Browsing by Author "Fayemiwo, S. A."

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Dyslipidemia in ART-naive HIV-infected persons in Nigeria-implications for care
(Sage, 2014) Kuti, M. A.; Adesina, O. A.; Awolude, O. A.; Ogunbosi, B. O.; Fayemiwo, S. A.; Akinyemi, J. O.; Adetunji, A. A.; Irabor, A. E.; Odaibo, G. N.; Prosper, O.; Taiwo, B. O.; Olaleye, D.; Murphy, R. L.; Kanki, P.; Adewole, I. F.
Aims: This study aimed to describe the prevalence and pattern of lipid abnormalities among antiretroviral therapy (ART)- naive HIV patients, understand if there is any relationship to virologic and immunologic status, and discuss the implications for care. Methods: This was a cross-sectional study in which baseline demographic, clinical, and laboratory data of all ART-naive HIV-infected individuals recruited into the adult ARV clinic, University College Hospital, Ibadan, between January and December 2006, were analyzed. Results: In total, 1316 ART-naive HIV-infected persons were recruited in the period. Females subjects and participants aged 35 years accounted for 67.1% and 57.7% of all participants, respectively. At least 1 abnormal lipid fraction was seen in 73.3% of participants. It was observed that in 11.5% participants the total cholesterol (TC) was ≥5.2 mmol/L, in 2.7% the low-density lipoprotein cholesterol (LDL)-C was >4.1 mmol/L in 56.5% the high-density lipoprotein cholesterol (HDL)-C was <1.0 mmol/L, and in 27.6% the triglyceride (TG) was >1.7 mmol/L. The TC, LDL-C, and HDL-C were all significantly positively correlated with CD4 counts and negatively correlated with viral load. On the contrary, the TG levels were negatively correlated with CD4 counts and positively correlated with viral load. Multivariate linear analysis showed a significant relationship between all the lipid parameters and viral load. CD4 counts were only significantly associated with TC. Conclusions: A significant burden of dyslipidemia exists among ART-naive HIV-infected persons. Low HDL-C was the most frequently observed abnormality. The abnormalities related more with viral load levels than with CD4 counts. Dyslipidemia screening should be done in ART-naive HIV-infected persons. Simple healthy lifestyle changes should be emphasized, with other care given to those with the disorder.
Dyslipidemia in ART-naive infected Persons in Nigeria- implications for care
(Sage Publications, 2015) Kuti, M. A.; Adesina, O. A.; Awolude, O. A.; Ogunbosi, B. O.; Fayemiwo, S. A.; Akinyemi, J. O.; Adetunji, A. A.; Irabor, A. E.; Odaibo, G. N.; Okonkwo, P.; Taiwo, B. O.; Olaleye, D.; Murphy, R. L.; Kanki, P.; Adewole, I. F.
Aims: This study aimed to describe the prevalence and pattern of lipid abnormalities among antiretroviral therapy (ART)- naive HIV patients, understand if there is any relationship to virologic and immunologic status, and discuss the implications for care. Methods: This was a cross-sectional study in which baseline demographic, clinical, and laboratory data of all ART-naïve HIV-infected individuals recruited into the adult ARV clinic, University College Hospital, Ibadan, between January and December 2006, were analyzed. Results: In total, 1316 ART-naive HIV-infected persons were recruited in the period. Females subjects and participants aged ≤35 years accounted for 67.1% and 57.7% of all participants, respectively. At least 1 abnormal lipid fraction was seen in 73.3% of participants. It was observed that in 11.5% participants the total cholesterol (TC) was ≥5.2 mmol/L, in 2.7% the low-density lipoprotein cholesterol (LDL)-C was >4.1 mmol/L in 56.5% the high-density lipoprotein cholesterol (HDL)-C was <1.0 mmol/L, and in 27.6% the triglyceride (TG) was >1.7 mmol/L. The TC, LDL-C, and HDL-C were all significantly positively correlated with CD4 counts and negatively correlated with viral load. On the contrary, the TG levels were negatively correlated with CD4 counts and positively correlated with viral load. Multivariate linear analysis showed a significant relationship between all the lipid parameters and viral load. CD4 counts were only significantly associated with TC. Conclusions: A significant burden of dyslipidemia exists among ART-naive HIV-infected persons. Low HDL-C was the most frequently observed abnormality. The abnormalities related more with viral load levels than with CD4 counts. Dyslipidemia screening should be done in ART-naive HIV-infected persons. Simple healthy lifestyle changes should be emphasized, with other care given to those with the disorder.
