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Virologic Response among Children and Adults in an Antiretroviral Therapy Programme in Northern Nigeria: A Cross-Sectional Descriptive Study

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World Journal of AIDS 2023年第4期13卷 178-192页

作者： Elon Warnow Isaac Ayomikun Ajani mohammed Manga Abubakar Joshua Difa Oyeniyi Christianah Oluwaseun mohammed hassan danlami Department of Paediatrics College of Medical Sciences Gombe State University Gombe Nigeria Kettering General Hospital University Hospitals of Northamptonshire Northamptonshire UK Department of Medical Microbiology College of Medical Sciences Gombe State University Gombe Nigeria Department of Community Medicine College of Medical Sciences Gombe State University Gombe Nigeria Infectious Disease Training and Research Group Gombe Nigeria Department of Molecular Microbiology Federal Teaching Hospital Gombe Nigeria

Introduction: Viral load suppression is a key determinant of successful anti-retroviral therapy. The study aimed to determine virologic response to Antiretroviral therapy in the large cohort of children and adults living with Human Immune deficiency Virus. Materials and Methods: Viral Load results from the HIV Ribonucleic Acid Polymerase Chain Reaction register of 10,887 children and adults on cART in 4 states in Northern Nigeria between 2017 and 2019 were retrieved and analyzed in the PCR Molecular Laboratory of the Federal Teaching Hospital, Gombe. Results: 10,887 children and adults were analyzed. Males were 28.4% (3094) and 71.6% (7793) females. 2.9% (311);3.5% (386);7.3% (797);65.2% (7098);14.5% (1583);5.2% (562) and 1.3% (150) were aged 0 - 9 years, 11 - 18 years;19 - 25 years, 26 - 45 years;46 - 55 years;56 - 65 years and 10 years. The most recent CD4count before viral load request was ≥1000/μL in 7.4% (810/10887);500 -999/μL in 39.0% (4240);350 - 499 μL in 22.7% (2466) and 1000 c/mL in 26.5% (821/3094) males and 24.1% (1876/7793) females. Viral load was significantly lower among females (p-value 0.007). 50.5% (157/311);52.1% (201/386);28.5% (227/797);23.5% (1670/7098);19.9% (315/1583);17.8% (100/562) and 18.0% (27/150) aged 0 - 9 years, 11 - 18 years;19 - 25 years, 26 - 45 years;46 - 55 years;56 - 65 years and 1000 c/mL respectively. Viral load was >1000 c/mL in 28.2% (229/811) for those on HAART for 6 months - 1 year and 23.6% (1243/5275) after receiving Highly Active Antiretroviral Therapy (HAART) for 1 - 5 years. 26.3% (1072/4075) and 21.1% (153/726) had viral load > 1000 c/mL after receiving HAART for 6 - 10 and >10 years respectively (p-value 0.001). Conclusion: HIV viral suppression was below the WHO recommended threshold.

关键词： HIV cART Viral Load Viral Suppression Children Adults Nigeria

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Low Level of Hepatitis B Surface Antigen Screening in a Tertiary Health Facility in Nigeria 2000-2014: Imperative for Provider Initiated Testing and Counselling for Hepatitis B Virus?

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Open Journal of Epidemiology 2020年第3期10卷 251-264页

作者： Elon Warnow Isaac Iliya Jalo Yaya Saidu Alkali Ayomikun Ajani Joshua Difa Abubakar John Tunde Aremu Christianah Oluwaseun Oyeniyi mohammed hassan danlami Department of Paediatrics College of Medical Sciences Gombe State University Gombe Nigeria Department of Paediatrics Federal Teaching Hospital Gombe Nigeria Department of Community Medicine College of Medical Sciences Gombe State University Gombe Nigeria Department of Medicine Federal Teaching Hospital Gombe Nigeria Infectious Diseases Training and Research Group Gombe Nigeria Department of Molecular Microbiology Federal Teaching Hospital Gombe Nigeria

