Adherence to Medication among Patients with Chronic Hepatitis B Infection Attending a Tertiary Hospital in South Western Nigeria.

INTRODUCTION: Chronic hepatitis B (CHB) is an international public health problem. Treatment reduces its morbidity, mortality and infectivity. The aim of this study was to determine adherence among CHB infected patients on Tenofovir and the reasons for non-adherence. METHODOLOGY: It was a cross-sectional study of patients on tenofovir for at least 6 months. Information was obtained on bio- data, adherence to tenofovir, duration and reasons for nonadherence using an interviewer administered questionnaire. Non- adherence was defined as patient reporting missing medication at all. Chi square or Fisher exact test and Student's t-test were used to determine associations. P value less than 0.05 was considered significant. RESULTS: A total of 150 participants comprising of 76 (50.7%) females and 74 (49.3%) males with mean age of 39.2 ± 11.4 years, participated in the study. Non adherence rate was 65%. There was no significant association between non-adherence and tribe (p=0.7), level of education (p=0.8), religion (p=0.2), sex (p=0.9), clinical state (p=0.8), treatment experience (p=0.8) and months on Tenofovir (0.1) while a significant association existed with age (0.01), the presence of comorbidity (p=0.02) and taking another medication apart from tenfovir (0.00). The reasons for non-adherence included out of station 22 (14.7%), financial constraint 19(12.5%), unavailability of the drug 19 (12.5%), forgetfulness 15 (10%), perceived side effects 12 (8%), undetectable serum DNA quantification 11 (7.3%), ignorance of continuous use of Tenofovir 10 (6.7%), and pregnancy 9 (6%) among others. CONCLUSION: Adherence to Tenofovir is poor among CHB patients attending University College Hospital, Ibadan.

INTRODUCTION: L'hépatite B chronique (HCB) est un problème de santé publique international. Le traitement réduit sa morbidité, sa mortalité et son infectiosité. Le but de cette étude était de déterminer l'adhésion chez les patients infectés par CHB sur Tenofovir et les raisons de la non-adhésion. MÉTHODOLOGIE: Il s'agissait d'une étude transversale de patients sous ténofovir depuis au moins 6 mois. Des informations ont été obtenues sur les données biologiques, l'adhésion au ténofovir, la durée et les raisons de la nonadhésion à l'aide d'un questionnaire administré par un intervieweur. La non-observance a été définie comme un patient déclarant qu'il n'y avait aucun médicament manquant. Le test du chi carré ou exact de Fisher et le test t de Student ont été utilisés pour déterminer les associations. Une valeur p inférieure à 0,05 a été considérée comme significative. RÉSULTATS: Un total de 150 participants comprenant 76 (50,7%) femmes et 74 (49,3%) hommes avec un âge moyen de 39,2 ± 11,4 ans, ont participé à l'étude. Le taux de non-adhésion était de 65 %. Il n'y avait pas d'association significative entre la non-adhésion et la tribu (p = 0,7), le niveau d'éducation (p = 0,8), la religion (p = 0,2), le sexe (p = 0,9), l'état clinique (p = 0,8), l'expérience du traitement (p=0,8) et des mois sous Ténofovir (0,1) alors qu'il existait une association significative avec l'âge (0,01), la présence de comorbidité (p=0,02) et la prise d'un autre médicament en dehors du tenfovir (0,00). Les motifs de non-observance inclus hors station 22 (14,7%), contrainte financière 19 (12,5%), indisponibilité du médicament 19 (12,5%), oubli 15 (10%), effets secondaires perçus 12 (8%), quantification de l'ADN sérique indétectable 11 (7,3 %), méconnaissance de l'utilisation continue du ténofovir 10 (6,7%) et grossesse 9 (6 %) entre autres. CONCLUSION: L'adhésion au ténofovir est faible chez les patients infectés par CHB fréquentant l'University College Hospital d'Ibadan. MOTS-CLÉS: Infection chronique par l'hépatite B, ténofovir, observance, Nigéria.

High rate of Hepatitis B virus infection among hairdressers in Ibadan, Nigeria.

