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Introduction: Nigeria has a low uptake of early infant diagnosis (EID) of HIV despite its high pediatric HIV infection rate. Efforts to increase the EID of HIV have been limited by many factors. This research assessed EID uptake and challenges service providers experienced in providing routine care for HIV-exposed infants. Methods: This is a mixed-method study at primary health centers (PHCs) in Lagos state, Nigeria. The quantitative component of the research was a review of the PMTCT Infant Follow-up Register at a purposive sample of 22 PHCs of Lagos State. The number of HIV-exposed infants (HEIs) returned for a dried blood sample (DBS) collection, date of collection, and the infant's EID results for one year preceding the study were captured on Research Electronic Data Capture (RedCap). In-depth interviews were conducted with service providers purposively selected per participating PHC. Electronic transcripts were analyzed using MAXQDA 2020 (VERBI Software, 2019). Results: Twenty-two Lagos State primary health centers participated in the research. Fifteen PHCs (68.2%) had PMTCT HIV counseling and Infant follow-up registers. Documentation of DBS sample collection was observed in 12 (54.6%) PHCs. Both DBS sample collection and EID results documentation were observed in only nine (40.9%) PHCs. In-depth interviews revealed both maternal and health systems' challenges to EID. The denial of HIV status was the only maternal factor reported as a barrier against the use of EID services. Health systems challenges include unavailability of EID services, uncertainty regarding whether EID is performed in a facility, referral to secondary health facilities for EID services (leading to losses to follow-up), and delay in getting results of EID. Task-shifting of DBS collection by nurses was suggested as means to increase access to EID services. Conclusions: There is a need to expand EID services and address women's denial of HIV infection. Counseling women and linkage to available services are emphasized. Re-training of health workers on DBS collection and proper documentation of EID services were noted as key to improving the implementation of early infant diagnosis of HIV in the state. [ABSTRACT FROM AUTHOR]

Elimination of barriers to identification of new HIV infections, treatment adherence and retention in care of people living with HIV/AIDS is vital to the attainment of WHO's ambitious vision 2030 of 90:90:90 for HIV/AIDS. However, HIV-related stigma, especially among health workers, has been widely documented as a serious threat to this project. This study explored the factors associated with the stigmatization of people living with HIV among healthcare workers in Nigerian hospitals. Electronic literature search was conducted on eight databases using keywords and MeSH guidelines. Using the PRISMA protocol, studies published from 2003 to 2022 were retrieved and analyzed. Of the 1481 articles identified, 9 met the inclusion criteria. All the included studies were conducted across 10 of the 36 states in Nigeria, with every geo-political zone in Nigeria represented by at least two studies. The overarching themes identified were attitude and beliefs (n = 7), knowledge of HIV/AIDS (n = 3), quality of care (n = 4), education and in-service training (n = 4), and health facility policies and procedures (n = 3). Factors associated with HIV-related stigma among healthcare workers varied by gender, healthcare settings, specialties of health workers, and the presence of institutional stigma reinforcements. Healthcare workers without recent in-service training on HIV/AIDS and those who work in hospitals without anti-HIV/AIDS stigma policies exhibited more HIV-related stigmatizing attitudes. Continuous in-service training of healthcare workers and the development of comprehensive stigma reduction interventions that will be reinforced with anti-HIV stigma policies in clinical settings may facilitate the attainment of national HIV prevention goals. [ABSTRACT FROM AUTHOR]

