. This is an observational study conducted in the University Hospital of Kinshasa donor population. A total of 9,128 blood donors were admitted to the Kinshasa University Clinics Blood Bank during the period from 01/01/2014 to 12/31/2018 for 11,054 blood donations. The highest attendance (50%) of blood donors was observed in 2014 and 2015. On the other hand, 2018 (11.9%; n = 1,085) was that of the lowest frequency of blood donors. The mean age of the blood donors was 34.72 ± 10.66 years. The minimum and maximum age corresponded to 16 years and 65 years, respectively. The median age was 34 years (interquartile range (IQR): 27 - 40 years). The majority of the study population (75%; n = 6,841) were at most 40 years old. There were significantly more male blood donors (77.3%; n = 7,060) than female blood donors (22.7%; n = 2,066). The difference between the two gender proportions was statistically significant (p < 0.0001) at risk α = 5%. The male/female gender ratio was 3:4. The seroprevalence of HIV, HBV, HCV and Treponema pallidum was estimated at 2.6% (n = 237), 4.7% (n = 429), 3.3% (n = 297) and 0.4% (n = 33), respectively. A total of 927 (10.16%) donors were infected with at least one agent transmissible by blood transfusion. The present surveillance proves that infectious transfusion safety in Kinshasa is still very low.

Analytical performances of Exacto® HIV self-test in the Central African Republic.

We herein evaluated the analytical performances of the CE-IVD capillary blood Exacto® HIV self-test (Biosynex, Strasbourg, France) in the Central African Republic (CAR). A cross-sectional study was conducted on a representative national panel of 200 sera positive for HIV and 200 negative for HIV, randomly selected thorough the CAR for HIV seroprevalence surveillance survey, according to reference test. The Exacto® HIV self-test showed 99.5% (95% CI: 98.2-99.9) sensitivity and 100.0% (95% CI: 99.0-100.0) specificity. The Youden´s J index and Cohen´s Kappa coefficient were 0.995. At HIV-1 seroprevalence of 3.5% in the general adult population of the CAR, the positive and negative predictive values were 100% (95% CI: 99.0-100) and 99.9% (95% CI: 98.9-100), respectively. The results are within the limits required by the WHO (i.e. sensitivity ≥ 99.0% and specificity ≥ 98.0%), making Exacto® HIV self-test suitable for routine use in the CAR.

Sociological variety and the transmission efficiency of Mycobacterium tuberculosis: a secondary analysis of qualitative and quantitative data from 15 communities in Zambia

ObjectivesSelected Zambian communities formed part of a cluster randomised trial: the Zambia and South Africa TB and AIDS Reduction study (ZAMSTAR). There was wide variability in the prevalence of Mycobacterium...

HIV seroprevalence in five key populations in Europe: a systematic literature review, 2009 to 2019.

BackgroundIn Europe, HIV disproportionately affects men who have sex with men (MSM), people who inject drugs (PWID), prisoners, sex workers, and transgender people. Epidemiological data are primarily available from national HIV case surveillance systems that rarely capture information on sex work, gender identity or imprisonment. Surveillance of HIV prevalence in key populations often occurs as independent studies with no established mechanism for collating such information at the European level.AimWe assessed HIV prevalence in MSM, PWID, prisoners, sex workers, and transgender people in the 30 European Union/European Economic Area countries and the United Kingdom.MethodsWe conducted a systematic literature review of peer-reviewed studies published during 2009–19, by searching PubMed, Embase and the Cochrane Library. Data are presented in forest plots by country, as simple prevalence or pooled across multiple studies.ResultsEighty-seven country- and population-specific studies were identified from 23 countries. The highest number of studies, and the largest variation in HIV prevalence, were identified for MSM, ranging from 2.4–29.0% (19 countries) and PWID, from 0.0–59.5% (13 countries). Prevalence ranged from 0.0–15.6% in prisoners (nine countries), 1.1–8.5% in sex workers (five countries) and was 10.9% in transgender people (one country). Individuals belonging to several key population groups had higher prevalence.ConclusionThis review demonstrates that HIV prevalence is highly diverse across population groups and countries. People belonging to multiple key population groups are particularly vulnerable; however, more studies are needed, particularly for sex workers, transgender people and people with multiple risks.

