Cytomegalovirus Antibodies Amongst Immunocompromised (HIV) Patients At Lagos University Teaching Hospital (LUTH) Idi - Araba, Lagos

Abstract

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

High seropositivity of IgG and IgM antibodies against cytomegalovirus (CMV) among HIV-1 seropositive patients in Ilorin, Nigeria

“…A high seroprevalence of between 90 -100% was also found in India amongst immunocompetent subjects in various studies 13 . Atul and Ramanchandrum 20 found 95.0% seroprevalence of CMV IgG amongst blood donors.…”

“…Akinsola et al 16 reported few cases of CMV retinitis in HIV infected Nigerians. The HIV patients who developed symptomatic CMV infection may have had the infection for a long time; immunosupression by HIV makes the virus to become pathogenic 13 . The higher the prevalence of CMV in the general population, the higher should be the prevalence of CMV infection in the population of HIV infected patients 13 …”

“…Discussion Cytomegalovirus (CMV) is a very frequent infection complicating AIDS. Sexual transmission appears to be the most common route of infection in adults, though CMV can also be spread through oropharyngeal sections, urine, breast milk, and blood [12][13] . CMV-specific antibody of the IgM class is a marker of active or recent primary infection with the virus.…”

“…Post-transfusion CMV infection correlates positively with the receipt of blood from CMV IgM-positive donors 14 . A decreased incidence of Transfusion associated-CMV infection was reported when only blood products negative for CMV IgM were used 15. Most patients with AIDS who develop clinical signs and symptoms of CMV infection probably have reactivation of previous infection rather than primary infection [12][13] . The prevalence of HIV/ AIDS in Sub Saharan Africa is high but the description of CMV infection as opportunistic infection amongst patients is scanty 13 .…”

“…day care centres) 24 . CMV infection constitute a real risk of pathogenicity in immunocompromised patient, it is likely that HIV infected patients who develop CMV infection may have a previous history of blood transfusion 13 . Also HIV infected patients who require transfusion are at high risk of developing symptomatic CMV infection when they are transfused with CMV infected donor blood 13 .…”