Background: Globally, two out of five children living with HIV (CLHIV) are unaware of their HIV status, and a little more than 50% are receiving antiretroviral therapy (ART). This paper describes case-finding strategies and their contribution to identifying CLHIV and linking them to ART in Nigeria. Methods: This before-after study used program data abstracted during the implementation of different paediatric-focused strategies (provider-initiated testing and counselling, orphans and vulnerable children testing, family-based index testing, early infant diagnosis (EID), community-driven EID, and community-based testing) delivered in health facilities and in communities to improve HIV case identification. Data were abstracted for children (0 to 14 years) who received HIV testing services and were initiated on ART in Akwa Ibom State, Nigeria during the pre-implementation period (April–June 2021) and during the implementation period (July–September 2021). Descriptive statistics were used to describe the testing coverage, positivity rate (proportion of tests that were positive for HIV), linkage to ART, and ART coverage, by age, sex, and testing modality. Interrupted time series analysis (ITSA) on STATA 14 was used to estimate the effect of the implementation of these strategies on HIV testing uptake and positivity rate at a 0.05 significance level. Results: A total of 70,210 children were tested for HIV within the six-month period, and 1,012 CLHIV were identified. A total of 78% (n = 54,821) of the tests and 83.4% (n = 844) CLHIV were diagnosed during the implementation period. During implementation, the HIV positivity rate increased from 1.09% (168/15,389) to 1.54% (844/54,821), while linkage to ART increased from 99.4% (167/168) to 99.8% (842/844). The contribution from community-based modalities to CLHIV identified increased from 63% (106/168) to 84% (709/844) during the implementation, with the majority, 60.8% (431/709), from community-based index testing. Overall, ART coverage increased from 39.7 to 55.6% at the end of the intervention period. Conclusion: The findings show that expanding differentiated HIV testing approaches provided mostly in the community significantly increased pediatric case identification. However, ART coverage remains low, especially for younger age groups, and requires further efforts. [ABSTRACT FROM AUTHOR]

Introduction: Among people living with HIV (PLHIV), fertility desire which is the desire to have more children is increasing due to the improvement in quality of life and survival resulting from anti-retroviral treatment and also improved sexual and reproductive health services. Fertility desires can result in increased risk of HIV transmission, especially in unprotected heterosexual intercourse. There is limited information regarding the fertility desires and predictors among PLHIV in our environment. Methods: This study was aimed at assessing the fertility desires and predictors in PLHIV in Northcentral Nigeria. Study was descriptive cross-sectional. Semi-structured interviewer administered pretested questionnaires was used to get information from 170 PLHIV accessing care in a secondary health-care facility selected by the systematic sampling technique. Data were analyzed using the SPSS software version 23.0. At 95% confidence interval (CI), a P < 0.05 was considered to be statistically significant. Chi-square and logistic regression. Results: Fertility desire was found among 64.1% of the respondents. Younger age (odds ratio [OR] = 0.2270; 95% CI = 0.0662–0.7791, P = 0.0184), having no child or a smaller number of children (OR = 0.0432; CI = 0.0046–0.4050; P = 0.0059) and suppressed viral loads (OR = 4.1069; CI = 1.1650–14.4784; P = 0.0280) were the predictors for fertility desire. Conclusion: This study showed that PLHIV had high fertility desires but do not know any safe method of conception, hence intensified effort should be made by primary care providers and other health-care workers to include sexual and reproductive health counselling during routine HIV clinic visits to enable PLHIV make informed decision about their fertility desires. [ABSTRACT FROM AUTHOR]

This paper documents the deleterious effects of petroleum extractive activities in the Niger Delta region of Nigeria, with a special focus on HIV infection. It argues against the hegemonizing claims of the "resource curse" thesis and deploys the framework of "accumulation by dispossession" to explain the crisis of development associated with the country's petroleum economy. The paper couches the challenges of economic survival in the petroleum resource-rich region on a predatory alliance between the extractive transnational corporations (TNCs) and the domestic compradors. It highlights the implications of extractive activities in the region for HIV infection. [ABSTRACT FROM AUTHOR]

Background: Retention in HIV care is the constancy of engagement in HIV treatment, care and support services which is essential to reducing morbidity and mortality associated with the infection as well as halting the development of resistance to antiretroviral therapy (ART). In most African countries, Nigeria inclusive, men who have sex with men (MSM) are major contributors to HIV/AIDS burden. HIV-positive MSM are generally understudied and mostly underserved due to social, political and legislation factors resulting in limited characterization and documentation of the existing health disparities particularly with regards to retention in HIV care. It was against this backdrop that we conducted this study to assess the level of retention in HIV care and its predictors among MSM linked to HIV care. Methods: A cross-sectional study conducted among 114 HIV-positive MSM in 2019 using interviewer-administered questionnaire. Data analysis was carried out using version 7 of Epi Info statistical software version 7 and a probability value of less than 0.05 used as the cut-off for drawing statistically significant conclusion. Results: The average age in years of the respondents was 26.0 ± 5.4 while 43 (37.7%) of the participants were adequately retained in HIV care. Adequate retention in HIV care was found to be predicted by awareness of regular male partner's HIV status (AOR = 11.2; 95% confidence interval [CI] = 1.924–65.167) and financial difficulty (AOR = 0.1; 95% CI = 0.022–0.840). Conclusions: A suboptimal level of retention in HIV care was demonstrated in the study with awareness of male partner's HIV status and financial buoyancy as its main predictors. [ABSTRACT FROM AUTHOR]