Hepatitis B virus (HBV) infection is a major public health problem for over two billion people infected globally. Occupationally exposed persons are at high risk of HBV infection and, apart from medical personnel, there is dearth of information concerning the prevalence and awareness of HBV among this population in Nigeria. This study was designed to determine the levels of HBV awareness and prevalence of HBV infection among hairdressers in Ibadan, Nigeria. Hairdressers and teachers (unmatched controls) in four local government areas in Ibadan were tested for HBV infection using ELISA technique. Dried blood spot (DBS) samples were collected from 171 participants. DBS elutes from the samples were tested for HBV surface antigen (HBsAg). The rate of HBV infection was higher (p = 0.005) among the hairdressers (13.0%) than teachers (4.8%). However, teachers were better informed about HBV (38%) compared to hairdressers (13%; p = 0.0001). Differences in HBV awareness and occupation type were found to be significant (P = 0.001). Hairdressers are at high risk of HBV infection and may constitute a major source of HBV spread among urban dwellers, especially in areas where awareness is low. Routine HBV screening and appropriate interventions for hairdressers are recommended to interrupt HBV transmission.

Is there any relationship between hearing threshold levels and CD4 cell count of human immunodeficiency virus infected adults?

Background The role of viral load level and/or CD4 (Cluster of differentiation 4) cell count in the aetiopathogenesis of hearing loss in HIV infection is unclear. Therefore, we investigated the relationship between CD4 cell counts, viral load and hearing threshold of HIV (Human immunodeficiency virus) infected adults. METHODS: This cohort audiometric study involved consecutive HIV-infected and HIV-uninfected adults as controls. Clinical data relating to hearing loss, HIV status, and highly -active antiretroviral therapy (HAART) were obtained. Audiornetric evaluation was performed. The most recent CD4 cell counts and RNA viral load-of HIV-infected participants were obtained from clinic records. RESULTS: There were 299(66.7%) HIV-infected adults and 149(33.3%) controls with mean age of 39.64± 12.45 years and 39.60±12.45 years respectively (p=0.98). In both groups, there were more participants with left hearing loss. Mild to profound hearing loss was found in 65.9% HIV- infected participants and 53.7% controls. Majority (86.3%) of the HIV-infected participants were on HAART. The mean CD4 cell count was 654.58±289.15 in 41 HIV-infected participants not on HAART and 523.95±300.17 in 258 participants on HAART (p=0.01). Majority,- 197 (62%) HIV- infected participants with hearing loss had CD4 cell count ≤200 cells/mm3. Higher viral load significantly correlated with low CD4 cell counts (p<0.0 1; r=0. 18) and low CD4 cell count significantly correlated with high hearing threshold (p

Tissue culture isolation of lyssa viruses from apparently healthy unvaccinated dogs in Nigeria.

BACKGROUND: There have been previous reports of inapparent infection and intermittent secretion of rabies virus in the saliva of apparently healthy dogs in some African countries, including Nigeria. OBJECTIVE: The study was therefore aimed at examining the carrier status of rabies in apparently healthy Nigerian dogs in the settlement areas studied. METHODS: Ninety-two swabs samples from oral mucosae of domestic dogs (mongrels) without vaccination history were assayed for lyssaviruses by tissue culture isolation test in Vero cells. RESULTS: Rabies or rabies-related viruses were recovered from eighteen, representing 19.6% of the samples. The study showed that lyssaviruses were present in 4 out of the 6 settlements of the study areas. Among the areas where the viruses were present, the rate of isolation ranged from 11.1% to 66.7%. Female dogs had a little higher infection rate (12.0%) than their male counterparts (7.6%). Among age groups, the highest rate of infection (66.7%) was detected in dogs aged one to 3 years while the rate of 3.7% was found in dogs aged less than one year. CONCLUSION: The results of this study agree with the carrier state of rabies in domestic dogs, the common reservoir hosts of its etiologic agents in Nigeria and the rest of Africa andAsia; this is a serious threat to humans in these settlements. Although the load of infective virus in saliva is lower than that in brain, saliva collection for rabies diagnosis is simple, safer, faster and cheaper. Thus we suggest that saliva samples could be used as an alternative to brain specimens for rabies virus antigen testing in dogs, especially, when it is not practicable to obtain brain specimen.

HIV-1 drug resistant mutations in chronically infected treatment naive individuals in the pre-ARV era in Nigeria.