Seroprevalence of HIV Infection among Pregnant Women Attending Antenatal Clinic in General Hospital Kumo, Gombe State Nigeria

Seroprevalence of HIV among pregnant women attending antenatal clinic in Kumo General Hospital was studied in 350 sera. The sera were obtained from women of different age group, occupation, social background including tradition (by tradition we mean people’s ways of life common in that locality). Screening was carried out using Abbot determine test strips and Gene 11 HIV 1 and 2. The Bio-data information of the women was gathered through questionnaire administration. Out of the 350 sera collected, 12(3.4%) were reactive for HIV. There was high prevalence among age group 21-30 (2.1%) followed by age group 11-20 (0.9%). High prevalence was also observed among the unemployed pregnant women (2.1%). Women who had no risk factor were also noted to have had high prevalence (1.7%); Spouses of seropositive pregnant women and those with no risk factor had 42% and (33%) prevalence respectively.

Prevalence, incidence and seroconversion of HIV and Syphilis infections among pregnant women of South Africa.

BackgroundPregnant women in South Africa suffer from HIV and syphilis infections resulting in negative pregnancy outcomes. Little is known about the prevalence, incidence, seroconversion, and associated risk factors for those attending a midwife run obstetric unit.MethodsA retrospective cohort study was undertaken among pregnant women attending antenatal clinic from January to December 2018. Logistic regression was conducted to determine the risk factors for HIV and syphilis.ResultsThe prevalence of HIV and syphilis were 44.3% (95% confidence interval [CI]; 41.6:46.7) and 3.8% (95% CI; 3.1:4.1), respectively. The seroconversion and incidence for HIV were 4.0% (95% CI; 3.6:4.6) and 17.1 per 100 person-years, and for syphilis 2.6% (95% CI; 2.3:2.8) and 10.9 per 100 person-years, respectively. Significant predictors for HIV prevalence were ages: ages < 20 years, Odds ratio (OR) = 0.11 (p < 0.05), ages 20–24 years, OR = 0.19 (p < 0.05) and ages 25–29 years, OR = 0.38 (p < 0.05); gestational age: second trimester, OR = 0.68 (p < 0.05) and non-reactive syphilis, OR = 0.45 (p < 0.05). Age was the predictor for HIV incidence or seroconversion (age < 20 year, OR = 0.12, p = 0.01). Predictors for syphilis were ages < 20 years, OR = 0.11 (p < 0.05), ages 20–24 years and HIV status. Gestational age > 27 weeks were nine times (OR = 9.2, p = 0.03) more likely to seroconvert to syphilis.ConclusionsThe present study found high rates of seroprevalence, seroconversion and incidence of HIV and syphilis among pregnant women.

Significance of Adopting Nucleic Acid Amplification Technique for Blood Donor Screening in a Resource Limited Setting: A Study from a Single Centre in South India.

Nucleic acid Amplification testing (NAT) has helped improve blood safety and detect window period and Occult Hepatitis B infections (OBI) This study was aimed at determining the following in blood donors: 1. seroprevalence of HIV, HBV & HCV, malarial parasite and Syphlis 2. NATand seroyield for HIV, HBV and HCV 3. viral load in NAT yield donations 4. Pattern of HBV serological markers in HBV NAT yield donations 80,809 blood donations were screened over an 8 year period (2012-2019) for antiHIV I and II, HBsAg, antiHCV antibodies, malarial parasite and VDRL. Seronegative samples were tested by NAT using a multiplex PCR in a pool of six. NAT yield samples were tested for viral load and HBV serological markers. Seropositive samples were tested for NAT and checked for seroyield. SPSS windows version 24.0 was used for statistical analysis. 1.07% of blood donors were found to be seropositive with 0.08%, 0.86%, 0.09%, 0.03% and 0 for anti HIV I and II, HBsAg, antiHCV, VDRL and Malarial parasite respectively. Out of 79,938 seronegative samples, 20 samples (0.025%) were NAT positive for Hepatitis B with a NAT yield OF 1:3997. Out of the 20 NAT positive samples, 17 were OBI and three were window period infections. 14 NAT yield samples subjected to a HBV viral load assay showed a range of < 6-146IU/ml. Minipool NAT in pools of six is able to indentify both OBI and window period infections. NAT could significantly improve the blood safety in a resource limited setting like India.

