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B Chaplin,
G Eisen, J Idoko,
D Onwujekwe,
E Idigbe,
I Adewole,
W Gashau,
S Meloni,
A D Sarr,
J L Sankalé,
E Ekong,
R L Murphy,
P Kanki
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ABSTRACT: A diverse array of non-subtype B HIV-1 viruses circulates in Africa and dominates the global pandemic. It is important to understand how drug resistance mutations in non-B subtypes may develop differently from the patterns described in subtype B. HIV-1 reverse transcriptase and protease sequences from 338 patients with treatment failure to first-line ART regimens were evaluated. Multivariate logistic regression was used to examine the effect of subtype on each mutation controlling for regimen, time on therapy, and total mutations. The distribution of HIV-1 subtypes included CRF02_AG (45.0%), G (37.9%), CRF06_cpx (4.4%), A (3.6%), and other subtypes or recombinant sequences (9.2%). The most common NRTI mutations were M184V (89.1%) and thymidine analog mutations (TAMs). The most common NNRTI mutations were Y181C (49.7%), K103N (36.4%), G190A (26.3%), and A98G (19.5%). Multivariate analysis showed that CRF02_AG was less likely to have the M41L mutation compared to other subtypes [adjusted odds ratio (AOR) = 0.35; p = 0.022]. Subtype A patients showed a 42.5-fold increased risk (AOR = 42.5, p = 0.001) for the L210W mutation. Among NNRTI mutations, subtype G patients had an increased risk for A98G (AOR = 2.40, p = 0.036) and V106I (AOR = 6.15, p = 0.010), whereas subtype CRF02_AG patients had an increased risk for V90I (AOR = 3.16; p = 0.003) and a decreased risk for A98G (AOR = 0.48, p = 0.019). Five RT mutations were found to vary significantly between different non-B West African subtypes. Further study to understand the clinical impact of subtype-specific diversity on drug resistance will be critically important to the continued success of ART scale-up in resource-limited settings.
AIDS research and human retroviruses 10/2010; 27(1):71-80. · 2.18 Impact Factor
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D K Oladepo,
E O Idigbe,
R A Audu,
U S Inyang,
G E Imade,
A O Philip,
G O Okafor,
D Olaleye,
S B Mohammed,
N N Odunukwe,
T O Harry,
M Edyong-Ekpa, J Idoko,
A Z Musa,
A Adedeji,
A Nasidi,
Y Ya'aba,
K Ibrahim
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ABSTRACT: A total of 2,570 apparently healthy human immunodeficiency virus-negative adults from the six geopolitical zones in the country were enrolled in our study in 2006. The samples were assayed using the Cyflow technique. Data were analyzed using the Statistical Package for Social Scientists (SPSS). The majority (64%) of the participants had CD4 counts within the range of 501 to 1,000 cells/microl. The reference range for CD4 was 365 to 1,571 cells/microl, while the reference range for CD8 was 145 to 884 cells/microl.
Clinical and vaccine immunology: CVI 08/2009; 16(9):1374-7. · 2.37 Impact Factor
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Infectious Agents and Cancer. 01/2009;
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ABSTRACT: Drug susceptibility testing for Mycobacterium tuberculosis (M. tuberculosis) is especially required in difficult cases of tuberculosis (TB) chemotherapy and in cases of multidrug resistance (MDR-TB; combined resistance to isonizid and rifampicin with or without resistance to any other drug). The methods for in vitro cultivation and drug susceptibility testing (DST) of M. tuberculosis are cumbersome and not readily adaptable in most routine laboratories, particularly those in the developing world due to limited resources and lack of political will in those countries. A simple and cost effective method, the nitrate reductase assay (NRA), was compared with the gold standard proportion (egg bases Lowenstein Jensen's [LJ]) method for DST of M. tuberculosis in order to substantiate its suitability for routine use in Nigeria and in other countries of the developing world with high TB endemicity.
