Effect of community treatment initiative on antiretroviral therapy uptake among linkage-resistant people living with HIV in Northern Nigeria.

BACKGROUND: Community Treatment Initiative (CTI) was developed in northern Nigeria as an intervention to link a cohort of people living with HIV (PLHIV) who refused antiretroviral treatment through a conventional linkage method to care and treatment. The CTI attempted to take treatment to PLHIV in the community. METHODS: This was a non-control interventional study that evaluated the proportion of linkage-resistant PLHIV linked to treatment through the CTI in nine geographical areas. Data were collected between October and December 2015. Linkage-resistant PLHIV were identified and linked to treatment using the CTI. Data were analyzed using Excel and IBM SPSS version 20.0. The simple proportion was used to estimate the linkage-resistant PLHIV who were eventually linked and retained in care and who ultimately achieved virological suppression (viral load <1000 copies/ml). The Chi-square test was used and the level of significance set at a p-value of <0.05. RESULTS: An estimated 541 (20%) PLHIV (239 (44.2%) male, 302 (55.8%) female) seen from October to December 2015 refused linkage to treatment. This was statistically significant at a p-value of <0.0001. Three hundred and seventy-seven (69.7%) of the PLHIV who refused linkage to treatment eventually accepted treatment using an alternative community treatment method; this was significant (p<0.0001). The 6-month retention rate for PLHIV who accepted the alternative treatment method was 88.1% (n=332); this was significant (p<0.0001). Seventy-eight percent of those retained in care attained virological suppression. CONCLUSIONS: The CTI improved linkage to care and treatment for a cohort of linkage-resistant PLHIV. Focus on this cohort of linkage-resistant positive clients is required to achieve HIV epidemic control.

Effect of methanol seed extract of Buchholzia coriacea on the leftventricle myocardium ofzidovudine-induced cardiotoxic Wistar rats

The degenerative and inflammatory changes were reported in cardiac tissues of rats exposed to zidovudine (ZDV). This study was designed to ex-amine the histochemical changes in the myocardi-um of adult Wistar rats exposed to ZDV and ad-ministered with methanolic extract of Buchholzia coriacea (MEBC) seed. Forty-eight healthy Wistar rats weighing 150-155 g. were randomly assigned into eight groups of six rats each. Group A served as control and received distilled water; group B received 100 mg/kg of ZDV; group C received 600 mg/kg of MEBC; group D received 100 mg/kg of vitamin C; group E received 100 mg/kg of vitamin C and ZDV; group F received 150 mg/kg of MEBC and 100 mg/kg of ZDV; group G received 300 mg/kg of MEBC and 100 mg/kg of ZDV, and group H received 600 mg/kg of MEBC and 100 mg/kg of ZDV. Treatment lasted for a period of 56 days. Blood was collected separately into clean capped plain tubes for biochemical parameters. Heartswere excised, fixed in 10% formal saline and pro-cessed for histology. ZDV induced a significant increase in the serum concentration of Nitric Oxide (NO) and Cardiac Troponin I (cTnI) in the ZDV-alone group when compared to control (p < 0.05). Also, there was reduction in activity of the Glutathi-one reductase (GR) enzyme in the ZDV-alone group relative to control (P = 0.0006, F = 7.0). Distor-tion of the cross banding pattern of cardiac muscle fibres in ZDV-alone group was manifested. These effects were reversed by administration of MEBC compared to vitamin C group

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