Association Between ART Adherence and Mental Health: Results from a National HIV Sero-Behavioural Survey in South Africa.

This paper assesses the levels of antiretroviral treatment (ART) adherence and mental health distress among study participants in a national behavioural HIV-sero prevalence study South Africa. The study was a cross-sectional population-based multi-stage stratified cluster random survey, (SABSSM V, 2017). Structured questionnaires were used to collect information on socio-demographics, HIV knowledge, perceptions, HIV testing and HIV treatment history. Study participants were tested for HIV infection, antiretroviral use, viral suppression, and ART drug resistance. A total of 2155 PLHIV aged 15years or older who were on ART were included in the study. Incidence of either moderate or severe mental health distress was 19.7%. Self-reported ART adherence among study participants with no, mild, moderate, or severe mental distress was 82%, 83%, 86% and 78%, respectively. The adjusted odds ratio for ART non-adherence was 0.58 (95% CI 0.24; 1.40) for mild mental distress, 0.82 (95% CI 0.35; 1.91) for moderate mental distress and 2.19 (95% CI 1.14; 4.19) for severe mental distress groups compared to the no mental health distress group. The other factors that were associated with ART non-adherence in adjusted models included education level, alcohol use and province/region of residence. The study revealed that mental health remains a challenge to ART adherence in South Africa. To improve ART adherence, HIV continuum of care programs should include screening for mental health among people living with HIV.

Seroprevalence of HIV infection among cataract surgery patients in south-east Nigeria: A retrospective cross-sectional study

Background: Human Immunodeficiency Virus remains an important cause of morbidity and mortality especially in sub-Saharan Africa. Despite the availability of highly active antiretroviral therapy, many people with this disease still present with its ocular complications. Cataracts remain the commonest reason for blindness in Nigeria and globally. The prevalence of HIV infection among cataract patients in south east Nigeria has remained unknown. Objectives: To determine the prevalence of human immunodeficiency virus among cataract patients in south east Nigeria. Materials and Methods: This was a retrospective cross-sectional study. The case files of all who had cataract surgery between September 1st, 2020 to March 31st, 2021 at City of Refuge Specialist Eye Clinic Onitsha, Nigeria was obtained from the Medical Record Department of the hospital to extract relevant information and demographic data. The outcome measures included the prevalence of HIV, as well as the gender and the age of affected cataract patients. Data was analyzed using SPSS 26.0 IBM Corporation. Fisher’s exact test was performed for categorical data, and Student’s t-test was applied to continuous variables depending on their distribution. A p value of &lt;0.05 was considered statistically significant. Results: In this study, 423 participants who underwent cataract surgery were included for analysis of which 16 were HIV positive. The overall seroprevalence of HIV among the study population was 3.78% with HIV prevalence showing the female to male ratio of 1:1. Up to 70.81% of the patients were at least 60 years of age. Although there was a statistically significant difference between the prevalence of HIV and seasonal presentation (p=0.015), there was no statistically significant relationship between the participants age and gender (p=0.195), prevalence of HIV and the participants’ age categories (p=0.149) or participants’ settlements (p=0.219). Conclusion: The prevalence of HIV among cataract patients in this study was 3.78%. This study confirms that HIV infections are an important public problem among cataract patients in Nigeria. Our findings draw attention to the significant burden HIV has on cataract surgery in Nigeria. We recommend advocacy for the national policymakers to initiate HIV tests in routine ophthalmology services.

