Virology

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Human Immuno-deficiency Virus and Hepatitis B virus coinfection in pregnancy at the University College Hospital, Ibadan
(2010) Adesina, O.; Oladokun, A.; Akinyemi, O.; Adedokun, B.; Awolude, O.; Odaibo, G. O.; Olaleye, D.; Adewole, J.
Human Immuno-deficiency virus (HIV) and Hepatitis B Virus (HBV) share common modes of transmission which include blood borne and the vertical routes. Although, the natural course of HIV does not appear altered by HBV, the rate of liver-related deaths is several times higher among HIV/HBV co-infected persons. Clinicians providing care for HIV positive individuals, including pregnant women, need to be aware of this problem. This is a 2-year cross-sectional study that commenced in January 2006, among HIV positive pregnant women seen at the University College Hospital, Ibadan. During the study period, 721 HIV positive pregnant women were screened for hepatitis B virus infection. Sixty-four women (8.9%) were positive for HBsAg, 14(1.9%) were HCV positive and 642 (89.2%) were negative for both HBV and HCV. One patient was positive forboth HBV and HCV. There were no remarkable differences between HIV infected and HIV-HBV coinfected patients in terms of the hematological, albumin and bilirubin measurements. Alanine transaminase was however higher in the HIV-HBV co-infected patients than HIV patients and this was statistically significant (17.5 iu/ ml vs. 15.0 iu/ml, p value--0.009). In addition, the CD4 cell count was lower and the viral load marginally higher in the hepatitis B virus positive patients. The differences were however not statistically significant (p value--0.114 and 0.644 respectively). HIV-HBV co-infection in HIV positive pregnant women is not of negligible proportions as demonstrated in this study. Thus, HIV positive pregnant women should be screened for HBV and assisted to access care targeted at preventing morbidity and vertical transmission.
Reliability of testing and potential impact on HIV prevention in Nigeria
(2006) Odaibo, G. N.; Donbraye, E.; Adewumi, M. O.; Bakaery, A. S.; Ibeh, M. A.; Olaleye, D. O.
Several factors including variability of human immunodeficiency virus (HIV), laboratory facilities, cost and competence of personnel handling the tests are some of the important factors that affect accuracy and reliability of HIV testing in most parts of Africa. Recently investigators in Africa have observed that antibody detection assays based on antigens derived from HIV-1 subtype B show moderate to significantly lower sensitivity for detection of infection by various non-B subtypes. In this study, we evaluated the reliability of two EIA and 12 rapid HIV-1/2 test kits that are commercially available in Nigeria using the Western immunoblotting technique as reference. A panel of 100 sera from Western blot confirmed symptomatic or asymptomatic HIV-1 infected persons and 90 seronegative patients from those referred for testing in our laboratory were used for this study. Each sample was tested with two HIV-1/2 EIA, and 12 HIV-1/2 rapid test kits commercially available at one time or the other for HIV-1/2 testing in Nigeria. Overall, the sensitivity of the two EIA kits were 100% and 91.0% with specificity of 96.7% and 91.1% respectively. The sensitivity of the rapid test kits ranged from 88% to 98.0% with specificity of 92.2% to 100%. Further analysis showed significant variation in the sensitivity and specificity of the same kit based on whether an individual had asymptomatic or symptomatic infection The results of this study highlight the problem of diagnosis of HIV infections in Africa. It shows that the sensitivity of most of the rapid assays shall not be adequate for detection of early infection. The implications of possible misdiagnosis on the various intervention strategies that rely predominantly on correct HIV status of an individual are enormous. Thus, there is an urgent need for review of the current HIV testing assays or algorithms in Nigeria and other parts of Africa.
HIV infection among patients with pulmonary tuberculosis in Nigeria
(2005) Odaibo, G. N.; Gboun, M. F.; Ekanem, E. E.; Gwarzo, S. N.; Saliu, I.; Egbewunmi, S. A.; Abebe, E. A.; Olaleye, D. O.
Respiratory problems like Pneumocystic carinni and Pulmonary tuberculosis (PTB) are among the common opportunistic infections in patients with HIV/AIDS. The risk of acquiring Mycobacterium tuberculosis in a community becomes greater with increase in the number of HIV positive persons with active tuberculosis. This study was carried out to determine the magnitude of HIV infection among PTB patients in different parts of Nigeria as part of the year 2000 national HIV surveillance programme. Blood samples were collected on blotting paper from a total of 2826 individuals attending TB clinics between 1st of September and 1st November, 2000. Samples were collected from patients with confirmed PTB from 12 states in the 6 geopolitical/health zone (2 states/zone) of Nigeria as part of high risk sentinel population groups. Samples were tested for the presence of HIV antibodies using commercial ELISA (Genescreen HIV-1/2, Sanofi Pasteur, Paris). All initially reactive samples were retested with a rapid EIA (Gene II, Sanofi Pasteur, Paris) according to the WHO recommendations (option II). HIV Prevalence in the states varied from 4.2% in Oyo to 35.1% in Benue States with a median prevalence of 17.0%. HIV Prevalence increased with age to a peak of 23.9% among PTB patients 30-39 years and then declined progressively to 12.8% among those 60 years and above. A relatively high HIV infection rate (13.8%) was found among the young adolescent age group 10-19 years. There was no significant difference in the rate among male and female PTB patients tested. Comparison with results of previous HIV sero-surveys shows a steady increase in HIV prevalence among PTB patients over the years. The high prevalence of HIV among young PTB patients aged 10-19 years in this study is worrisome and must be noted for intervention.

Virology

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