In Nigeria the Federal Government rolled out antiretroviral drugs for the management of HIV infection in year 2002. This study was carried out to determine the circulating antiviral drug mutations among ARV naïve patients with chronic HIV infection during the pre-ARV roll out era in the country. DNA was extracted from stored whole blood samples collected from 75 HIV positive patients attending the Medical outpatient clinic between December 1996 and November 2001. The Reverse transcriptase (RT) and the protease (PR) regions of the viral genome were amplified by nested PCR and then sequenced by cycle sequencing and analyzed using the ABI 3100 DNA sequencer to determine the mutations associated with protease inhibitors (PI), nucleoside reverse transcriptase inhibitors (NRTI) and non-nucleoside reverse transcriptase inhibitor (NNRTI). Ten of the 64 (15.6%) samples with positive PCR had mutations for PR inhibitors (PI) including R8D, I 15V, G16E, M36I, M46L, L63P and H69K, while 5 of 63 harbored RT inhibitor (NRTI/NNRTI); V179I, A98T, V179E and A98S. Detection ofARV drug resistant mutations when ARV was not known to be in use in Nigeria calls for caution in the interpretation of drug resistance profile of HIV-1 from infected persons on treatment ARVs in the country.

HBV infectivity among Nigerians.

The study involved 60 (non-immunized), 14 (immunized against HBV), healthy Nigerian adults and 28 Nigerian patients with hepatitis. Their sera were tested for HBsAg, HBeAg, anti-HBe, anti-HBc, anti-HBs and anti-HCV while only 15 subjects with chronic hepatitis had HBV DNA assay by PCR. The subjects aged 21 to 72 years and comprised 75 male and 27 female adults. The prevalence of HBV infection by HBsAg and/or anti-HBc sero-positivity was 55.9%. Only HBsAg and anti-HBs were detectable in 21% each among immunized while HBsAg, HBeAg, anti-HBe, anti-HBc, anti-HBs were present in 58%, 20%, 6%, 32%, and 42% respectively in the non-immunized subjects. HBV DNA was positive in 86.7% of the 15 subjects. About fifty five percent of all subjects were infectious of HBV with 13.7%, 3.9%. 32.3% and 4.9% accounting for high, medium, low and very low infectivity respectively while 44.1% and 1% of the subjects were susceptible and naturally immuned to HBV respectively. Coinfection with HCV tends to favour HBV infectivity. In conclusion, the infectivity of HBV among Nigeria is varied but high and a great proportion of the population is susceptible.

Are patients with primary hepatocellular carcinoma infectious of hepatitis B, C and D viruses?

Primary HepatoCellular Carcinoma (PHCC) has been strongly associated with HBV and HCV infections among other aetiological factors. However; do the patients still spread the viruses? This study involved forty one Nigerian adult patients with PHCC and 45 controls who were tested for HBsAg, HBeAg, Anti-HBe, Anti-HBs, anti-HCV IgM and IgG, anti-HDV and HDV antigen using ELISA. Statistical analysis was carried out with the student - t - test and Mc Nemar test at p < 0.05. The subjects consisted of male:female ratio of 3:1 for both the PHCC patients and controls. Evidence of exposure to hepatitis B, C and D viruses was detected in 95.1%, 44% and 0% of the patients respectively while the respective values of 24%, 11.1% and 0% were obtained for the controls. Indication for high (HBeAg) and low (anti HBe) HBV viral replication, and acute HBV infection were detected in 12.5%, 92.7% and 2.2% respectively among the patients while only 35.6% of the controls had low HBV viral replication. Acute and chronic infections of HCV were also found in 26.8% and 24.4% of the patients respectively compared to the respective values of 2.2% and 11.1% of the controls. Occult HBV infection occurred in equal proportions (11%) of both the patients (31.7%) and controls (35.6%). In conclusion, infectious HBV and HCV particles are present among Nigerian patients with PHCC while HDV infection is uncommon. Hence, safe medical care should be practised for all patients with PHCC while relatives should be screened for these viruses.

Genital ulcer diseases among HIV-infected female commercial sex workers in Ibadan, Nigeria.