Transmission of HIV through blood and blood products in the Eastern Mediterranean Region

Over90% of recipients of HIV infected blood will seroconvert. In the Region 368 cases were due to transmission through blood or blood products. With establishment of HIV screening facilities, the proportion of AIDS cases due to blood transmission has decreased. AIDS due to blood transmission will continue to occur due to the time lag between the occurrence of HIV infection and appearance of AIDS. HIV seroprevalence among recipients of multiple blood transfusions decreased from 270 per 10 000 in 1987-89 to 7 per 10 000 in 1995. Effective methods are available for prevention of HIV transmission through blood, but antigen and PCR tests are expensive and not recommended for screening of blood donations in developing countries

Seroprevalence of hepatitis B virus infection, anti-HCV antibodies and HIV and knowledge among people who use drugs attending methadone therapy clinic in Tanzania; a cross-sectional study

BackgroundMethadone therapy clinics have been recently introduced in Tanzania, aiming at reducing risk behaviors and infection rates of viral hepatitis and HIV among people who use drugs. The objective of this study was to estimate the prevalence, associated factors and knowledge level of these conditions among people who use drugs attending a methadone clinic in Tanzania.MethodsWe enrolled 253 People who using drugs receiving Methadone therapy. Clinical data was retrospectively collected from the medical records and face-to face interviews were conducted to determine the behavioral risk factors and respondents’ knowledge on viral hepatitis and HIV.ResultsAn overall seroprevalence of viral hepatitis (either hepatitis B surface antigen or anti-hepatitis C virus) was 6.3%, while that of hepatitis B virus mono infection was 3.5% and anti-hepatitis C antibodies was 3.5%. Seroprevalence of HIV was 12.6%. Viral hepatitis was strongly predicted by advanced age (> 35 years) (p = 0.02) and staying at Kirumba area (p = 0.004), and HIV infection was predicted by increased age (> 37 years) (p = 0.04) and female sex (p < 0.001). Regarding the knowledge of viral hepatitis, majority of the respondents were unaware of the transmission methods and availability of hepatitis B virus vaccines and only 17% were classified as well informed (provided ≥4 correct answers out of 7 questions). Good knowledge was highly predicted by higher education level of the individual (p = 0.001).ConclusionsDespite the efforts to curb viral hepatitis and HIV infections through Methadone clinics, infection rates among people who use drugs are still high and the general knowledge on preventive measures is inadequate.

Retrospective Study of the Seroprevalence of HIV, HCV, and HBV in Blood Donors at a Blood Bank of Western Mexico.

Obtaining blood which is safe for transfusions is one of the principal challenges in the health systems of developing countries. Supply of contaminated blood increases morbidity, mortality, and the costs of patient care. In Mexico, serological screening is mandatory, but only a few of the main blood banks routinely perform a nucleic acid test (NAT). Data from 80,391 blood donations processed between August 2018 and December 2019 at the Central Blood Bank of the Western National Medical Center of the Mexican Social Security Institute (IMSS) were analyzed. All donors were screened for serological markers and NAT was performed. Reactive donors were followed-up to confirm their results. The number of reactive donors and seroprevalence rates for HIV, HCV, and HBV were 152 (18.91/10,000), 385 (47.89/10,000), and 181 (22.51/10,000), respectively; however, these rates decreased when NAT-confirmed reactive results were considered. Male donors were found to have a higher seroprevalence than females, and younger donors higher than older donors. The present study shows that HIV, HCV, and HBV seroprevalence in blood donors in Western Mexico is low. We propose that Mexico should establish future strategies, including pathogen reduction technologies (PRTs), in order to improve blood safety and reduce transfusion-transmissible infections (TTIs).

Human Immunodeficiency Virus and Syphilis Among Blood Donors at Western Oromia, Ethiopia.

