An Evaluation of Selected Populations for HIV-1 Vaccine Cohort Development in Nigeria

Abstract

Development of a globally effective HIV-1 vaccine will need to encompass Nigeria, one of the hardest hit areas, with an estimated 3.2 million people living with HIV. This cross-sectional Institutional Review Board (IRB) approved study was conducted in 2009–12 at four market sites and two highway settlements sites in Nigeria to identify and characterize populations at high risk for HIV; engage support of local stakeholders; and assess the level of interest in future vaccine studies. Demographic, HIV risk data were collected by structured interviewer-administered questionnaires. Blood samples were tested on site by HIV rapid diagnostic tests, followed by rigorous confirmatory testing, subtype evaluation and testing for HBV and HCV markers in a clinical reference laboratory. Of 3229 study participants, 326 were HIV infected as confirmed by Western Blot or RNA, with a HIV prevalence of 15.4%-23.9% at highway settlements and 3.1%-9.1% at market sites. There was no observable correlation of prevalence of HIV-1 (10.1%) with HBV (10.9%) or HCV (2.9%). Major HIV-1 subtypes included CRF02_AG (37.5%); G (27.5%); G/CRF02_AG (25.9%); and non-typeable (8.9%), with 0.3% HIV-2. Univariate analysis found age, gender, marital status, level of education, and sex under substance influence as significant risk factors for HIV (p<0.001). Educating and winning the trust of local community leadership ensured high level of participation (53.3–77.9%) and willingness to participate in future studies (95%). The high HIV prevalence and high risk of HIV infection at highway settlement and mammy markets make them well suited for targeting future vaccine trials in Nigeria.

The impact of HIV-1 subtypes on virologic and immunologic treatment outcomes at the Lagos University Teaching Hospital: A longitudinal evaluation

“…In this evaluation of HIV-1 genetic diversity in southwest Nigeria, we found the most common variants to be CRF02_AG and subtype G, which is similar to what previous studies examining genetic diversity in Nigeria have found [7,8,10,11,34] The dominant spread of CRF02_AG in West Africa has been attributed to the replicative fitness it confers over subtype A and G in the same geographical region [35]. The other subtypes, including D, J, K, CRF43_02G, CRF06_cpx and CRF36_cpx, which were also found in this study have also been reported in other West African settings, largely at a lower prevalence [36].…”

New infections and HIV‐1 subtypes among febrile persons and blood donors in Oyo State, Nigeria

“…have been previously characterized in the country. 7 Several HIV-1 high-risk groups such as commercial sex workers, 8,9 voluntary blood donors, 10,11 long-distance drivers, [12][13][14] mammy markets contiguous to military facilities, 15 etc., have also been identified.…”

Detection of Early HIV-1 Infection among Febrile Persons and Blood Donors in Oyo State, Nigeria

“…have been characterized in the country previously 6 . Several HIV-1 high risk groups such as commercial sex workers 7,8 , voluntary blood donors 9,10 , long distance drivers 11–13 , mammy markets contiguous to military facilities 14 etc. have also been identified.…”