Background: CMV infection constitutes a real risk of pathogenecity in immunocompromised patient. HIV- infectedpatients who require transfusion are at high risk of developing symptomatic CMV infection when they are transfusedwith CMV-infected donor blood. This study intends to determine CMV infection risk in correlation with bloodtransfusion in a population of HIV- infected patientsMethods: The study was carried out amongst clients attending HIV clinic at Lagos University Teaching Hospital(LUTH), who were recruited consecutively. Replacement blood donors of the hospital were recruited as controls. Atotal of 10mls of blood sample was collected per consenting participant. The serum obtained from 5ml of blood wasassayed for CMV IgG/IgM using an enzyme- linked immunosorbent assay (ELISA) based Kit whilst full blood countand CD4 cell counts were also performed on the remaining 5mls.Results: A total of 129 HIV-infected were studied. All (100%) were IgG anti-CMV positive. 8 (6.6%) were IgM anti-CMV positive. This difference was found to be statistically significant P=0.004, (P<0.05). Of 122 replacement blooddonor controls, 118 (96%) of them were IgG anti-CMV positive whilst 26 (19.5%) of 121 were IgM anti-CMVpositive.The mean CD4+ cell count of HIV-infected patients was (234 ± 173.181). Previous history of bloodtransfusion did not affect CMV antibody positivity directly.Conclusion: The seroprevalence of CMV is very high in HIV-infected patients, which is comparable to theseroprevalence amongst the general population The use of leukoreduced blood units for anaemic HIV infectedpatients, is recommended.Keywords: Seroprevalence; CMV IgG/IgM; ELISA; healthy blood donors; HIV-infected patients.DOI: 10.3329/jom.v11i2.5462J MEDICINE 2010; 11 : 151-154
Anti-A and anti-B hemolysins exist in significant frequencies and titers among blood group O donors in Lagos. It is recommended that the use of group O donor blood for recipients who are non-O be discouraged. Clinical studies to determine the frequency and severity of hemolysis in non-group O recipients of blood group O are required.
Current efforts of Nigerian public hospitals to provide safe blood and CTT fall short of best practice. Provision of apheresis machines, improvement of voluntary non-remunerated donor drive, screening for red cell antigens and antibodies, and availability of iron chelators would significantly improve SCD care in Nigeria.
SUMMARYObjective: Prescribing, adherence, and adverse drug events to HAART in a large antiretroviral programme in Lagos was evaluated. Design A retrospective 5 year open cohort study Setting The AIDS Prevention Initiative in Nigeria (APIN) clinic at LUTH is one of the United States Presidential Emergency Plan for AIDS Relief (PEP-FAR) funded centers for HIV relief program in Nigeria Participants The case files of 390 patients on HAART and attending the APIN clinic were reviewed sequel to random selection. Main outcome measures: Demographics of the patients and pattern of antiretroviral (ARV) combination drugs prescribed were extracted from their case files. The details of the adverse drug events (ADEs) were extracted from drug toxicity forms regularly filled for each patient. A Chi-square test with Yates correction was used to determine the association between adherence and therapeutic outcome Results A total of 2944 prescriptions were assessed. Zidovudine + lamivudine + nevirapine (35.87%) and stavudine + lamivudine + nevirapine (35.63%) were the most frequently prescribed combinations. Over 2000 ADEs were reported with cough (13.3%), fever (8.75%) and skin rashes (8.01%) being the most frequently reported. Drug adherence was associated with good therapeutic outcome (χ2 = 115.60, p<0.0001). Conclusions: Zidovudine + lamivudine + nevirapine was the most frequently prescribed ARV combination. Cough was the most frequently reported ADE. Interventions aimed at rational prescribing of ARV drugs and improving adherence to antiretroviral drugs is essential for good therapeutic outcome in the treatment of HIV infection.
Background:Preeclampsia (PE) is the second most common cause of maternal death after obstetric hemorrhage in Africa, a resource-limited region. This study was designed to examine the potential usefulness of a single screening plasma plasminogen activator inhibitor-1 (PAI-1) and fibronectin (FN) level for the prediction of PE in pregnant women.Materials and Methods:In a cohort of 180 pregnant women who were normotensive at baseline, venous blood samples were obtained before 20 weeks of gestation for the assay of plasma levels of PAI-1 and FN levels measured by enzyme-linked immunoassay technique. Twenty nonpregnant normotensive women were also evaluated as a control group. Outcomes of gestation were evaluated and correlated with the plasma levels of PAI and FN measured at mid-trimester. Mean plasma values of PAI-1 and FN were also compared between the different outcome groups.Results:Plasma PAI-1 level was significantly higher in the pregnant women (8.68 ± 0.56 ng/ml) than in nonpregnant controls (5.55 ± 0.32 ng/ml) (P = 0.01). However, plasma FN did not show any significant difference in pregnant women (2.60 ± 0.37 μg/ml) and nonpregnant controls (2.60 ± 0.23 μg/ml) (P = 0.9). Mid-trimester mean plasma PAI-1 level measured in women who developed PE (7.08 ± 5.49 ng/ml, n = 12) and gestational hypertension (GH) (9.78 ± 6.2 ng/ml, n = 13) was not significantly different in comparison to normotensive pregnant women (8.78 ± 5.63 ng/ml, n = 153) (P = 0.75). Likewise, the mean FN level in women who developed PE was also not significantly different from nonpreeclamptics; however, the FN level in the pregnant women who developed GH was significantly different from women who remained normotensive throughout pregnancy (P = 0.02).Conclusion:Single mid-trimester assessment of PAI-1 and FN levels in maternal plasma was not found to be useful in predicting PE as an outcome of pregnancy in the study population.
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