We evaluated the prevalence and association of Genital Ulcer Diseases (GUDs) among HIV-1 infected female commercial sex workers (FCSWs) in Ibadan, Nigeria. A total of 250 FCSWs from brothels in Ibadan were tested for presence of antibodies to HIV and Syphilis. Pelvic examinations for signs of sexually transmitted infections (STIs) were carried out on the subjects. Endocervical and high vaginal swabs were collected from each of the subjects to establish laboratory diagnosis of STIs. Their age ranged from 15 to 55 years (Mean = 25.8 yrs; SD = 3.74). Majority (246/250) were Nigerians, while 1.6% were from neighboring West African countries. Sixty four (25.6%) of the subjects were positive for HIV-1 while seven (2.8%) had dual HIV-1/2 infection. Analysis of the STIs showed that 49 (19.6%) of the CSWs had GUDs. Herpes genitalis was the commonest GUDs as it occurred in 25 (10%) of the subjects. Other STIs identified were chancroid (5.6%), syphilis (4.0%) and lymphogranuloma venerum (LGV) (4%). Sixteen (64.0%) of the CSWs with herpes genitalis had HIV-1 infection. The risk ratio of herpes genitalis for HIV acquisition was 3.0 (95% CI: 2.0 - 4.4). Syphilis and chancroid were also found tobe significantly associated with increased risk of HIV infection (p < 0.0001). The adjusted odd ratios for Herpes genitalis, chancroid, and syphilis were 3.7 (1-13.0, p < 0.05), 19.8 (2.7-13.0, p < 0.05) and 19.1 (1-231.0, p < 0.05) respectively. There is need to educate FCSWs continually to adopt safer sexual behaviours, seek early diagnosis and treatment of GUDs to reduce their risk of transmitting HIV infection.

Molecular characterization of canine parvovirus from domestic dogs in Nigeria: Introduction and spread of a CPV-2c mutant and replacement of older CPV-2a by the "new CPV-2a" strain.

Canine parvovirus (CPV) is a contagious and highly pathogenic virus of dogs. After its first report in 1978, the CPV original type (CPV-2) was rapidly and totally replaced by three antigenic variants named CPV-2a, CPV-2b and CPV-2c that circulate in various countries at different frequencies and recently reported in Nigeria. This study describes the molecular characterization of 28 CPV strains in dogs presenting with gastroenteritis in veterinary clinics at Lagos and Ibadan, Nigeria. The results show the predominance (92.8%) of CPV-2a, while CPV-2c was found only in two samples. Phylogenetic analyses revealed that the CPV Nigerian strains were closely related to Asian strains and 26 CPV-2a out of 28 CPV sequences fell into 2 different subclades consistent with predicted amino acid mutations at position 267, 321, 324 and 440. Lys321Asn was evident in all the Nigerian strains whilst Phe267Tyr and Tyr324Ile were observed in 96.4% of the sequences, respectively. Thr440Ala occurred in 89.3% of sequences from this study. The new CPV-2a was predominant and appears to have replaced other CPV-2a strains in South-western Nigeria whilst the CPV-2c strain which is identical to the isolate recently reported in Northern Nigeria, may have been introduced in this country at the time of this study. Monitoring virus epidemiology is important to better understand the dynamics of CPV evolution and the eventual need to change or improve existing vaccination strategies.

Predominant amino acid substitutions in NS5B gene of hepatitis C virus in blood donors and treatment-naïve hepatitis and HIV patients in Nigeria