External genital warts in HIV-infected patients with sexually transmitted infections in Ibadan, Nigeria
(2017) Fayemiwo, S. A.; Adesina, O. A.; Akinyemi, J. O.; Michael, O. S.; Adekanmbi, O. A.; Awolude, O. A.; Kuti, M. A.; Odaibo, G. N.; Adewole, I. F.
Background: Human Papilloma Virus (HPV) infection in the genital area is usually asymptomatic, and when symptomatic, manifests in cither benign or malignant forms. This study aims at providing information on the prevalence of external genital warts (EGWs) among people living with HIV (PLWHIVs) attending Antiretroviral Treatment (ART) clinic at the University College Hospital. Ibadan, Nigeria. Methods: This is a descriptive cross-sectional survey of PLWHIVs attending ART clinic between January 2006 and December 2007. Diagnosis of genital warts was based on the findings of typical lesions on the external genitalia, vaginal, cervix or perianal region after clinical examination and informed consent from each participant. Antibodies against Herpes and HPV were measured using, Enzyme-linked immunosorbent Assay (ELISA). Results: A total of 5.207 patients, 3519 female and 1688 males attended the ART clinic during the period. The mean age of the patients was 34,67 yrs (± 9.16). Five hundred and forty-two (10.0%) had various sexually transmitted infections (STIs). The prevalence of anogenital warts was 3.65% among the HIV-infected patients and 35.0 % among the subset of HIV- infected patients with STIs. The prevalence of genital warts was 1.5 times higher in treatment experienced patients (OR =1.46; 95%CI: 1.02,2.10). Genital wart was found to be associated with low CD4 count, high viral load, treatment- experience and non-use of condom during sexual intercourse. (P = 0.002). Conclusions: External genital warts are common among people living with HIV infection. According to the appropriate guidelines, HPV vaccine should also be offered to HIV-infectcd adolescents that are non-rcactivc to the virus.
Genital ulcer diseases among HIV_infected female commercial sex workers in Ibadan, Nigeria
(2011) Fayemiwo, S. A.; Odaibo, G. N.; Oni, A. A.; Ajayi, A. A. A
We evaluated the prevalence and association of Genital Ulcer Diseases (GUDs) among HIV-1 infected female commercial sex workers (FCSWs) in Ibadan, Nigeria. A total of 250 FCSWs from brothels in Ibadan were tested for presence of antibodies to HIV and Syphilis. Pelvic examinations for signs of sexually transmitted infections (STIs) were carried out on the subjects. Endocervical and high vaginal swabs were collected from each of the subjects to establish laboratory diagnosis of STIs. Their age ranged from 15 to 55 years (Mean = 25.8 yrs; SD = 3.74). Majority (246/250) were Nigerians, while 1.6% were from neighboring West African countries. Sixty four (25.6%) of the subjects were positive for HIV-1 while seven (2.8%) had dual HIV-1/2 infection. Analysis of the STIs showed that 49 (19.6%) of the CSWs had GUDs. Herpes genitalis was the commonest GUDs as it occurred in 25 (10%) of the subjects. Other STIs identified were chancroid (5.6%), syphilis (4.0%) and lymphogranuloma venerum (LGV) (4%). Sixteen (64.0%) of the CSWs with herpes genitalis had HIV-1 infection. The risk ratio of herpes genitalis for HIV acquisition was 3.0 (95% CI: 2.0 - 4.4). Syphilis and chancroid were also found tobe significantly associated with increased risk of HIV infection (p < 0.0001). The adjusted odd ratios for Herpes genitalis, chancroid, and syphilis were 3.7 (1-13.0, p < 0.05), 19.8 (2.7-13.0, p < 0.05) and 19.1 (1-231.0, p < 0.05) respectively. There is need to educate FCSWs continually to adopt safer sexual behaviours, seek early diagnosis and treatment of GUDs to reduce their risk of transmitting HIV infection.