BACKGROUND: Nigeria is the second largest country with paediatric HIV infections. Mother to Child transmission of HIV remains a major source of paediatric infection in Nigeria. This study was conducted to determine the outcomes of HIV exposed infants in selected Primary Health Care Centres. METHODS: A retrospective cohort study on HIV exposed infants between January 2015 to July 2016. A proforma was used to abstract information from clinic records on socio-demographics characteristics, ARV prophylaxis, mode of delivery, birth weight, infant prophylaxis, early infant diagnosis (EID), referral to ART. Descriptive and multivariate analysis was done to determine predictors of HIV infection among exposed infants. RESULTS: 170 exposed infants were recruited, and more than two-third of the infants were males (74.1%) with median age 4±3months ranging from (0 -11months). One hundred and fifty (88.2%) received infant prophylaxis and 116 (68.2%) had EID done at 6weeks. Of the 170 exposed infants 19(11.1%) were positive at 18months. Predictors of HIV infection were age of mothers =30years (Adjusted Odd's Ratio = 2.5,95%CI 1.9 - 16.93), Vaginal tear (Adjusted OR= 2.7,95%CI 2.1- 19.21), infants whose maternal CD4 count < 500(Adjusted OR= 3.5,95%CI 1.7 -15.02) and infant received prophylaxis other than daily Nevirapine for 6weeks (Adjusted OR=3.0,95%CI 2.4-12.74). CONCLUSION: The positivity rate among studied exposed infants was high. Continuous placement of younger HIV positive mothers and exposed infants on recommended prophylaxis and timely early infant diagnosis will go a long way in reducing the burden of paediatric HIV. [ABSTRACT FROM AUTHOR]

Background There are challenges in the diagnosis of TB in people with smear-negative pulmonary TB (SNPTB) in resource-limited settings. We evaluated the diagnostic usefulness of Xpert MTB/RIF compared with TB culture among SNPTB. Methods The study was a cross-sectional study among patients with SNPTB. The Xpert MTB/RIF tests and sputum culture (using Lowenstein-Jensen medium) were performed. Sensitivity and specificity were calculated. Results Of 150 patients studied, the sensitivity and specificity of GeneXpert MTB/RIF were 81.8 and 97.4%, respectively. Conclusion The sensitivity and specificity of Xpert MTB/RIF assay was comparative with culture in SNPTB patients. [ABSTRACT FROM AUTHOR]

Background: Globally, female-perpetrated IPV has been well studied among various groups but little is known about IPV against heterosexual men living with HIV. This study sought to identify the prevalence and determinants of female-perpetrated IPV among heterosexual HIV-positive men in Birnin Kudu, Jigawa State, Nigeria., Materials and Methods: This was a descriptive crosssectional study carried out at one secondary and tertiary health facility respectively, both situated in Birnin Kudu. Using an intervieweradministered pre-tested questionnaire, the prevalence and determinants of female-perpetrated IPV was assessed among 322 heterosexual HIV-positive men attending the anti-retroviral therapy clinics at the two health facilities. Data was entered into and analyzed using statistical package for social sciences version 25., Results: The prevalence of IPV in the last year was 45% (145D 322). Out of the survivors of IPV, 143 (98.6%), 75 (51.7%), and 51 (35.2%) had experienced psychological aggression, physical assault and sexual coercion respectively. The number of children fathered, experience of childhood violence, and marital status were significantly associated with IPV (p< 0.05) However, they remained significant determinants of IPV after controlling for confounders (ethnicity, marital status, educational status ) {Adjusted Odds ratio (aOR) = 7.34 and 95% confidence interval (C.I.) = 1.49 - 35.4; aOR= 1.84 C.I. 1.33 - 2.80; aOR = O.51 (0.29 - 0.90) respectively}., Conclusion: This study identified a high prevalence of femaleperpetrated IPV against heterosexual men living with HIV and emphasizes that exposure to childhood violence and being childless are determinants of IPV. Efforts should be made to screen for IPV among men living with HIV so as to optimize their health and wellbeing., Competing Interests: The Authors declare that no competing interest exists., (Copyright © 2023 by West African Journal of Medicine.)

