African Journal of AIDS and HIV Research

African Journal of AIDS and HIV Research ISSN: 2326-2691 Vol. 4 (2), pp. 196-200, February, 2016. © International Scholars Journals

Full Length Research Paper

Correlates and risk factors for abnormal papanicolaou smear among HIV infected and HIV non infected women in Northeastern Nigeria

Umaru Inuwa¹, Calvin Chama², Bala Audu², Jessy Obed², Haruna Ngadda³, Mohammed Bukar², Salisu Kwayabura², Babagana Bako², Ballah Akawu Denue⁴, Ukaobasi Alex⁵, Bukar Musa³, Anna Peter²

¹Department of Obstetrics and Gynaecology, Federal medical centre Yola, Adamawa State, Nigeria.

²Department of Obstetrics and Gynaecology University of Maiduguri Teaching Hospital, Maiduguri, Borno State, Nigeria.

³Department of Histopathology University of Maiduguri Teaching Hospital, Maiduguri, Borno State, Nigeria.

⁴Department of Internal Medicine, University of Maiduguri Teaching Hospital, Maiduguri, Borno State, Nigeria.

⁵Department of Histopathology Federal Medical Centre Yola, Adamawa State, Nigeria.

Corresponding author. E-mail: [email protected]. Tel: +2348035763388

Accepted 20 February, 2016

Abstract

Background: Universal access to antiretroviral therapy has resulted in increased life expectancy among HIV infected women clients, however the risk of certain clinical conditions including premalignant lesion of the cervix may remain or enhanced compared with HIV negative control. Objectives: To compare the prevalence and the risk factors of abnormal Pap smear among HIV positive and HIV negative women attending clinics of two tertiary hospitals in Northeastern Nigeria. Methodology: This was a hospital based case control cross sectional study involving three hundred and sixty-five consecutive consenting HIV infected women and three hundred and sixty-five HIV non- infected women. Socioeconomic and clinical variables, abnormal Pap smear and CD4 cell count of all the HIV positive women were recorded. Results: Abnormal Pap smear among HIV infected women of 47.94 % (18.1% epithelial and 29.8% benign cells abnormalities) in this report was higher than 31.78% (8.0% epithelial and 23.78% benign cells abnormalities) among HIV non-infected women. A negative correlation was observed between CD4 cell count and the abnormal Pap smear.  Other correlates of abnormal Pap smear include early coitache, multiple sexual partners and low social class. Conclusion: HIV infection is associated with increased risk of abnormal Pap smear in women. Other risk factors associated with abnormal Pap smear, include early coitache, multiple sexual partners and low social class. Recommendation: Cervical screening should be included among investigations in evaluating HIV infected women.

Key words: Abnormal Pap smear, HIV, CD4 cell count, risk factors, HPV.

African Journal of AIDS and HIV Research ISSN 2326-2691 Vol. 3 (6), pp. 180-188, June, 2015. © International Scholars Journals

Full Length Research Paper

Renal disease in HIV infected Nigerian Children coinfected with hepatitis B and C

*Iduoriyekemwen N.J and Sadoh A.E

Senior Lecturer/ Consultant Paediatrician, Department of Child Health, University of Benin/University of Benin Teaching Hospital, P.M.B. 1111, Benin City, Edo State, Nigeria.

Senior Research Fellow/ Consultant Paediatrician, Institute of Child Health, University of Benin/ University of Benin Teaching Hospital, P.M.B. 1111, Benin City, Edo State, Nigeria.

*Corresponding author. E-mail: [email protected]. Tel: 08023287095.  

Abstract

HIV, HBV and HCV are known to individually cause chronic glomerulopathies. This cross sectional study was carried out to identify renal disease and the risk of developing renal disease in HIV/Hepatitis B and C co-infected Nigerian children aged 10 months to 17 years. Each child was tested for hepatitis B surface antigen, antibody to hepatitis B core antigen and antibody to hepatitis C virus. Serum creatinine levels were determined and used in calculating the glomerular filtration rate. Urine was tested for proteinuria and microalbuminuria. Renal disease was defined as presence of proteinuria of ≥1+ on dipstick with or without GFR <60 ml/ min/1.73 m^2.  Renal disease risk was defined as presence of microalbuminuria of ≥20mg/l. Of the 114 HIV infected children HIV/HBV coinfection was observed in 10(8.8%) and HIV/HCV coinfection in 7(7%). All HIV/HBV coinfected children had risk of renal disease 6(60%) or established renal disease 4(40%). Two HIV/HCV coinfected children had risk of renal disease while 1 had established renal disease. The mean CD4 count 497±333.5 in HIV/HBV coinfected children with renal disease was significantly lower than the 1222.6±400.6 in HIV monoinfected children with renal disease p<0.01. HIV/HBV coinfected children with renal disease were more likely to be unimmunized compared to HIV monoinfected children with renal disease. P= 0.02. We conclude that renal disease was common in HIV/HBV coinfected children and this was associated with being unimmunized against hepatitis B.