Molluscum contagiosum virus infection among PLWHA In Ibadan, Nigeria
(African Journal of Clinical and Experimental Microbiology, 2014) Fayemiwo, S. A.; Adesina, O. A.; Akinyemi, J. O.; Odaibo, G. N.; Omikunle, T. O.; Adewole, I. F.
Background: Molluscum contagiosum (MC) infection is caused by a pox virus and the virus is probably passed on by direct skin-to- skin contact which may affect any part of the body. There is anecdotal evidence associating facial lesions with HIV-related immunodeficiency. This study was aimed to determine the prevalence and associated risk factors of Molluscum contagiosum infection among PLWHAs attending ART clinic at the University College Hospital, Ibadan, Nigeria. Methods: This is a descriptive cross-sectional survey of 5,207 patients (3519 female and 1688 males) attending ART clinic between January 2006 and December 2007. Physicians performed complete physical and pelvic examinations. Diagnosis of Molluscum Contagiosum infection was based on the clinical findings of typical lesions on the external genitalia, perianal, trunk, abdominal and facial regions. Results: The mean age of the patients was 34.67 yrs. ± 9.16). About 10% (542) had various sexually transmitted infections (STIs). The male to female ratio was 1: 4.2. One hundred and twenty seven subjects (23.4%) had no formal or primary education with 247 (45.6 %) being treatment naive while 295 (54.4 %) were treatment experienced. Of the 542 PLWHAs with STIs, 3.3 % had undetectable viral load (< 200 copies/ ml) while 272 (50.1 %) had low CD4 count (< 200 cells / mm3.) and The Mean log10 viral load was 5.02 ± 0.94. Molluscum Contagiosum infection was diagnosed in 13 patients (0.024%; 8 females and 5 males). Vaginal Candidiasis was the commonest genital infection diagnosed in 223 (41.1%) of the patients with STIs. MC patients had higher viral load, lower CD4 count and more likely to be treatment experienced”. Conclusions: Molluscum Contagiosum infection is not uncommon among the HIV-infected patients, but underreported. Awareness of this cutaneous manifestation should be known to Physicians in AIDS care.
Obstetric and newborn outcomes and risk factors for low birth weight and preterm delivery among HIV-infected pregnant women at the University College Hospital Ibadan
(Society of Gynaecology and Obstetrics of Nigeria, 2015-04) Adesina, O. A.; Michael, O. S.; Ogunbosi, B. O.; Akinyemi, J. O.; Kuti, M. A.; Awolude, O. A.; Fayemiwo, S. A.; Adewole, I. F.