The problem o f HIV has continued to rise steadily with women and children bearing the greatest burden. This study is to assess the prevalence o f HIV among pregnant women attending the antenatal clinic o f Ahmadu Bello University Teaching Hospital (ABUTH) Zaria, in Northern Nigeria within the period o f 5 years. This retrospective study accessed data from the register on HIV Counselling and Testing Unit and the Antenatal Clinic; these centres were purposiveiy selected. A total o f 9,513 clients were obtained. Findings revealed that out o f the 9,513 clients that registered only 8,098 agreed to be tested for HIV out o f which 1265(16%) tested positive, 1315 refused test. Out o f the 1265 that tested positive, 1263 agreed to post-test counselling and were placed on various antiretroviral treatment regimes/prophylaxis to prevent mother to child transmission. The HIV positive cases were mostly seen in women aged 25 and 29 years. I t is concluded that antenatal prevalence o f HIV remains a challenge. There is need for more skilful approaches by counsellors in both pre and post testing counselling for HIV, with emphasis on counselling and testing for prevention o f mother-to-chi/d transmission o f HIV infection as a way o f preventing new cases o f infection in children. [ABSTRACT FROM AUTHOR]

Objective: To determine the prevalence and factors associated with unintended pregnancy among HIV-positive pregnant women in Enugu, southeast Nigeria.Methods: A questionnaire-based cross-sectional study was performed of HIV-positive pregnant women receiving prenatal care at two tertiary health institutions in Enugu between March 1 and August 31, 2012. The women were interviewed with a pretested questionnaire.Results: Overall, 180 HIV-positive pregnant women were recruited, 67 (37.2%) of whom declared that their pregnancy was unintended. Overall, 174 (96.7%) patients were receiving antiretroviral therapy and 99 (55.0%) had future fertility intensions. Participants with regular partners (married or cohabiting) had a significantly higher rate of unintended pregnancy than those with unstable partners (40.3%, n=64/159 vs 14.3%, n=3/21 P=0.029). Age, parity, educational level, and current treatment with antiretroviral therapy did not significantly affect the prevalence of unintended pregnancy.Conclusion: A substantial number of HIV-positive pregnant women declared their pregnancies to be unintended. Modern contraceptives should be made readily available and accessible to HIV-positive women to help eliminate mother-to-child transmission of HIV and subsequent new pediatric HIV infections. [ABSTRACT FROM AUTHOR]

The failure of conventional medicine to cure the human immunodeficiency virus (HIV) infection compels many people living with the virus to seek alternative therapy. This pilot study determined the effectiveness (clinical and laboratory responses) of α-Zam (defined by the herbal therapist as Nigella sativa and honey), which is used by patients seeking herbal remedies for HIV infection in Nigeria. Six patients taking this herbal concoction as an alternative therapy for HIV infection were recruited into the study and monitored for 4 months. All six patients were infected by HIV, as confirmed by Western blot analysis in the nearest teaching hospital, i.e. LAUTECH teaching hospital or Ahmadu Bello University Teaching Hospital, before commencing preliminary clinical and laboratory examinations using World Health Organization (WHO) and Centres for Disease Control and Prevention (CDC) criteria. The patients were contacted daily and visited regularly after commencement of herbal medications to assess the efficacy (disappearance of presenting signs and symptoms associated with HIV infection), side-effects, drug toxicity, and compliance. The symptoms and signs associated with HIV infection disappeared within 20 days of commencement of herbal therapy with significant difference (p <0.05) before treatment and at periodic intervals on α-Zam therapy. Body weight increased from an average of 53±2kg to 63±2kg, viral load (HIV-RNA) decreased from 42,300±1500copies/ml to an undetectable level (≤50copies/ml), and CD4+ count increased from an average of 227±9 to 680±12mm3/μL at 4 months post-therapy. This study concluded that the herbal remedy (α-Zam) is effective in the treatment of HIV infection based on a significant improvement in both the clinical features and laboratory results of HIV infection. However, a longer follow-up is suggested to ensure that the observed improvement is sustained. In addition, a large population study is needed to confirm our observation in this cohort of people. [ABSTRACT FROM AUTHOR]