Drug susceptibility test was performed for 70 pulmonary isolates of M. tuberculosis (Indirect DST) and 20 sputum (10 acid fast bacilli [AFB] positive and 10 AFB negative) specimens (direct DST) by the NRA and the proportion method using 0.2microg isoniazid (INH), 2microg ethambutol (EMB), 40 microg rifampicin (RIF) and 4 microg streptomycin STR).
The indirect NRA showed sensitivity and specificity for INH: 100% and 100%, EMB: 75% and 100% RIF: 90% and 96.6%, STR: 66.6% and 91.8%. The results of direct NRA and proportion method for INH, EMB RIF and STR agreed 10/10 (100%) for AFB negative specimens and 9/10 (90%) with AFB positive specimens.
Drug susceptibility test of M. tuberculosis by the NRA is simple and sensitive with shorter turn around time of 10 to 1 4 days compared to 42 days by the LJ proportion method. The direct use of AFB positive sputum specimens is likewise reproducible and excludes about 3 - 8 weeks period required for isolation of M. tuberculosis .
The Journal of Infection in Developing Countries 01/2009; 3(1):16-9. · 1.19 Impact Factor
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ABSTRACT: The drug resistance profile of 100 Mycobacterium tuberculosis isolates from pulmonary tuberculosis (PTB) cases in Jos, Nigeria, was investigated between August 2006 and September 2007. Drug susceptibility testing for 50 new, 11 follow-up and 39 unclassified cases of PTB was performed on Löwenstein-Jensen medium by the proportion method, using isoniazid (0.2 microg/ml), rifampicin (40 microg/ml), ethambutol (2 microg/ml) and streptomycin (4 microg/ml). Susceptibility to all four drugs was found in 76, 62 and 55%, and multidrug resistance (combined resistance to isoniazid and rifampicin with or without resistance to any other drug) in 4, 31 and 18% of the new, unclassified and follow-up cases, respectively. Monoresistance was found in 15% of the cases. Nine of the 16 isolates (56%) showing multidrug resistance were resistant to all four drugs. These findings are critical and the risk to public health is high, particularly with an overall multidrug resistance of 16%. We suggest that TB management and control programs in Jos are revised to enhance patient's accessibility to treatment sites, promote patients' adherence to drugs, improve diagnostic practices, regularly assess drug resistance profiles, and undertake contact tracing for patients with multidrug-resistant TB.
Transactions of the Royal Society of Tropical Medicine and Hygiene 10/2008; 103(1):67-71. · 2.16 Impact Factor
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ABSTRACT: Between April and August 2004, all pregnant women in labour at JUTH, were offered rapid HIV testing and counselling with opportunity to decline testing. HIV positive women were offered the standard nevirapine mono-therapy prophylaxis regimen (HIVNET 012). Four hundred and thirty (99.8%) of the 431 pregnant women who were offered rapid HIV testing and counselling, agreed to test. A sero-conversion rate of 2.1% (5 of 235) was found among women who had previously tested negative for HIV during the index pregnancy. A seroprevalence rate of 9.6% (16 of 166) was found among women with unknown HIV status. One patient who had an indeterminate HIV status prior to labour tested positive in labour. Rapid HIV testing and counselling in labour is a useful practice in high prevalence settings since it detects a substantial number of HIV-infected women and HIV-exposed babies that would otherwise have missed interventions to prevent MTCT.
African Journal of Reproductive Health 05/2006; 10(1):76-80.
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ABSTRACT: To determine risk factors for HIV among pregnant women (N = 2657) receiving antenatal services in Jos, Plateau state, Nigeria.
Information about potential risk factors was obtained at interview. Biological samples were collected for detection of HIV and other sexually transmitted infections (STIs).