There remains uncertainty about the impact of HIV on pregnancy outcomes and effects of highly active antiretroviral therapy on fetal development. This study describes obstetric outcomes among HIV positive parturients at the University College Hospital, Ibadan. HTV positive parturients were identified in the birth register. During the 30-month period, 318 of 6203 deliveries were HIV positive (5.1%) with 97.6% record retrieval. The mean age of the HTV positive parturients was 31.66 years (± 4.66); the mean gestational age at delivery was 38.02 weeks (± 2.75) and the mean birth weight 2.85kg (±0.59). There were 35.8% (109) preterm births, 2.9% stillbirths and 21.5% low birth weights. The regimen most commonly (198, 64.5%) used was a non-nucleoside reverse transcriptase (NNRTI) based HAART. Preterm births were similar following spontaneous vaginal delivery (31.5%) and elective section (31%) but higher (41.3%) with emergency section (p=0.4). On univariate analysis, the preterm infants had lower mean birth weights (2.46±0.61 vs 2.96±0.44; p=0.000). The proportion of preterm births was higher among Low birth weight infants (71.9% vs 28.1%; p=0.00). Variables with more preterm births were age >35 years (51.6%), ≤ 6years of schooling (51.5% vs 48.4%) and being on combination ARV (PI, 37.5% or non-PI, 36.2%). However, these differences did not attain statistical significance. Low birth weight infants had mothers who had higher mean ages (33.28 years ±4.59 vs 31.28 years ± 4.59,. p= 0.02), lower mean gestational age at delivery (35.72 weeks ± 3.16 vs 38.49 weeks ±2.1, p= 0.00). Variables with more low birth weight include <12years of schooling and being on mono/ dual therapy (31.8%). These differences were not statistically significant. On logistic regression, factors that retained an association with low birth weight were mean maternal age at delivery (p= 0.002; β- 0.904; 95% CI, 0.848 - 0.966) and being on mono/ dual therapy (p= 0.039; β= 3.042; 95% CI, 1.055 - 8.768). The only factor that retained an association with preterm birth was mean maternal age at delivery (p= 0.015; β= 0.935; 95% CI, 0.886-0.987). HIV positive (especially older) women, have high rates of preterm deliveries and low birth weights. The beneficial effects of HAART on mother-to-child transmission are indisputable but monitoring antiretroviral therapy in pregnancy remains a priority and antenatal surveillance should include fetal growth assessment.
Obstetric and newborn outcomes and risk factors for low birth weight and preterm delivery among HIV-infected pregnant women at the University College Hospital, Ibadan
(2015-04) Adesina, O. A.; Obaro, S. M.; Ogunbosi, B. O.; Akinyemi, J. O.; Kuti, M. A.; Awolude, O. A.; Fayemiwo, S. A.; Adewole, I. F.
There remains uncertainty about the impact of HIV on pregnancy outcomes and effects of highly active antiretroviral therapy on fetal development. This study describes obstetric outcomes among HIV positive parturients at the University College Hospital, Ibadan. HIV positive parturients were identified in the birth register. During the 30-month period, 318 of 6203 deliveries were HIV positive (5.1%) with 97.6% record retrieval. The mean age of the HIV positive parturients was 31.66 years (± 4.66); the mean gestational age at delivery was 38.02 weeks (± 2.75) and the mean birth weight 2.85kg (±0.59). There were 35.8% (109) preterm births, 2.9% stillbirths and 21.5% low birth weights. The regimen most commonly (198, 64.5%) used was a non-nucleoside reverse transcriptase (NNRTI) based HAART. Preterm births were similar following spontaneous vaginal delivery (31.5%) and elective section (31%) but higher (41.3%) with emergency section (ƿ=0.4). On univariate analysis, the preterm infants had lower mean birth weights (2.46±0.61 vs 2.96±0.44; ƿ=0.000). The proportion of preterm births was higher among Low birth weight infants (71.9% vs 28.1%; ƿ=0.00). Variables with more preterm births were age >35 years (51.6%), ≤6years of schooling (51.5% vs 48.4%) and being on combination ARV (PI, 37.5% or non-PI, 36.2%). However, these differences did not attain statistical significance. Low birth weight infants had mothers who had higher mean ages (33.28 years ± 4.59 vs 31.28 years ± 4.59, ñ= 0.02), lower mean gestational age at delivery (35.72 weeks ± 3.16 vs 38.49 weeks ± 2.1, ƿ= 0.00). Variables with more low birth weight include <12years of schooling and being on mono/ dual therapy (31.8%). These differences were not statistically significant. On logistic regression, factors that retained an association with low birth weight were mean maternal age at delivery (ƿ= 0.002; β= 0.904; 95% CI, 0.848 –0.966) and being on mono/ dual therapy (ƿ= 0.039; β= 3.042; 95% CI, 1.055 – 8.768). The only factor that retained an association with preterm birth was mean maternal age at delivery (ƿ= 0.015; β= 0.935; 95% CI, 0.886 – 0.987). HIV positive (especially older) women, have high rates of preterm deliveries and low birth weights. The beneficial effects of HAART on mother-to-child transmission are indisputable but monitoring antiretroviral therapy in pregnancy remains a priority and antenatal surveillance should include fetal growth assessment.