Objective: There are conflicting report on the association of HIV infection and asymptomatic bacteriuria (ASB). Most of these studies were from areas with low HIV burden. This study determined the prevalence and risk factors of ASB in HIV positive pregnant women. Methods: A cross sectional study among HIV positive pregnant women seen at a large PMTCT clinic in Lagos Nigeria. The women were evaluated for ASB at first clinic attendance. Blood samples were also collected for viral load, CD4 count and hemoglobin levels assessment. Data were managed with SPSS for windows version 19. Results: 102 (18.1%) women out of 563 studied were found positive for asymptomatic bacteriuria. Ninety-seven (95.1%) of the positive samples yielded single bacterial isolates. Escherichia coli (44.3%) and Proteus mirabilis (21.6%) were the most common bacterial isolates. Previous urinary tract infection (OR: 4.3), HIV-1 RNA greater than 10,000 copies/ml (OR: 3.9), CD4 count <200 cells/mm3 (OR: 1.4) and maternal hemoglobin <11 g/dl (OR: 1.4) were factors significantly associated with ASB after controlling for possible confounders. Conclusion: ASB is common in HIV positive pregnant women in our environment and is associated with previous UTI, high viral load, low CD4 count and maternal hemoglobin <11 g/dl. [ABSTRACT FROM AUTHOR]

Background: Human immunodeficiency virus (HIV), the pathogen responsible for the acquired immunodeficiency syndrome and the most significant emerging infectious disease is causing health, social, and developmental problems to mankind. Aims, Setting and Design: This is a cross-sectional study to evaluate the socio-demographic characteristics of adults screened for HIV infection in Ahoada Community in Rivers State in the Niger Delta of Nigeria. Materials and Methods: HIV antibodies were detected using "Determine" (Abbott Laboratories, Japan), Start-Pak (Chembio Diagnostics, USA) and SD Bioline HIV-1/2 kits (Standard Diagnostics, Korea). All test procedures were carried out according to the manufacturers' instructions. Subjects included 152) consecutively recruited adults consisting of 955 females and 566 males aged 18-54 years with a mean age of 36.25±7.02 years. Statistical Analysis: Data were entered and analyzed using statistical package SPSS version 9. A P-value ≤0.05 were considered statistically significant in all statistical comparisms. Results and Conclusion: Out of a total of 1521 persons screened for HIV infection, 162 persons tested positive for HIV (10.6%). HIV infection was higher among females (10.9%) compared to males (10.1%) and in the 25-34 and 45-60 years age groups (11.1%) (P= 0.08). HIV-1 was the predominant subtype (74%) compared to 26% for dual HIV-1 and 2. This study indicates the urgent need for both government and non-governmental organizations to intensify awareness campaign programme to reduce the spread of the HIV infection in the area with emphasis on behavioral change and economic empowerment of the people as well as provision of universal access to antiretroviral therapy for those with HIV infection. [ABSTRACT FROM AUTHOR]

The objective of this study was to explore the acceptability, feasibility, affordability, safety and sustainability of replacement feeding options for HIV-infected mothers in Ile-Ife, in south-west Nigeria. Six focus group discussions were conducted with a purposive sample of mothers, fathers and grandmothers. The HIV status of all participants was unknown to investigators. All text data were analysed using the Text-based Beta Software program. With regard to the acceptability of replacement feeds, respondents perceived the stigma associated with not breastfeeding to be an important consideration. In this community, breastfeeding is the norm – even though it is not necessarily exclusive. For infected mothers who choose to breastfeed exclusively and then to wean their infants before 6 months of age, respondents did not anticipate early cessation of breastfeeding to be problematic. Respondents noted that acceptable replacement foods included infant formula, soy milk and cow’s milk. Barriers to replacement feeding that were mentioned included: the high costs of replacement foods and fuel for cooking; an unreliable supply of electrical power; poor access to safe water; and poor access to storage facilities. The research confirms the difficulty of replacement feeding for HIV-infected mothers in sub-Saharan Africa. The results also provide the basis for new issues and hypothesis for future research in other communities with similar socio-cultural and economic characteristics. [ABSTRACT FROM AUTHOR]