BackgroundBlood transfusion saves lives and improves health, but many patients requiring transfusion do not have timely access to safe blood. Human immunodeficiency virus and syphilis are the commonest transfused transmitted infections and threats to blood recipients. Proper donor selection and screening of the donated blood for major transfusion-transmitted infections evidently reduced challenge in blood safety. Therefore, the objective of this study was to determine the sero-prevalence HIV and syphilis infections among blood donors at East Wollega, West Ethiopia.Patients and MethodsA five-year (from January 2015 to December 2019) retrospective study was conducted by reviewing blood donor laboratory test results from Nekemte blood bank which is serving hospitals in Western Oromia. Blood donor data were analyzed by Statistical Package for Social Sciences version 20 software.ResultsThe total of 17,810 individual’s blood was screened during the study period. The overall prevalence of HIV, syphilis, and their co-infection was 222 (1.25%), 142 (0.80%), and 5 (0.03%), respectively. The prevalence of HIV was associated with unmarried (AOR: 2.4; 95% CI: 1.5, 5.2), male (AOR: 2.1; 95% CI: 1.5, 2.9), and blood donors resident in a rural area (AOR: 1.5; 95% CI: 1.5, 5.9). Besides, the prevalence of syphilis was associated with education, age, marital status and residence of study participant.ConclusionIn the current study, the sero-prevalence of HIV and syphilis among blood donors was low, when it was compared to other sub-Saharan Africa country. However, to ensure the health of all recipients screening blood using standard methods is highly recommended.

Prevalence of Syphilis and Human Immunodeficiency Virus Among Pregnant Women Attending Antenatal Care Clinic In Jinka General Hospital, Southern Ethiopia from 2015-2017.A Retrospective Study

Sexually transmitted infections are a major public health issue. Syphilis and HIV are the leading STIs highly prevalent in sub-Saharan African countries including Ethiopia, which can have a critical impact on reproductive, maternal, and newborn health such as stillbirth. Therefore, this study was aimed to assess the seroprevalence of syphilis and HIV among pregnant women who attended antenatal care clinics in Jinka General Hospital, South Omo, Ethiopia. A retrospective cross-sectional study was carried out in Jinka General Hospital from 2015 to 2017. Data were obtained from individual charts and laboratory logbooks using a structured checklist. Statistical package for social sciences version 21 was used to analyze the data. Finally, the results were presented in text, tables, and graphs. A total of 1712 pregnant women attended antenatal care clinics between 2015 and 2017. The seroprevalence of syphilis and HIV were found to be 18 (1.05%) and 70(4.0%) respectively. Most of the syphilis seropositive cases were observed among married pregnantwomen 13(72.22%) in the age group of 20-30 14(77.78%). Syphilis and HIV co-infection was found in 14 (0.82%) subjects. The trend of syphilis infection peaked from 0.41% in 2015 to 1.48% in 2016 but declined to 1.16% in 2017. A downward trend has been observed in the case of HIV infection, wherethe prevalence rate fell steeply from 5.9% in 2015 to 1.46% in 2017. The seroprevalence of HIV and syphilis among pregnant women showed slightly high, which needs due attention with special consideration for active childbearing age women.

Seroprevalence of Hepatitis B and C Viruses, and HIV among Antenatal Pregnant Women in Nsukka, Enugu State, Nigeria