Background: Hepatitis C virus (HCV) genome undergoes high rate of mutation, which results in generation of genetically diverse HCV isolates. There is paucity of data on mutations in the nonstructural 5b (NS5b) gene of circulating HCV and their implications in the Nigerian population. Here, we identified clinically-important mutations in HCV isolates, which may influence response to therapy and disease prognosis. Methodology: HCV RNA was extracted from a total of 301 blood samples collected from 99 symptomatic treatment-naïve hepatitis patients, 125 HIV-infected individuals and 77 asymptomatic blood donors in Ibadan, Nigeria. The RNA was reverse­transcribed to complimentary DNA and HCV NS5B gene amplified by nested PCR. The amplified products of 42 HCV were sequenced and sequences were aligned with those from GenBank and HCV databases in MEGA 7.0. Nucleotide sequences were translated to amino acids while substitutions in the amino acids were analyzed with reference to H77 prototype strain of HCV. Results: A total of 10 amino acid polymorphisms were observed from the 42 sequenced NS5B gene, with the major clinically-important amino acid mutations being S15G in 28 (66.7%) participants, T7N (24, 57.1%), G61R (23, 54.8%), S54L (22, 52.4%), G89E (14, 33.3%), T79M (12, 28.6%), and T711 (11, 26.2%). Others were Q67R (7, 16.7%), Q47H (7, 16.7%) and S84F (2, 4.8%). S15G/A/V mutations were more predominant in patients with HIV (76.9%, 10/13) followed by patients with clinical hepatitis (75.0%, 12/16) and blood donors (46.1%, 6/13). Q67R and T71I mutations were not predominant in patients with clinical hepatitis as they were detected in only 31.3% (5/16) and 43.8% (7/16) participants respectively, compared to S15G (75.0%, 12/16), S54L (68.8%, 11/16), G61R/E (68.8%, 11/16) and T7N/S (56.3%, 9/16). There was no statistically significant difference in the distribution of each of the 10 amino acid polymorphisms detected within patients with symptomatic clinical hepatitis (x 2=9.311, p=0.409), HIV-infected patients (x 2=13.431, p=0.1440) and asymptomatic blood donors (x 2=3.775, p=0.9256). Similarly, there was no significant difference in the distribution between the 3 categories of the study participants except for T79M mutation, which was significantly higher in HIV-infected patients (61.5%, 8/13) compared to patients with clinical hepatitis (18.8%, 3/16) and asymptomatic blood donors (7.7%, 1/13) (x 2=10.456, p=0.0054). Conclusion: Mutations in the NS5B gene could be associated with worse prognosis of the disease or antiviral failure due to viral resistance in patients undergoing therapy. The absence of Q47H mutations in majority of the study participants in our study implies that they will not respond well to daprevir and mericitabine. Screening of patients for pre-existing resistant mutations before commencement of therapy and monitoring during and after therapy are recommended.

Complete genome sequencing of H1N1pdm09 swine influenza isolates from Nigeria reveals likely reverse zoonotic transmission at the human-animal interface in intensive piggery.

Prevailing agro-ecological conditions and intermingling of human and animals in intensive farms in urban and peri-urban areas in Africa favour cross species transmission of pathogens at the human-animal interface. However, molecular epidemiology studies of zoonotic swine influenza viruses in this region are limited. In this study, isolates of pandemic influenza virus (H1N1pdm09) obtained from pigs in Nigeria were fully sequenced. BLAST of swine influenza virus genes from Nigeria was carried out in GenBank and gene alignment was done using MEGA version 7. Maximum likelihood method (PhyML program) was used to determine gene evolutionary relationships with other viruses and phylogenetic trees were constructed to infer genomic clusters and relationship. Swine influenza viruses isolated and sequenced in this study were monophyletic and 99% congenetic with human isolates from Nigeria, Cameroon, Ghana and USA suggesting reverse zoonotic transmission from humans to pigs in intensive husbandry. A Q240R and S31N substitution among others were detected in the haemagglutinin and matrix genes, respectively, indicating potentials for mutations during interspecies co-mingling and transmission. The A/H1N1pdm09 viruses circulating in pigs that are also exposed to avian influenza in the same epidemiological zones could engender emergence of novel viruses with zoonotic or pandemic potential requiring enhanced surveillance and monitoring.

Detection of HIV antigen and cDNA among antibody-negative blood samples in Nigeria.

In developing countries as many as 50% of patients for whom a transfusion is indicated are at risk of dying immediately if transfusion is withheld. It is therefore important that blood transfusion is made as safe as possible. This study was designed to assess the safety of blood transfusion in two large blood banks in Ibadan, Nigeria. Aliquots of 250 samples already screened and passed as negative for HIV-1 and -2 were collected from each of the blood banks. Samples were tested for the presence of HIV-1 antigen (ELAVIA Ag I) and the antigen-positive samples tested for the presence of specific HIV-1 antibodies by Western blot (BioRad, France). All antigen-positive samples were also subjected to PCR. HIV-1 antigen was detected in 6 (1.2%) of the 500 samples, of which 4 (0.8%) and 3 (0.6%) were Western blot-indeterminate and PCR-positive, respectively. Transfusion of HIV-contaminated blood may be contributing significantly to the spread of the virus in Nigeria. There is therefore an urgent need for an organized blood-banking system with facilities for more sensitive assays for the detection of HIV in blood to prevent transmission through transfusion.

Nigerian butchers and hepatitis B virus infection.