Eight patients, 3 men and 5 women, aged between 24 and 40 years who had herpes zoster ophthalmicus (HZO) were seen in the Eye Department of the University of Nigeria Teaching Hospital, Enugu between 1994 and 1997. One of the patients was already on treatment for active pulmonary tuberculosis at the time he was first seen. All had skin eruptions at different stages of development in the area of distribution of the first trigeminal nerve on the affected side of the face and head. Ocular examination revealed impaired vision in the affected eye (between 6/12 and hand movement) in all the patients. All had lid oedema while 5 had ptosis (3 partial and 2 complete). Various degrees of conjunctival injection were observed in all patients while 6 of them had corneal anaesthesia and keratitis. Uveal inflammation, present in all the patients varied from mild iritis in 4 individuals to severe iridocyclitis in the remaining 4. Pupils reacted to light sluggishly in 2 patients while they were dilated and fixed in 3 others. None had any associated abnormalities in the posterior segment. Six of the patients consented and were screened for human immunodeficiency virus (HIV) infection. Of these, 4, including the patient with pulmonary tuberculosis, tested seropositive while 2 were seronegative. All 8 were treated with topical acyclovir. This was combined with oral acyclovir in one of the patients. Follow-up period was between 2 and 52 weeks. During this period skin eruptions and anterior segment signs improved in 5 patients while remaining stable in 3 others; post-herpetic neuralgia persisted on the affected side in 4 patients. Patients who were HIV seropositive did not recover as quickly or to the same extent as the seronegative ones. It is concluded that HZO infection may indicate underlying HIV infection in young Africans as has been found in whites. [ABSTRACT FROM AUTHOR]

Background: The human immunodeficiency virus infection remains a devastating disease of public health importance., Objectives: To assess the association between oral health and quality of life and the factors affecting the oral health related quality of life among HIV positive patients in Nigeria., Methods: This was a cross sectional study of HIV positive patients attending two HIV outpatient clinics in Nigeria. Impact of oral health on quality of life was assessed using the OHIP-14. Oral health status was assessed by the DMFT and Simplified OHI indices. Level of significance was set at p< 0.05., Results: Three hundred and fifty-two patients were seen, 64.2% being females. Prevalence of impact was 8.5%; and the mean OHIP scores was 8.05±9.54. Highest impact was "painful aching" 67(19.1%) with the domain of physical pain scoring the highest mean impact of 2.32. Most patients (88.6%) were on HAART. Following logistic regression, after controlling for potential confounders, independent factors associated with poor OHRQoL were perceived need for dental treatment, HAART use, and higher DMFT (p<0.05)., Conclusion: The domain of physical pain had the highest impact, while perceived need for dental treatment, HAART use and higher caries index were contributory to poor OHRQoL., (© 2021 Umeizudike KA et al.)

About 80% of HIV-positive pregnant women in our unit have a seronegative spouse. The prevalence, pattern and determinants of spousal disclosure of HIV serostatus was evaluated among 166 HIV-positive pregnant women receiving antiretroviral treatment. Although 146 women (88%) disclosed their HIV serostatus, 20 women (12%) did not disclose their status to their spouse. Non-disclosure was significantly associated with nulliparous ( p == 0.024) and unmarried women ( p == 0.026). Fear, regarding spread of the information (57.8%), stigmatisation (53%) and deterioration in the relationship with the spouse (47%) were the three commonest reasons for non-disclosure. Disclosure of HIV-positive status remains a sensitive issue among infected pregnant women. Strategies to reduce the stigma associated with HIV infection, appropriate management of the information following disclosure of seropositive status by HIV-infected persons are necessary to encourage disclosure to sexual partners and ultimately prevent new HIV infections. [ABSTRACT FROM AUTHOR]

Serum samples from 60 subjects with confirmed HIV-1 infection including 28 AIDS patients and 32 carriers were examined by immunodiffusion for precipitating antibodies to antigens of Histoplasma, Blastomyces and Candida. Seven of the subjects, four patients and three carriers, showed antibodies to histoplasmin prepared from mycelial cultural filtrate of Histoplasma capsulatum var. capsulatum and H. capsulatum var. duboisii although without any clinical signs of classical or African histoplasmosis. Another eight subjects comprising five patients and three carriers demonstrated antibodies to yeast cell antigen of Candida albicans; three of the patients had oral lesions clinically suggestive of Candida infection. None of the serum samples revealed antibodies to ‘‘A’’ antigen (yeast cell antigen) of Blastomyces dermatitidis. [ABSTRACT FROM AUTHOR]

