HIV-associated anaemia before and after initiation of antiretroviral therapy at Art Centre of Minilik II Hospital, Addis Ababa, Ethiopia.

BACKGROUND: HIV associated anaemia is always overseen and it could be a challenge for prognosis of patients who are taking ART. The prevalence of anemia due to HIV at the early stage of infection is more prevalent than in the late stage. Knowing the impact of HIV on the haematopotosis of HIV infected patients is very essential for the management and care of people living with HIV/AIDS. HIV related anemia decreases the quality of life and survival rate of HIV patients. OBJECTIVE: The aim of this study is to determine prevalence of HIV associated anaemia before and after initiation of antiretroviral therapy (ART) in HIV infected adults. METHOD: A retrospective record review was conducted on HIV infected patients before ART and had follow up at the ART Clinic of Minilik II Hospital Addis Ababa, Ethiopia. Haemoglobin measurement and CD4+ T cell count was measured using standard methodology at baseline and after 4 months of antiretroviral therapy (ART). Paired t -test was used to assess mean differences for haemoglobin and CD4+ T cell count before and after ART initiation. RESULTS: Of the 230 study subjects 121 (52.6%) were anemic before ART. However, the prevalence of anemia after ART (37.4%) was significantly decreased (p < 0.05). The prevalence of anemia was higher in females than in males at base line (70.25% vs. 29.75%) (P = 0.017), and after ART treatment (69.23% vs. 30.77%) (P = 0.000). Mean CD4 cell count of study subjects was 112 cells/microl +/- 67/microl at baseline. The mean CD4+ T cell count is significantly increased after ART and found to be 211 cells/microl +/- 120/microl (p < 0.05). Significance association was observed between Hb aind CD4+ T cell count after ART (P = 0.011). CONCLUSIONS: There was a decline in the prevalence of anemia and increment of mean CD4+ T cell count among HIV infected patients after ART. However, a number of HIV/AIDS patients had still anemia and their CD4+ T cell count is not improved. Thus, there should be a large scale and longitudinal study for further characterization of HIV related anemia.

Human herpesvirus 8 infection in HIV-1-infected and uninfected pregnant women in Ethiopia.

BACKGROUND: Human Herpes Virus (HHV-8) is related to Kaposi Saracoma, an opportunistic infection occurring with HIV infection. Little is known about the seroepidemiology of Human Herpesvirus 8 (HHV-8) infection among Ethiopian women, even though women are a major HIV risk group in Ethiopia. OBJECTIVES: This study aimed at determining the seroprevalence of HHV-8 infection in HIV-1-infected and uninfected pregnant women in five selected regions of Ethiopia. METHODS: A cross-sectional study was conducted from December 2006 to June 2007 where pregnant women were recruited after age-matching in groups. A total of 400 pregnant women were enrolled, with 200 being HIV-infected and 200 being HIV-uninfected Sera were screened for IgG lytic antibody to HHV-8 using an Indirect Fluorescence Assay (IFA) in Virology Unit of Ethiopian Health and Nutrition Research Institute (EHNR1). RESULTS: Of 400 pregnant women attending antenatal clinic (ANC) testing sites of five regions in Ethiopia, 212 (53.0%) were positive for HHV-8 IgG lytic antibody. There was a high prevalence of HHV-8 infection among HIV-1-infected pregnant women (138, 69.0%) as compared with HIV-1-uninfected pregnant women (74, 37.0%). CONCLUSION: The study shows a high prevalence of HHV-8 infection among HIV-1-infected pregnant women as compared with HIV-1-uninfected pregnant women. Therefore, creating awareness and educating women on safe sexual practice and avoiding deep kissing may be a fundamental ways to limit the roots of transmission. Moreover, initiating strong antiretroviral therapy (ART) for HIV infected women would be best treatment prior to the development of Kaposi's sarcoma (KS).

Assessment of the implementation of HIV-rapid test kits at different levels of health institutions in Ethiopia.

OBJECTIVE: Evaluation and monitoring of Human Immunodeficiency Virus (HIV) testing reagents at the point of service is helpful to prevent the occurrence of problems related to testing and interpretation. To evaluate the implementation of HIV rapid test kits at the point of services in voluntarily counseling and testing (VCT) and diagnostic centers in Ethiopia. METHODS: The assessment was the third phase of evaluation of HIV rapid test kits in Ethiopia followed from phase-I and phase-II. Known proficiency testing panels, well-structured questionnaire (addressing type of tests, human resource and problems related to tests), onsite supervision and retesting of samples collected from sites were used to evaluate the performances of reagents and laboratories. RESULTS: Forty-four health institutions were included. Thirty-six (90.0%) health institutions had trained human resource on HIV testing. In 27 (61.4%) three types of HIV rapid test kits (Determine, Capillus and Unigold) were available. Serial-algorithm was used in all the laboratories. In 31 (70.4%) of them external quality control specimens were not used. Twenty two (50.0%) of the laboratories reported frequent shortage of reagents. All (100%) were able to identify negative specimens distributed. Positive proficiency panel samples were identified in 37 (94.8%) of the 39 laboratories. There was 98.3% agreement at a screening level between the sites and the central laboratory. Rate of discrepancy between screening and confirmatory assays was found to be 3.0% and 2.1% at the sites and at central laboratory, respectively. CONCLUSION: The test kits showed a good performance at the point of services in the field sites. However, continuous assessment of HIV test kits at the point of service and training of professionals on newly arrived techniques are recommended to have effective testing performance with acceptable sensitive and specific testing algorithm. Effective quality assurance program should be in place to support programs such as VCT, prevention of mother-to-child-transmission and antiretroviral therapy.