Pattern if sexually transmitted Disease among HIV-! Infected commercial sex workers in Ibadan, Nigeira
(MEDIMOND, 2004) Fayemiwo, S. A.; Bakare, R. A.; Odaibo, G. N.; Oni, A. A.; Fasina, A. A.; Olaleye, D. O.; Sankale, J. L.; Kanki, P.
"This study evaluatcd the association of HXV-1 infection with some other sexually transmitted diseases (STDs) among fernaIe commercial sex workers. BIood samples were collected from 250 female commercial sex workers in Ibadan Oyo State, Nigeria and tested for the presence of HEV antibodies using ELISA and Western blot. Endocervical and high vaginal swab samples were also collected for microscopy and culture. The prevalence of HIV- 1 infection among CSWs in Ibadan, Nigeria was 25.6% with 2.8% having dual reactivity to HIV- 1 and HIV- 2. Bacterial vaginosis was the commonest STDs (32.8%) followed by herpes genitalis, vaginal candidiasis, gonorrhoea, trichornoniasis, chancroid,syphilis, tinea curiz, genital warts, Iympholgranuloma venerum (LGV) and scabics. Recurrcnt vaginal discharge, gcnital ulccr discascs as well as non-genital ulcer diseases (tinea curiz and scabies) were associated with increased risk of HIV infections. Access to prevention and prompt management of these STDs will reduce the spread of HIV."
Pattern of asymptomatic sexually transmitted infections in women undergoing hysterosalpingography for infertility evaluation in Ibadan Nigeria
(Society of Gynaecology and Obstetrics of Nigeria (SOGON)., 2013) Atalabi, O. M.; Fayemiwo, S. A.; Oladokun, A. A.; Bakare, R. A.
"The roles of gonorrhea and non-gonococcal urethritis due to Chlamydia trachomatis in the etiology of infertility due to tubal occlusion have been established by various studies. Hysterosalphingography WSG) is done to investigate tubal patency. This study was aimed at finding the prevalence of asymptomatic sexually transmitted infections (STIs) in women being investigated for infertility in a tertiary institution.Methods: This was a cross-sectional study of asymptomatic infertile women referred for pre-HSG screening. Detailed medical history, Endocervical and high vaginal swabs were collected to establish diagnosis of STIs following clinical examination and informed consent. These specimens were evaluated microscopically for Chlamydia trachomatis and bacterial vaginosis. Endocervical secretions were Gram-stained for intracellular Gram - Negative diplococci and suspected isolates were confirmed as Neisseriagonorrhoeae by standard laboratory methods. Results: There were 250 participants with a mean age of 34.6 years (SD = 5.4, range = 25 -49). The mean age of sexual debut of participants was 21.5 years (SD = 4.3). Fifty-six (22.5%) of the women engaged in oral sex while 53 (2 1.2 %) shared their spouses with other sexual partners. 1 7.7% had previous PID, 43.1% of them has vaginal discharge syndrome. The commonest ST1 was Vulvo- vaginal candidiasis (24.4%) and others were bacterial vaginosis (18.4%), Chlamydia cervicitis ( 17.6% ), trichomoniasis (11.2% ), and gonomhea ( 2.4 % ). Conclusion: The procedure of HSG is invasive and asymptomatic infections in the cervix can be dislodged and propagated by injectionof contrast to the fallopian tubes thus causing tubal blockage. Routine Per -HSG screening for occult STIs is encouraged to avoid iatrogenic Pelvic Inflammatoty Disease "