Various target groups have been identified in Nigeria for studying the prevalence of hepatitis B virus infection; however there is no information on its prevalence among workers in slaughter houses. This study determined the seroprevalence of hepatitis B virus infection in Nigerian butchers at Ibadan, and comprised 360 healthy Nigerian adult subjects (180 butchers, 180 traders as controls) selected by multistage stratified sampling. A questionnaire was used to collect relevant information and included points about risk behaviour. ELISA was used to detect the hepatitis B surface antigen in the serum; the seroprevalence rate in butchers and controls was 9.4% and 3.3%, respectively (p<0.05). Risk behaviour was seen more commonly in butchers than in controls. The presence of hepatitis B surface antigen in the serum was not related to the duration of occupational exposure or the number of partners. In summary, butchers comprise a high-risk occupational group for exposure to hepatitis B virus infection. We conclude that routine screening for parenterally acquired infections in this group is thus necessary in order to identify those who will require treatment and immunisation, especially against hepatitis B virus infection.

Risk of hepatitis B virus in the slaughter house.

The study involved 180 Nigerian butchers and 180 traders (controls) selected by multistage stratified sampling who had their sera assayed for HBsAg (hepatitis B surface antigen) by enzyme-linked immunosorbent assay method. The butchers and the controls had an HBsAg sero-prevalence rate of 9.4% and 3.3%, respectively. Various risky practices were more common among the butchers but their hepatitis B antigenaemia was not related to the duration of their occupational exposure. The study shows that the butchers constitute a high risk occupation for hepatitis B viral infection.

Genetic Diversity of Hepatitis C Virus Among Blood Donors and Patients with Clinical Hepatitis in Ibadan, Nigeria.

Hepatitis C virus (HCV) infection is responsible for liver diseases and hepatocellular carcinoma in chronically-infected patients. Owing to high sequence variability in HCV genome, numerous subtypes have emerged. This study determined HCV strains among patients with clinical hepatitis and blood donors in Ibadan. Blood samples were collected from consented 176 subjects who tested positive to HCV IgM antibodies, including 99 patients with clinical hepatitis and 77 apparently healthy blood donors. Viral RNA was extracted from blood samples, while presence of HCV was tested by amplifying the NS5B gene using polymerase chain reaction (PCR). The amplified NS5B gene was sequenced and sequences were aligned on MEGA 7.0. Phylogenetic tree was constructed with Neighbor-Joining method. Data were analyzed using descriptive statistics at P<0 .05. The NS5B gene was amplified in 38 samples, of which 29 were successfully sequenced. Phylogenetic analysis revealed three of seven known genotypes of HCV including genotypes / subtypes 1a (34.5%), 1b (17.2%), 2b (13.8%), 2c (3.6%) and 5a (31.3%). Subtypes 1b and 2b were found among patients with clinical hepatitis, while the single 2c was found among donors. Although subtype 1a was detected among both populations, its rate was higher among blood donors (P = 0 .003). Subtype 5a was found among the two groups (P= 1. 00). HCV subtypes 1a and 5a are the predominant strains in Ibadan. The diversity of HCV observed has implications for treatment of patients and design of a broadly protective vaccine against the virus.

Prevalence and Risk Factors for Genital Human Papillomavirus Infections Among Women in Southwest Nigeria.

There is a great variation in the prevalence of cervical HPV infection worldwide with some of the highest rates being found in African women. Early onset of sexual activity (≤ 15 age), multiparity and sexual promiscuity have been recognized as some of the significant risk factors for HPV infection. In Nigeria, there is scarcity of data on the degree of relationship between these factors and the prevalence of HPV infection. Thus, this study was designed to determine the prevalence of genital HPV infection with its potential risk factors among women in Southwest Nigeria. Cervical swab specimen was collected from 295 consenting women including those presenting for routine cervical cancer screening, STI clinic attendees and women who attended community based outreach programmes. Viral DNA was extracted from the swab samples using commercially available DNA extraction Kit and amplified by PCR using two set of consensus primers (PGMY09/11 and degenerate GP-E6/E7). Fifty-five samples were positive to HPV DNA giving a prevalence of 18.6%. Risk factors such as lack of formal education (P-value: 0.003), divorcee (P-value: 0.019), polygamy (P-value: 0.027), unemployment (P-value: 0.023), low income earnings (P-value: 0.018), younger age (<18years) at sexual debut (P-value: 0.039) and passive smoking (P-value: 0.017) were significantly associated with HPV infection. High HPV prevalence and associated risk factors observed in this study shows the continuous transmission of the virus in Southwest Nigeria. Hence, enlarged monitoring including intense public awareness and cervical cancer screening is urgently needed for prevention and control strategies.