Keywords: Renal disease, Human immunodeficiency virus, Hepatitis B and C, Coinfection, Children.

African Journal of AIDS and HIV Research ISSN 2326-2691 Vol. 3 (6), pp. 078-077, June, 2015.  © International Scholars Journals

Case Report

Managed virological reaction after treatment with daclatasvir/pegylated interferon and ribavirin as a component of a clinical trial in a cirrhotic human immunodeficiency infection

*William Grant caine, Balogun V. Ayo and Funmilayo Odukoya

Department of Infection and Immunology, Loughborough University, Loughborough, England.

E-mail: [email protected] 

Accepted 19 April, 2015

Abstract 

This study presents a case of a sustained virological response to 24 weeks early cessation of hepatitis C direct acting antiviral (DAA) treatment with daclatasvir/peginterferon (PEG-IFN)/ribavirin (RBV), mandated by liver decompensation, in a clinical trial subject with advanced liver disease and human immunodeficiency virus (HIV)/hepatitis C virus (HCV) co-infection.

Key words: Human immunodeficiency virus (HIV), hepatitis C, daclatasvir, liver decompensation, sustained virological response, HIV/hepatitis C co-infection.

African Journal of AIDS and HIV Research ISSN 2326-2691 Vol. 3 (5), pp. 074-077, May, 2015. © International Scholars Journals

Full Length Research Paper

An examination on Human immunodeficiency Virus/AIDS (HIV/AIDS) clinical trial movement on the African Continent

Trevor Noah Tutu

Department of Community Medicine, College of Medicine and Health Science, University of Johannesburg, Johannesburg, South Africa.

E-mail: [email protected]

Accepted 7 March, 2015

Abstract 

The human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) pandemic is a major public health problem which poses a significant threat to livelihoods and social security in resource-poor countries due to the rapid spread of the infection amongst individuals at the prime of their productive age. Sub-Saharan Africa is the region most affected by HIV/AIDS with an estimated 24.7 million people living with HIV in 2014, and accounts for almost 70% of new infections globally. It is necessary for researchers, health workers, policy-makers and consumers to have information on planned and ongoing clinical trials. This will enable them to effectively assess interventions for the prevention and treatment of HIV/AIDS and its related conditions, as well planning appropriate future research. The aim of this study was to describe the current status of ongoing HIV clinical trials on the Pan African Clinical Trials Registry (PACTR) to inform African stakeholders of gaps in research, and potential areas of duplication. A cross-sectional analysis of trials currently registered on PACTR was conducted and excluded all trials that did not research HIV/AIDS interventions. Currently, there are 66 trials investigating HIV interventions registered with 28 looking at treatment. Co-morbid conditions are investigated in 20 trials. Forty-one of the trials are single-centered and being conducted across 14 countries. The remaining 52 trials are multicentered with sites in 14 African countries. At present, there is a growing number of planned or ongoing HIV/AIDS trials currently registered on www.pactr.org. This is encouraging as previous studies of published trials noted that not many were conducted in Africa. There has also been an increase in the number of African principal investigators, an indicator of regional capacity to conduct research.

Key words: Human immunodeficiency virus/Acquired immune deficiency syndrome (HIV/AIDS) treatment, clinical trials, trial registration.