The prevalence of HIV was 8.2%. Women aged 20-29 years had more than 4-fold increased risk of HIV. Women of Catholic (adjusted odds ratio (AOR) = 1.72, 95% CI = 1.01-2.95) and Pentecostal (AOR = 2.57, 95% CI = 1.46-4.52) denominations were more likely to be HIV-infected when compared to Moslem women. The risk of HIV was also increased among women with multiple marriages and in women married to a banker/accountant. Other predictors of HIV were having a husband with other partners, perceived risk of HIV, STIs, candidiasis and bacterial vaginosis.
Development of effective interventions, including behavioral change, expansion of perinatal HIV prevention services and STI control, should be given the highest priority.
International Journal of Gynecology & Obstetrics 08/2005; 90(1):61-7. · 2.05 Impact Factor
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ABSTRACT: Even though HIV-HCV co-infection rates vary widely according to western reports, not so much has been documented about the situation in our environment. We determined the prevalence of HCV among our HIV cohort as well as described the relationship between the immune and virological status of the patients in this report.
Data of 1044 consenting HIV infected patients (confirmed by Western blot assay) receiving treatment at our centre between Sep 2002 and Feb 2005 were analyzed using EpiInfo 2004 retrospectively. The sera of the patients were used to determine their anti-HCVstatus by third generation ELISA (DIA.PRO Diagnostic, Bioprobes srl, Italy). HIV RNA levels and CD4 cell counts were also determined at recruitment by Roche Amplicor 1.5 and Flow Cytometry (Partec, Germany).
Ninety out of 1044 patients (8.6%) were positive for anti-HCV The rate of co-infection was highest among the divorced (10.3%), followed by widows (9.9%) though this did not reach statistical significance. The odds of finding anti-HCV was more than twice with CD4 cell counts >600 cells/microlitre compared to below 200 cells/microlitre (p=0.026). The median HIV RNA levels of HCV co-infected individuals was 514 copies/ml, while it was 200 copies/ml for HIV monoinfected persons (p>0.05).
The prevalence of HCV among this HIV cohort is high. There is also an associated higher chance of detecting anti-HCV in sera of the HIV patients whose immunological status is better than severely immunocompromised individuals.
Nigerian journal of medicine: journal of the National Association of Resident Doctors of Nigeria 16(3):231-4.
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D. K. Oladepo,
E O Idigbe,
R A Audu,
U. S. Inyang,
G E Imade,
A. O. Philip,
G O Okafor,
D. Olaleye,
S. B. Mohammed,
N N Odunukwe,
T O Harry,
M. Edyong-Ekpa, J Idoko,
A Z Musa,
A. Adedeji,
A Nasidi,
Y. Ya’aba,
K. Ibrahim
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[show abstract]
[hide abstract]
ABSTRACT: The drug resistance profile of 100 Mycobacterium tuberculosis isolates from pulmonary tuberculosis (PTB) cases in Jos, Nigeria, was investigated between August 2006 and September 2007. Drug susceptibility testing for 50 new, 11 follow-up and 39 unclassified cases of PTB was performed on Löwenstein–Jensen medium by the proportion method, using isoniazid (0.2 μg/ml), rifampicin (40 μg/ml), ethambutol (2 μg/ml) and streptomycin (4 μg/ml). Susceptibility to all four drugs was found in 76, 62 and 55%, and multidrug resistance (combined resistance to isoniazid and rifampicin with or without resistance to any other drug) in 4, 31 and 18% of the new, unclassified and follow-up cases, respectively. Monoresistance was found in 15% of the cases. Nine of the 16 isolates (56%) showing multidrug resistance were resistant to all four drugs. These findings are critical and the risk to public health is high, particularly with an overall multidrug resistance of 16%. We suggest that TB management and control programs in Jos are revised to enhance patient's accessibility to treatment sites, promote patients’ adherence to drugs, improve diagnostic practices, regularly assess drug resistance profiles, and undertake contact tracing for patients with multidrug-resistant TB.
Transactions of the Royal Society of Tropical Medicine and Hygiene.