Introduction: Viral hepatitis is a major public health challenge that requires an urgent response. Reducing mortality requires major scale-up in prevention, testing and treatment access;coverage in HBV vaccination, testing and treatment is low and must accelerate massively to achieve the 2030 targets. Less than 1% of HBV-infected individuals are diagnosed in Sub-Sahara Africa, despite the availability of rapid tests with good diagnostic accuracy. Materials and Methods: This was retrospective cross sectional study conducted in Federal Teaching Hospital Gombe, in North East Nigeria. All children and adults who presented to the out-patient departments, and those that were admitted irrespective of their HIV and or Hepatitis C virus status and had Hepatitis B and/or Hepatitis B envelope antigen test were conducted between 2000 to 2015. All children and adults were tested using the Hospital standard for Hepatitis B surface antigen test strip. Results: Between 2000 and 2014, 739,456 children and adults were admitted and reviewed in the outpatient units of the Federal Teaching Hospital Gombe;there were 685,552 adults and 53,904 children. Children constituted 7.3% (53,904/739,456) of admissions and outpatient consultations. 2.8% (210/7570), 3.3% (773/23,783), 3.6% (1145/32,142), 5.2% (1694/33,043), 3.3% (986/29,216), 1.9% (661/3321), 0.1% (53/41,626), 0.2% (113/46,634), 2.6% (1418/54,423), 5.4% (3717/69,696), 3.7% (2332/62,086), 3.5% (3241/90,623), 3.2% (2881/89,398), 3.8% (2428/62,687), 2.8% (1835/63,208) of children and adults were tested for HBsAg in 2000, 2001, 20002, 2003, 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013 and 2014 respectively. 23,487 children and adults were tested for HBsAg with a cumulative testing rate of 3%. Overall 4465/23,487 children and adults were seropositive for HBsAg giving a cumulative prevalence of 19%. Conclusion: HBV screening in our health facility is very low

关键词： Hepatitis B Testing Provider Initiated Counseling and Testing Sub-Saharan Africa

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HIV Viral Suppression in Children in a Subnational Antiretroviral Treatment Programme in Nigeria

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World Journal of AIDS 2020年第3期10卷 170-185页

作者： Elon Warnow Isaac Ayomikun Ajani Jalo Iliya Oyeniyi Christianah danlami mohammed hassan Department of Paediatrics College of Medical Sciences Gombe State University Gombe Nigeria Department of Paediatrics Federal Teaching Hospital Gombe Nigeria Infectious Diseases Training and Research Group Gombe Nigeria Department of Medical Microbiology Federal Teaching Hospital Gombe Nigeria

Background: Despite years of Paediatric Antiretroviral therapy in Nigeria, the National implementation plan for the scale up of viral load testing was only rece ntly launched. Viral load determination is the most important indicator of ART response. Material & methods: First viral load samples were collected from 663 children living with HIV between December 2017-Decemb er 2019 aged 0 - 18 years on highly active antiretroviral therapy from 4 states within Nigeria. Samples were analyzed at a Polymerase Chain Reaction laboratory of the Federal Teaching Hospital Gombe. Results: Males were 311 (46.9%) and 352 (53.1%) female. Children aged 0 - 9 years constituted 44.9% (298);55.1% (365) were aged 10 - 18 years. This first viral load was primarily routine in 94 .2% (625);2.9% (19) of children respectively had suspected clinical or immunological failure. ART combination was AZT/3TC/NVP in 78.1% (518/663) of CLHIV;TDF/3TC/EFV in 21.2% (141);AZT/3TC/LPV/rtv in 4 (0.6%). Prior to initiation of routine viral load testing $0.55 (366/663) CLHI V had received HAART for 1 - 5 years;7.8% (52/663) for 6 months but 10 years. The most recent CD4 count before viral load request was ≥1000/μL in 24.7% (164) of CLHIV;500 - 999/μL in 42.9% (285);350 - 499 μL in 11% (73) and 1000 c/ml in 59.9% (174/311) males and 47.2% (166/352) females. Viral load was significantly lower among females (P-value 0.02). Of children aged 0 - 9 years 50.3% (150/298) had viral load > 1000 c/ml and 10 - 18 years 52.1% (190/365) (P value 0.660). Viral load was >1000 c/ml in 38.5% (20/52) of children on HAART for 6 months - 1 year and 52.2% (191/366) after receiving HAART for 1 - 5 years. 52.3% (114/218) and 55.6% (15/27) CLHIV had viral load > 1000 c/ml after receiving HAART for 6 - 10 and >10 years respectively (P value 0.29).

