BackgroundThe prevalence of peripheral artery disease (PAD) is not well known among HIV-infected patients in Africa. The aim of this study was to determine the prevalence and associated risk factors of PAD among HIV-infected patients at the Douala General Hospital (DGH).MethodsThis was a cross-sectional descriptive and analytic study between November 2015 and April 2016. We recruited patients aged ≥21 years, diagnosed with HIV infection, and who were receiving care at the DGH. We collected sociodemographic data and past medical history of patients. We measured their ankle-brachial index (ABI). We defined PAD as an ABI <0.9. We also measured their fasting blood glucose and lipid profile.ResultsWe recruited 144 patients for this study. The mean age was 46±9 years, and 72.2% were females. Of which, 89% were on antiretroviral treatment (ARV). Their mean CD4+ T lymphocytes count was 451±306 cells/mm3. Their mean ABI was 1.12±0.17 and 1.07±0.11, respectively, on the left and right legs (P>0.05). The prevalence of PAD was 6.9% (95% CI: 3.4–12.4), and 60% of patients with PAD were symptomatic. After adjusting for age, sex and ARV, ARV treatment was protective (aOR: 0.18, [95% CI: 0.04–0.82], P=0.034), while WHO stages III or IV was associated with PAD (aOR: 11.1, [95% CI: 2.19–55.92], P=0.004).ConclusionThe prevalence of PAD was not as high as expected in this group of patients with high cardiovascular risk infected with HIV. Advanced HIV disease was associated with PAD, while ARV was protective.

No abstract

As specific antiplatelet alloimmunization directed against Human Platelet Antigens (HPA) during pregnancy or after platelet transfusion is not a rare event, this study aims at identifying such a risk in the context of the diversity caused by the population migrations we see today in our hospitals and particularly in the Sub-Saharan African (SSA), south East Asia and Polynesian populations. Samples were collected from 155 Beninese, 118 Cameroonian, 96 Congolese (Kinshasa), 107 Vietnamese and 81 Polynesian Ma’ohis, all unrelated, healthy blood donors. DNA was extracted by salting out method and the platelet genotype was determined by PCR-RFLP. We did not observe any significant deviation from the Hardy-Weinberg equilibrium. As opposed to Caucasian populations, the risk of anti HPA-1a alloimmunization is extremely low, due to the absence, or at least the low frequencies of HPA-1 b homozygous individuals in these populations (Cameroon 0.8 % and Benin 1.3 %). An important risk could be associated with HPA-2 immunization in the SSA population, as we observed a relatively high frequency of HPA-2b homozygous individuals. Moreover we noted the frequency of HPA-3b homozygous to be between 11 and 24%. Given that, as neonatal alloimmune thrombocytopenia (NAIT) caused by anti HPA-3a or 3b is similar in severity to disease caused by incompatibility of HPA-1a, this risk should not be ignored particularly in the Vietnamese population with 24.3 % of HPA3b homozygous. We noted the absence of HPA-4b allele. Finally, in contrast to the frequency of HPA-6 heterozygous in the Polynesian population (17%), we do not observe HPA-6b homozygous individuals, suggesting a small risk for that antigen to be implicated in alloimmunization. The repartition of HPA-15 alleles is heterogeneous in these populations. In conclusion: HPA-2 alloimmunization in SSA populations should be identified for platelet transfusion refractoriness or NAIT, similarly for HPA-3 especially in the Vietnamese population and to a lesser degree, HPA-5 in the Cameroon and in the Congo. Genotype frequencies HPA-1 HPA-2 HPA-3 HPA-5 HPA-6 HPA-15 bb ...ab ↑bb ...ab ↑bb ...ab ↑bb ↑ ...ab bb ↑ ...ab bb Viet Nam 0.0 ↑ 09.4 0.0 54. ↑24.3 05.6 ↑0.0 02.8 ↑0 ↑ 57.0 24.3 Polynesia 0.0 ↑ 16.3 0.0 ↑ 37.5 18.7 05. ↑0.0 ↑ 17.1 0 ↑ 52.4 28.4 Benin 1.3 ↑ 44.8 7.1 42.8 ↑11.1 34.1 ↑0.8 0.00 ↑0 ↑ 41.6 14.1 Cameroon 0.8 32.7 ↑7.8 ↑ 50.8 13.1 29.8 ↑6.4 ↑ 0.00 0 ↑ 41.2 10.9 Congo 0.0 40.0 ↑2.5 49. ↑18.6 45.2 ↑4.1 ↑ 0.00 0 ↑ 43.8 05.5

La chirurgie cardiaque sous circulation extracorporelle (CEC) est régulièrement associée à la perte d’une quantité importante de sang. Une bonne anticipation de ces pertes sanguines et une bonne hémostase peropératoire sont reconnues comme moyens permettant de limiter ces saignements post opératoires. Jusqu’à ce jour, la compensation des besoins en plaquettes des patients opérés sous CEC dans notre service se faisait par transfusion de sang total ou de concentrés plaquettaires prélevés à partir de plusieurs donneurs. Nous rapportons la première expérience de prélèvement de concentrés plaquettaires par la technique d’aphérèse à l’Hôpital Général de Douala.