FACULTY OF BASIC MEDICAL SCIENCES

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Combination of reduced levels of serum albumin and alpha-2-macroglobulin differentiates newly diagnosed pulmonary tuberculosis patients from patients on chemotherapy
(2009) Adedapo, K. S.; Arinola, O. G.; Ige, O. M.; Adedapo, A. D. A.
Pulmonary tuberculosis (PTB) is global disease affecting about one third of the world’s population with its attendant mortality and morbidity. Acute phase proteins have been used in monitoring the progression of infections but not in relation to PTB in this environment. The levels of total protein, albumin, α-2-macroglobulin, transferrin, and haptoglobulin were determined in 23 patients with PTB and 17- age / sex matched PTB-free controls using spectrophotometric and immunodiffusion methods respectively. The result showed that α-2-macroglobulin was significantly raised in PTB patients compared with controls (p<0.001), while the levels of transferrin and albumin were significantly reduced in PTB patients compared with the controls (p<0.001,0.000 respectively). The levels of α-2-macroglobulin and albumin were significantly raised in PTB patients on treatment compared with newly diagnosed PTB patients (p=0.05, p=0.01 respectively). The combination of reduced levels of albumin and α-2-macroglobulin may be used to differentiate newly diagnosed PTB and those on chemotherapy
Prevalence of hepatitis B virus and C seropositivity in a Nigerian cohort of HIV-infected patients
(2008) Otegbayo, J. A.; Taiwo, B. O.; Akingbola, T. S.; Odaibo, G. N.; Adedapo, K. S.; Penugonda, S.; Adewole, I. F.; Olaleye, D. O.; Murphy, R.; Kanki, P.
"INTRODUCTION:The clinical and public health implications of the convergence of the human immunodeficiency virus (HIV) epidemic and chronic viral hepatitis in sub-Saharan Africa are poorly understood. This study was designed to determine the seroprevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV), and the impact of co-infection on baseline serum alanine transaminase (ALT), CD4+ T lymphocyte (CD4) count, and plasma HIV-RNA (viral load) in a cohort of HIV-infected Nigerians. METHODS:A retrospective study was conducted, on eligible treatment-naive patients who presented between August 2004 and February 2007 to the University College Hospital (UCH), Ibadan, Nigeria. Demographic data and pre-treatment laboratory results (hepatitis B surface antigen (HBsAg), HCV antibodies (anti-HCV), ALT, CD4 count and viral load) were retrieved from the medical records. Fisher's exact, two sample t-tests, and the Wilcoxon rank sum tests were used to compare groups. A logistic regression model was fitted to explore characteristics associated with co-infection status. RESULTS:A total of 1779 HIV-infected patients (male: female ratio, 1:2) met inclusion criteria. HBsAg was present in 11.9%, anti-HCV in 4.8% and both markers in 1%. HBsAg was more common among males than females (15.4% vs 10.1%, respectively p = 0.001) while anti-HCV was detected in a similar proportion of males and females (5.3% versus 4.6%, respectively p = 0.559). HIV-infected patients with anti-HCV alone had a lower mean baseline CD4 count compared to those without anti-HCV or HBsAg (197 cells/mm3 vs 247 cells/mm3, respectively p = 0.008). Serum ALT was higher among patients with HBsAg compared to those without HBsAg or anti-HCV (43 International Units (IU) vs. 39 IU, respectively p = 0.015). Male gender was associated with HBV co-infection on logistic regression (OR1.786; 95% CI, 1.306-2.443; p < 0.005). CONCLUSION:More HIV-infected females than males presented for care in this cohort. We identified a relatively high prevalence of HBV and HCV co-infection in general, and a higher rate of HBV co-infection among males than females. Pre-treatment CD4 count was significantly lower among those with HCV co-infection, while ALT was slightly higher among those with HBV co-infection. Triple infection with HIV, HBV and HCV was present in a small but significant proportion of patients. These findings underscore the importance of testing for HBV and HCV in all HIV-infected persons in our setting."