Aim: Hepatitis B and C viruses and HIV infections remain major global health concerns as causes of high morbidity and mortality in developing countries. This study aimed at determining the prevalence of HBsAg antibody, anti-Hepatitis C and HIV 1 and 2 antibodies in antenatal pregnant women in Nsukka, Nigeria.&#x0D; Study Design, Area and Duration of Study: The study utilized both experimental and survey designs. Blood samples were collected from women attending antenatal clinics in two prominent hospitals in Nsukka, Enugu State, Nigeria from April to August 2016.&#x0D; Methods: Blood samples from 200 pregnant women were collected into plain vacutainers and allowed to clot. The serum was separated and used to test for antibodies to the viral infections using rapid test kits with immobilized antigens following the manufacturer’s instructions. Additional information was collected using standard questionnaire. &#x0D; Results: From the results, 11 (5.5%), 9 (4.5%) and 5 (2.5%) women tested positive for HBsAg antibody, anti-HCV and HIV 1 and 2 antibodies, respectively. None of the patients was co-infected with HBV/HCV, HBV/HIV, HCV/HIV or triple infections with HBV/HCV/HIV. The mean age distribution was 28.2 years (Standard Deviation = 6.46). Marital status, age distribution and occupation were found to be statistically insignificant to the prevalence of HBsAg antibody, anti-HCV and HIV 1 and 2 antibodies (P &gt; 0.05). Blood transfusion and history of previous surgeries were the risk factors for HBsAg and HIV 1 and 2 antibodies (P &lt; 0.05), but not for anti- HCV (P&gt; 0.05) among the study population. None of the respondents had body tattoo or admitted to have multiple sexual partners.&#x0D; Conclusion: There are still high seroprevalence of HBV, HCV and HIV among antenatal pregnant women in the study area. Hence, there is need for integration of hepatitis screening tests among the antenatal pregnant women in the town.

Geographical Disparities in HIV Seroprevalence Among Men Who Have Sex with Men and People Who Inject Drugs in Nigeria: Exploratory Spatial Data Analysis.

BackgroundThe assessment of geographical heterogeneity of HIV among men who have sex with men (MSM) and people who inject drugs (PWID) can usefully inform targeted HIV prevention and care strategies.ObjectiveWe aimed to measure HIV seroprevalence and identify hotspots of HIV infection among MSM and PWID in Nigeria.MethodsWe included all MSM and PWID accessing HIV testing services across 7 prioritized states (Lagos, Nasarawa, Akwa Ibom, Cross Rivers, Rivers, Benue, and the Federal Capital Territory) in 3 geographic regions (North Central, South South, and South West) between October 1, 2016, and September 30, 2017. We extracted data from national testing registers, georeferenced all HIV test results aggregated at the local government area level, and calculated HIV seroprevalence. We calculated and compared HIV seroprevalence from our study to the 2014 integrated biological and behavioural surveillance survey and used global spatial autocorrelation and hotspot analysis to highlight patterns of HIV infection and identify areas of significant clustering of HIV cases.ResultsMSM and PWID had HIV seroprevalence rates of 12.14% (3209/26,423) and 11.88% (1126/9474), respectively. Global spatial autocorrelation Moran I statistics revealed a clustered distribution of HIV infection among MSM and PWID with a <5% and <1% likelihood that this clustered pattern could be due to chance, respectively. Significant clusters of HIV infection (Getis-Ord-Gi* statistics) confined to the North Central and South South regions were identified among MSM and PWID. Compared to the 2014 integrated biological and behavioural surveillance survey, our results suggest an increased HIV seroprevalence among PWID and a substantial decrease among MSM.ConclusionsThis study identified geographical areas to prioritize for control of HIV infection among MSM and PWID, thus demonstrating that geographical information system technology is a useful tool to inform public health planning for interventions targeting epidemic control of HIV infection.

Seroprevalence and Risk Factors Associated with Human Immunodeficiency Virus Infection Type 1 in Donors of the National Blood Transfusion Center of Libreville (Gabon)