关键词： Children ART Viral Load > 1000 c/ml Nigeria

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Deoxyribonucleic Acid-Polymerase Chain Reaction Status of HIV Exposed Infants in a Sub Regional Prevention of Mother-to-Child Transmission of HIV Programme during the Period 2009-2020

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Open Journal of Epidemiology 2023年第4期13卷 328-341页

作者： Elon Warnow Isaac Ayomikun Ajani Jalo Iliya mohammed Manga Abubakar Joshua Difa Oyeniyi Christianah Oluwaseun Muhammad danlami hassan Department of Paediatrics College of Medical Sciences Gombe State University Gombe Nigeria Infectious Disease Training and Research Group Gombe Gombe Nigeria Kettering General Hospital University Hospitals of Northamptonshire Kettering United Kingdom Department of Medical Microbiology College of Medical Sciences Gombe State University Gombe Nigeria Department of Community Medicine College of Medical Sciences Gombe State University Gombe Nigeria Department of Molecular Microbiology Federal Teaching Hospital Gombe Gombe Nigeria

Introduction: Transitioning to more efficacious Antiretrovirals for HIV infected pregnant women and infant prophylaxis has reduced Mother to child transmission of HIV significantly. This study aimed to determine HIV infection status in HIVexposed infants who had their first DNA polymerase chain reaction test in our molecular Laboratory. Subjects, Materials and Methods: Dried Blood Spots for HIV DNA results from 5 states between 2009 and 2020 were analyzed in the PCR laboratory of the Federal Teaching Hospital, Gombe. Results: Nine thousand eight hundred and twenty-three Human Immunodeficiency Virus Deoxyribonucleic acid polymerase Chain Reaction results were analysed;4937 (50.2%) were males. During the study period, there was an overall declining trend in the mother-to-child transmission rate from 3.8% in 2009 to 1.0% in 2020. 6120 (62.3%) of HIV + mothers received Highly active antiretroviral therapy HAART before pregnancy. 7845 (76.2%) of the infants received Nevirapine prophylaxis. Dried blood spot samples were collected from 4077 (41.5%) at 6 - 8 weeks. 8438 (85.9%) received cotrimoxazole. 9469 (96.4%) were ever breastfed. Of the 9823 HIV DNA PCR results, 255 (2.6%) were positive while 69/4077 (1.7%) and 109/2662 (4.1%) were positive for HIV DNA at 6 - 8 weeks and > 12 weeks respectively. (p = 0.001). 86/747 (11.5%) of infants whose HIV-positive mothers received no ARVS were HIV DNA positive. (p = 0.001). 106/884 (12.0%) of infants who had no Antiretroviral prophylaxis had positive HIV DNA results;7/413 (1.7%) with Zidovudine/Nevirapine prophylaxis had positive results. (p = 0.001). 246/9469 (2.6%) of infants that were ever breastfed were positive for HIV DNA;11/354 (3.0%) that never breastfed had positive HIV DNA. Conclusion: Lack of maternal/infant ARVs and prolonged breastfeeding increased the risk of infant HIV infection.

关键词： Mother to Child Transmission of HIV Antiretrovirals HIV Exposed Infants Deoxyribonucleic Acid Polymerase Chain Reaction Early Infant Diagnosis

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