Background: Infection with the human immune deficiency virus (HIV) is still a prevalent problem in Africa., Objectives: The aim of this study was to determine the prevalence of hypocortisolism among patients with HIV and their clinical profile at Aminu Kano Teaching Hospital (AKTH), Kano, Nigeria., Method: Three hundred and fifty adult patients with HIV infection were recruited from the HIV clinic of AKTH, Kano. Blood samples for serum electrolytes, and cortisol both before and after the short Synacthen test were taken for estimation. Data were analyzed using the SPSS version 20.0 software., Results: One hundred and eight (30.9%) of participants had low baseline serum cortisol levels, while 57 (16.3%) had a low serum cortisol after short synacthen test. There was no significant relationship between the cortisol levels and clinical features of hypocortisolism, WHO clinical stage of HIV, hypernatremia or HAART regimen. There was a negative correlation between the stimulated serum cortisol and duration of diagnosis of HIV, participants BMI and CD4 counts., Conclusion: The biochemical evidence of hypocortisolism was common among patients infected with HIV, associated with a longer duration of HIV infection. However, none of CD4 counts, clinical features or HAART regimen were associated with hypocortisolism., (© 2019 Akase et al.)

Introduction: Sub-Saharan Africa accounts for 66% of 36.7 million individuals living with HIV in 2015 with Nigeria having the second highest prevalence in Africa. The study aimed to find the prevalence and socio-demographic factors associated with HIV infection and compare these findings between high and low prevalence areas., Methods: We conducted a cross-sectional study among adults aged 15 to 49 years from March to April 2015. We administered a questionnaire to collect linked anonymous data on socio-demographic and socio-cultural characteristics and screened all respondents for HIV infection. We defined a high HIV prevalence area as area with prevalence consistently above 5% and an area with prevalence consistently below 2% as low prevalence area. We performed univariate, bivariate and logistic regration analysis to assess factors associated with HIV infection., Results: We screened and interviewed all 480 respondents. Majority 344 (71.7%) were females, mean age was 30.1 years (±7.4 years), high proportion were employed 246 (51.2%). In high HIV prevalence area, aged <30 years (Adjusted Odd Ratio (AOR) = 4.2, 95% Confidence Interval (CI) = 1.1-20.4) and being employed (AOR= 3.7, 95% CI=1.0-58.8) increased the likelihood of HIV infection. In low HIV prevalence area, lack of education (AOR=7.1, 95% CI= 0.9-32) was the only predictor of HIV infection., Conclusion: Interplay of socio-demographic factors was responsible for differences in HIV prevalence. To further decrease prevalence in low prevalence areas (below 1%), government should make universal basic education mandatory and in high prevalence areas, interventions should target the young and the employed., Competing Interests: The authors declare no competing interests.

Presents a case for funding new approaches to HIV prevention in developing countries. Use of vaginal douches of lime or lemon by female commercial sex workers in Nigeria; Potential of the citrus juice in preventing HIV; Setback received by funding opportunities for work on commercial sex workers; Details of the Mary Magdalene Project to fund HIV prevention trials among the female commercial sex workers of Jos, Nigeria.

Background: There are few studies from Nigeria and Africa regarding the contribution of obesity and hypertension to cardiovascular risk in HIV-infected patients. This study investigates the prevalence of hypertension and obesity and their association with HIV infection and antiretroviral treatment (ART)., Methods: We conducted a cross-sectional cohort study in a rural tertiary health center in Nigeria. The data collected included demographic variables, blood pressure, body mass index (BMI), monthly income, educational attainment, HIV status and ART treatment, duration of treatment, and CD4 T-lymphocyte count., Results: A total of 403 participants met the inclusion criteria. There were 153 (38.0%) HIV-negative subjects (42.5% male, 57.5% female; mean age: 35.5 ± 7.6 years), 120 (29.8%) HIV-positive drug-naïve subjects (42.5% male, 57.5% female; mean age: 36.5 ± 9.1 years), and 130 (32.2%) HIV-positive subjects taking antiretroviral drugs (33.1% male, 66.9% female; mean age: 38.6 ± 8.0 years). The prevalence of hypertension was 13.7% in HIV-negative subjects, 19.0% in HIV-positive drug-naïve subjects, and 12.3% in HIV-positive ART subjects. The prevalence of obesity was 15.9% in the HIV-negative group, 3% in the HIV-positive drug-naïve group, and 8% in the HIV-positive ART group. Multivariate regression analysis showed no relationship between hypertension and HIV status (P=0.293) or ART status (P=0.587). In contrast, BMI showed a strong relationship with HIV status (odds ratio: 0.281; 95% confidence interval: 0.089-0.884; P=0.030) but not with ART status (P=0.593). BMI was a significant predictor of hypertension., Conclusion: HIV or ART status was not associated with hypertension. HIV infection was associated with a lower BMI, and a lower prevalence of obesity compared with HIV-negative subjects.