Background: Transmission of HIV through blood transfusion remains a public health problem, particularly in countries in Sub-Saharan Africa. However, no study has determined the epidemiological data regarding HIV-1 infection in Gabonese blood donors. The objective of this study is to assess the seroprevalence of HIV-1 and the risk factors associated with infection in donors from the National Blood Transfusion Center in Libreville (Gabon).&#x0D; Methods: A cross-sectional study carried out from June to August 2020 in 3669 persons donating blood at the National Blood Transfusion Center (NBTC). The ELISA technique (Evolis®, BioRad), the chemiluminescence technique (Cobas® e601, Roche), and the SD Bioline® HIV 1/2 test (Standard Diagnostics. Inc) were used for the detection of anti-HIV-1/2 antibodies and P24 antigen in donor plasma. Data were analyzed using SPSS software version 21.0, with p˂.05 considered statistically significant. &#x0D; Results: The seropositivity rate HIV-1 was 0.8% (30/3669) (95% CI: 0.5; 1.1). The study was composed of 79.4% men and 20.6% women. The most representative age group was of 25-34 years with 54.5%. The seropositivity of men, women, and unrelated voluntary donors was 0.7%, 1.2%, and 1.0%, respectively. The risk factors such as the first blood donation (Adjusted Odds Ratio (AOR) = 0.1 [0.0 ;0.4], P= .002), multiple sexual partners (AOR = 6.2 [2.2;17.2], P= .001), primary educational level (AOR = 10.1 [1.4;75], P = .024), and dental care (AOR = 3.6 [1.2;11], P = .024) were significantly associated with HIV infection. About 0.14% of the patients had co-infection.&#x0D; Conclusion: In the Gabonese context, about one out of a hundred blood donors are HIV-infected. These carriers of HIV infection in the blood banks are mainly new donors with multiple sexual partners, limited education, and poor dental care.

The value of routine blood-borne virus testing in the intensive care unit.

ICU patients may require renal replacement therapy (RRT). Sharing RRT equipment carries a risk of BBV transmission, which mainly relates to Hepatitis B (HBV), Hepatitis C (HCV) and HIV. Since 2012, all Glasgow Royal Infirmary ICU patients undergo routine BBV screening, with RRT machines allocated for patients with specific BBV statuses. Routine BBV testing is beneficial to both the individual and society. This study aims to determine if routine BBV testing in the ICU contributes to the discovery of undiagnosed BBV infections. This single-centre retrospective observational study examined prospectively collected clinical data from 1069 ICU admissions. Proportions were compared using a two-proportion z-test and a logistic regression model was carried out to determine if deprivation quintile was independently associated with the seroprevalence of BBVs. The BBV seroprevalence in the cohort studied: 0.45% (HBV), 11.7% (HCV), and 0.91% (HIV). The seroprevalence of HBV in the cohort studied was similar to that of Scotland (p = 0.11), but the seroprevalence of HCV (p < 0.001) and HIV (p = 0.01) were significantly higher than that of Scotland. The relationship between deprivation and BBV seroprevalence was explored for HCV only. The only independent variable associated with a reactive anti-HCV test result was "current or previous illicit drug use" (adjusted odds ratio of 40.2; 95% confidence interval of 21.1-76.4; p < 0.001). This study shows that routine BBV testing in the ICU is useful in discovering new BBV infections. This is the first observational study focusing on the value of routine BBV testing in an ICU setting to our knowledge.

The Epidemiology Pattern of Human Immunodeficiency Virus/Acquire Immune Deficiency Syndrome, Diagnostic, Transmission and Prevention in Nigeria-Past and Present

Human immune Virus/Acquire immune deficiency syndrome (HIV/AIDS) epidemic is one of the major public health challenges faced by Nigeria. The review present the Epidemiology of Human immune Virus/Acquire immune deficiency syndrome, diagnostic and Prevention in Nigeria. The method use was based on the data obtain in Nigeria. Nigeria’s first two AIDS cases were diagnosed in 1985 in Lagos. Today, Nigeria’s epidemic is characterized as one the most rapidly increased rates of HIV/AIDS cases in West Africa. Nigeria's population of 160 million and estimated HIV prevalence of 3.34% (2011) makes Nigeria the second highest HIV burden worldwide, with 3.2 million people living with HIV (PLHIV). Recently, it is estimated that about 3, 229, 757 people live with HIV in Nigeria and about 220, 393 new HIV infections occurred in 2013 and 210,031 died from AIDS- related causes. As of 2020 in Nigeria, the HIV prevalence rate among adults ages 15–49 was 3.1 percent Nigeria has the second-largest number of people living with HIV. In some states, the epidemic is more concentrated and driven by high-risk behaviors, while other states have more generalized epidemics that are sustained primarily by multiple sexual partnerships in the general population. HIV is spread by sexual contact with an infected person and by blood or body fluid exchange through sharing of contaminated needles or transfusions of infected blood or blood clotting factors. Infants born to HIV-infected women may become infected in gestation, during birth, or through breastfeeding. An antenatal clinic (ANC) HIV seroprevalence sentinel survey has been conducted biennially in Nigeria since 1991 to track the epidemic. The Joint United Nations Programme on HIV/AIDS (UNAIDS) estimates that 3.5 million Nigerian adults and children were living with HIV/AIDS by the end of 2001. Among sex workers in Lagos, HIV prevalence rose from 2 percent in 1988–89 to 12 percent in 1990–91. By 1995–96, up to 70 percent of sex workers tested positive. As a result of the epidemic, the crude death rate in Nigeria was about 20 percent higher in 2000 than in 1990. In 2019, 170,000 adults and children died of AIDS and UNAIDS estimated that 1 million children orphaned by AIDS were living in Nigeria. The main thrust of HIV prevention strategies in Nigeria is based on the following: Information, Education, and Communication; Condom Promotion; Behavior Change; and Vaccine Development.

