Browsing by Author "Kanki, P. J."

Now showing 1 - 2 of 2

Condom use among antiretroviral therapy patients in Ibadan, Nigeria
(2010) Akinyemi, J. O.; Awolude, O. A.; Awolude, O. A.; Adewole, I. F.; Kanki, P. J.
Background: While antiretroviral treatment (ART) has improved the health status of people living with HIV, new challenges to their sexual and reproductive health (SRH) needs and their ability to prevent secondary HIV infections have risen. This study aimed to determine the level and factors that affect condom use among ART-experienced patients at the premier teaching hospital in Nigeria. Methodology: This longitudinal study involved patients who initiated treatment at the University College Hospital, Ibadan, Nigeria, between January and December 2006. Sexually active patients who had received treatment for at least six months and had not defaulted on clinic follow-up schedules were studied. Data on socio-demographic characteristics and condom use were extracted from clinic records. Chi square test and logistic regression were employed to determine factors associated with condom use. Results: The study involved 866 patients, specifically, 306 (35.3%) men and 560 (64.7%) women aged 40.7 (SD 7.6) and 33.3 (SD 6.5) years respectively. Condoms usage before treatment and at last clinic visits was 14.0% and 43.3% respectively. Overall reports of condom use at specified periods were as follows: 1 – 6 months (33.0%); 7 – 12 months (37.3%) and above 12 months (53.8%). Patients in a marital union and those with higher education were more likely to use condoms. Conclusions: Condom use is significantly influenced by marital status and educational level. Although condom use increases together with follow-up time, the level can be improved. Primary and secondary prevention efforts targeting high-risk sexual behaviour among ART patients need to receive greater and continual attention.
Subtypes-specific patterns in HIV type 1reverse transcriptase and protease in Oyo state, Nigeria: implications for drug resistance and Host Response
(Mary Ann Liebert, Inc, 2006) Ojesina, A. I.; Sankale, J.; Odaibo, G.; Langevin, S.; Meloni, S. T.; Sarr, A. D.; Olaleye, D.; Kanki, P. J.
As the use of antiretroviral therapy becomes more widespread across Africa, it is imperative to characterize baseline molecular variability and subtype-specific peculiarities of drug targets in non-subtype B HIV-1 infection. We sequenced and analyzed 35 reverse transcriptase (RT) and 43 protease (PR) sequences from 50 therapy-naive HIV-1-infected Nigerians. Phylogenetic analyses of RT revealed that the predominant viruses were CRF02_AG (57%), subtype G (26%), and CRF06_cpx (11%). Six of 35 (17%) individuals harbored primary mutations for RT inhibitors, including M41L, V118I, Y188H, P236L, and Y318F, and curiously three of the six were infected with CRF06_cpx. Therefore, CRF06_cpx drug-naive individuals had significantly more drug resistance mutations than the other subtypes (p = 0.011). By combining data on quasisynonymous codon bias with the influence of the differential genetic cost of mutations, we were able to predict some mutations, which are likely to predominate by subtype, under drug pressure. Some subtype-specific polymorphisms occurred within epitopes for HLA B7 and B35 in the RT, and HLA A2 and A*6802 in PR, at positions implicated in immune evasion. Balanced polymorphism was also observed at predicted serine-threonine phosphorylation sites in the RT of subtype G viruses. The subtype-specific codon usage and polymorphisms observed suggest the involvement of differential pathways for drug resistance and host-driven viral evolution in HIV-1 CRF02_AG, subtype G, and CRF06_cpx, compared to subtype B. Subtype-specific responses to HIV therapy may have significant consequences for efforts to provide effective therapy to the populations infected with these HIV-1 subtypes