African Journal of AIDS and HIV Research ISSN 2326-2691 Vol. 3 (4), pp. 067-073, April, 2015.  © International Scholars Journals

Full Length Research Paper

Psychometric properties of moore rendition of World Health Organization's Personal satisfaction (WHOQOL) HIV-BREF in persons living with HIV in Burkina Faso

Blaise D. Sanou

Department of Community Medicine, College of Medicine and Health Science, University of Ouagadougou, Burkina Faso. E-mail: [email protected]

Accepted 17 March, 2015

Abstract 

This study aims to examine psychometric properties of Moore version of World Health Organization's Quality of Life assessment short instrument in HIV patients (WHOQOL HIV-BREF). A study was conducted on 100 persons living with human immunodeficiency virus infection and acquired immune deficiency syndrome (HIV/AIDS) in Ouagadougou, Burkina Faso. The internal consistency was evaluated using Cronbach's α. For the convergent validity of the Moore version WHOQOL-HIV BREF, the satisfaction with life scale (SWLS) was used as a comparison instrument and cross-product correlations were calculated. The test-retest reliability was assessed using the interclass correlation coefficient. The study showed high internal consistency with Cronbach's α at 0.92 for the whole instrument. According to domains, Cronbach's α found ranged from 0.58 to 0.87, showing acceptable internal consistency for all domains. Domains scores for test-retest reliability, using interclass correlation gave coefficients ranged from 0.40 (spiritual domain) to 0.99 (level of independence domain) with p < 0.001 for all domains except for spirituality domain (p < 0.05). The study showed significant correlation between general facets and quality of life score (p < 0.001), as wheel as WHOQOL HIV-BREF and satisfaction with life scale (p < 0.01) except for spirituality domain. The instrument demonstrated good discriminative properties according to clinical stages of HIV infection with higher scores for asymptomatic HIV patients and lower scores at AIDS stage (p<0.001), except for spirituality domain (p > 0.05). As a demonstrated cross-cultural instrument, the WHOQOL HIV-BREF in its Moore version can be used for quality of life assessment in a routine way or longitudinal studies in Burkina Faso with persons living with HIV/AIDS.

Key words: Quality of life, WHOQOL HIV-BREF, Burkina Faso, moore, psychometrics.

African Journal of AIDS and HIV Research ISSN 2326-2691 Vol. 3 (3), pp. 059-066, March, 2015. © International Scholars Journals

Full Length Research Paper

Change in serum lipid profiles and glucose subsequent to changing from stavudine/lamivudine to zidovudine/lamivudine in non-nucleoside reverse transcriptase inhibitors based hostile to retroviral regimens in Southern Ethiopia

Azeb N. Wogderess

Department of Community Medicine, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia.

E-mail: [email protected]

Accepted 21 February, 2015

Abstract 

Data concerning any difference in serum lipid profiles and glucose level after patients switched from stavudine to zidovudine in Ethiopia is very limited. Seventy eight adults receiving antiretroviral therapy (ART) that included stavudine/lamivudine with either of efavirenz or nevirapine during ART initiation were enrolled. Of these patients, 53 were switched to zidovudine/lamivudine/nevirapine (NVP-group) and the rest 25 were switched to zidovudine/lamivudine/efavirenz (EFV-group). Serum lipid profiles and glucose were determined after overnight fasting. Dyslipidemia and dysglycaemia were assessed according to the United State National Cholesterol Education program-III guideline. Statistical analysis was done using Statistical Package for Social Sciences (SPSS) Version 20. Of the 78 patients, 39.7% were males and 60.3% were females. At the end of the study follow-up, the prevalence of TC ≥ 200 mg/dl, LDL-c ≥ 130 mg/dl, TG ≥ 150 mg/dl, HDL-c < 40 mg/dl and glucose ≥ 110 mg/dl were higher in EFV group when compared with NVP. About 74.4% patients had at least two laboratory abnormities which is compatible with a diagnosis of dyslipidemia at 12 month of post switch. Four lipid profiles abnormal within a single individual was 16% in EFV and 3.8% in NVP group, p = 0.08. Raised HDL-c concentration was observed in NVP group in both periods when compared with EFV. In addition, patients that switched from d4T/3TC/NVP to AZT/3TC/NVP had a significant change in TC and TG (p = 0.001 for both). Also TC ≥ 200 mg/dl was decreased from 49 to 16% (p = 0.04). Furthermore, sex was significantly and negatively associated with raised TC and TGs among patients using NVP based regimen. Raised HDL-c concentration, decreased proportion of abnormal lipid profiles and abnormal glucose was observed in the NVP group. Based on these findings, NVP may be expected to reduce the risk of cardiovascular diseases.

Key words: Dyslipidemia, dysglycaemia, human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS), antiretroviral therapy, Ethiopia.