#33: A Tale of Two Pneumos: the Impact of HIV Exposure or Infection Status on Pediatric Carriage of Streptococcus pneumoniae and Pneumocystis jirovecii, a Nested Case–control Analysis from the Pneumonia Etiology Research in Child Health (PERCH) study in Zambia

Abstract Background Most pediatric HIV cases in Africa reflect maternal to child transmission (MTCT). The persistently high seroprevalence of HIV in pregnant women (16.6%) and the low rates of mother to child HIV transmission (~2%) have resulted in a high number of children who are HIV exposed but uninfected (HEU). HIV exposed but uninfected (HEU) children have increased rates of morbidity and mortality vs. HIV unexposed and uninfected (HUU). Methods To explore the mechanisms behind this phenomenon, each case and control was sampled using a nasopharyngeal NP swab and an oropharyngeal (OP). A multiplex real-time polymerase chain reaction (PCR) assay was used to determine the presence of Streptococcus pneumoniae and Pneumocystis jirovecii in the NP/OP specimens. We compared nasopharyngeal carriage rates of S. pneumoniae and P. jirovecii between HIV-infected, HEU, or HUU case (pneumonia) and control (without pneumonia) children. In bivariate analyses, using carriage as a dichotomous outcome, proportions we compared using chi-square or odds ratios with 95% confidence intervals. In multivariate models, we created logistic and linear regression models adjusting for nutritional status as possible mediators of carriage status. Results SP carriage rates were similar between cases and controls. However, density was increased among HIV-infected children vs. HEU or HUU children (15.8 vs. 4.7 vs. 3.6 × 105 copies/mL, respectively). Among cases, PJ carriage among HIV positive, HEU and HUU children was 31%, 15% and 10%,, respectively, (P &amp;lt; 0.05) and carriage density was 63.9, 20.9, and 4.8 × 103 copies/mL, respectively (P &amp;lt; 0.05). In adjusted logistic regression models, HIV-infected cases were slightly more likely to be an S. pneumoniae carrier compared with HUU cases (aOR = 1.1; 95% CI: 0.57–2.14). In contrast, all other case/exposure combinations were less likely to be S. pneumoniae carriers with the lowest adjusted odds among HIV-infected controls children (aOR = 0.34; 95% CI: 0.17–0.71). The odds of being a PJ carrier was almost 6 times higher in HIV-infected cases than in HIV unexposed cases (aOR = 6.63; 95% CI: 3.24–13.54). Conclusions We demonstrate that HIV infection and HIV exposure without infection each have an impact on carriage rates and density for S. pneumoniae and P. jirovecii, though the magnitude and nature of these effects differs substantially between the two pathogens. This may be explained in part by differences in immune responses to these two different pathogens. Our analysis provides further evidence of fundamental differences in immune function among HIV exposed but uninfected infants compared with HIV unexposed, uninfected infants.