Introduction: Hepatitis B infection impacts negatively on disease progression in HIV infected children thereby increasing morbidity and mortality. In spite of the foregoing, there is paucity of data on Hepatitis B co-infection in children living with HIV in Owerri, South Eastern Nigeria.This study set out to determine the prevalence of Hepatitis B Co- infection in HIV infected children attending the Paediatric HIV Care and Treatment clinic of the Federal Medical Centre Owerri., Methods: The study period was between February and July 2010. Testing for Hepatitis B infection was done using the ACON Hepatitis B surface antigen Rapid test strip. (Acon Laboratories Inc. San Diego.CA)., Results: A total of 139 HIV infected children were enrolled during the study period. The overall prevalence of Hepatitis B Co- infection was 5.8% (8/139). The prevalence in males was 8.2% (5/61) while in females it was 3.8% (3/78). The prevalence of Hepatitis B Co- infection amongst patients on antiretroviral therapy was 4.6%. They accounted for 62.5% of Hepatitis B Co- infection in our study. Previous blood transfusion, gender and age of patient did not show statistically significant relationship with Hepatitis B Co-infection., Conclusion: Though our study shows a low prevalence of Hepatitis B co infection in HIV infected children in our centre, reduction of the rate is still strongly desirable. Reduction can be achieved by strengthening the uptake of Hepatitis B vaccine as part of the routine childhood immunization programme.

Objective: To determine the causes and characteristics of maternal deaths in HIV-infected women., Design: A retrospective study of maternal deaths in a cohort of HIV-infected women., Setting: A facility-based maternal death review using case records and mortality summaries., Methods: Thirty seven maternal deaths which occurred in HIV-infected women were reviewed in a university teaching hospital in southern Nigeria over a 4-year period. Causes and circumstances surrounding each maternal death were identified., Result: One in every four maternal deaths occur in women with HIV infection. Majority (64.9%) of the women presented in advanced stage (WHO stage III/IV) of HIV syndrome while 86.5% had missed opportunities for antiretroviral programme. Pregnancy-related sepsis was the commonest cause of maternal death. Other common causes were death from tuberculosis and pneumonia., Conclusion: HIV-related maternal death is emerging as a leading cause of pregnancy related death in Nigeria. There is need to scale-up preconception care and ensure comprehensive and sustainable prevention of mother -to-child transmission service for all pregnant women throughout Nigeria to reduce the burden of HIV/AIDS infection and minimize avoidable deaths from opportunistic infections.

Background: Many patients are referred to labour ward as emergencies, and therefore do not benefit from the antenatal HIV counselling and testing and treatment offered to registered patients., Objective: To assess the acceptability and suitability of offering HIV counselling and testing to women of unknown HIV status presenting in labour., Methods: A cross-sectional study comprising counselling and obtaining consent for HIV testing among 104 unregistered patients who presented in labour over a 3-month period. Rapid and enzyme-linked immunosorbent assay screening was performed for 90 consenting respondents. Reactive results were confirmed by Western blot. Appropriate therapy was instituted., Results: Acceptance rate for HIV testing was 86.5%, prevalence of HIV was 6.7%. Women of lower educational status were more likely to accept testing in labour (OR: 0.3; 95% CI: 0.1-0.7; p=0.01); age, parity, occupation and knowledge of HIV had no influence. Most women (66.3%) had satisfactory knowledge of HIV. No one admitted to feeling coerced to test in fear of being denied care. Most refusals for screening were to avoid needle pricks (28.6%). Compared to ELISA screening test, specificity of the rapid test was 100%, sensitivity 85.7%, positive predictive value 100% and negative predictive value 98.8%. Attitude to testing was maintained on post-partum re-evaluation., Conclusion: The prevalence of HIV amongst unregistered parturients showed the importance of offering point-of-care HIV testing and intervention, especially in an environment where antenatal clinic attendance is poor. Rapid testing appeared to be acceptable and feasible in labour to prevent the mother-to-child transmission of HIV.