Human Respiratory Syncytial Virus Subtypes A and B Infection Among Children Attending Primary and Secondary Health Care Facilities in Ibadan, Nigeria.

Human respiratory syncytial virus (HRSV) causes high morbidity and mortality in infants and young children. Although a high prevalence of HRSV has been reported in Nigeria, the subtype of the virus circulating in the country is not known. This crosssectional study was therefore designed to determine the subtypes of HRSV circulating among children in Ibadan. Two hundred and thirty-one nasopharyngeal and oropharyngeal swabs were collected from children presenting with respiratory infections in Secondary Health Facility (SHF) as well as those attending immunization centers in Primary Health Centers (PHCs) in Ibadan, Nigeria. Viral RNA was extracted directly from the clinical specimen and used for HRSV detection with a pair of primers that targets the conserved region of the viral matrix gene. HRSV-positive samples were subtyped using subtype-specific primers targeting the second hypervariable region of the G gene. The prevalence of HRSV infection was 8.7% and 34.6% among children attending the PHCs and SHF respectively. Both subtypes of HRSV were detected (co-circulating) among the study population. None of children was co-infected with of HRSV A and B. Overall, HRSV-A was the predominant subtype detected among children presenting with respiratory infection at the SHF while subtype B was predominant among participants attending PHCs for routine immunization. Higher disease severity scores were associated with HRSV-A infection than infection with HRSV-B. Only HRSV subtype A was detected from those diagnosed of bronchopneumonia and bronchiolitis. In conclusion, subtypes A and B co-circulating among children in Ibadan, with HRSV-A being the predominant subtype. Additional study including samples collected from other parts of the country over a longer period that will cover both wet and dry season will be done to determine the pattern of HRSV circulation in Nigeria.

Occult HBV Infection in Nigeria.

Occult hepatitis B virus infection (OBI) is manifested by presence of HBV-DNA in the absence of detectable Hepatitis B surface antigen (HBsAg) with or without anti-HBV antibodies. Hence it is a potential threat in blood transfusion medicine. This study was carried out to determine the prevalence of OBI as well as evaluate the effectiveness of using Hepatitis B surface antigen (HBsAg) marker alone in the diagnosis of HBV infection among HBsAg negative blood donors in Ilorin, Nigeria. A purposive sampling, including samples from 206 already donated and prescreened blood units from HBsAg negative from apparently healthy volunteer blood donors at the General Hospital Blood Transfusion Centre, Ilorin, Nigeria, were collected for further laboratory analysis for this study. Five millilitres of blood was collected and plasma sample tested for the presence of HBsAg using a commercially available ELISA kit. In addition, Polymerase Chain Reaction (PCR) was used for molecular detection of HBV DNA in each of the samples. Data was analyzed using descriptive statistics, Chi square at p = 0.05. Of the 206 HBsAg Micropoint® rapid kits pre-screened seronegative samples collected from the blood transfusion centre, 8 (3.9%) samples were positive for the presence of HBsAg when retested using ELISA in the laboratory. Eighteen of the 206 samples (8.7%) were HBV-DNA positive by a semi-nested PCR technique giving an OBI rate of 8.7%. Out of the 18 HBV-DNA positive samples, 17 (4.4%) were from males and only one (5.6%) was from a female donor. Analysis of the 18 HBV DNA positive samples using genotype specific primers into genotype A and Non-A showed that 15 (83.3%) were HBV genotype A, while 2 (11.1%) were genotypes other than A (Non-A), one (5.6%) sample had mixed genotypes (A & non-A). A prevalence of 8.7% OBI found in this study indicates substantial risk of post transfusion HBV infection in the study area in Nigeria. Hence, the need to include HBV DNA detection in the routine blood screening that is, using Nucleic Acid Testing (NAT) technique for transfusion safety in the country.

Prevalence and Genotypes of Parvovirus B19 Among HIV Positive Children in Ibadan, Oyo State, Nigeria.

Human Parvovirus B19 (B19V) is a global infection with over 50% of infected children residing in sub-Saharan Africa. It causes persistent anaemia under immuno-compromised states such as HIV infection, thereby complicating the course of HIV infection. This study was therefore designed to determine the prevalence and genotypes of B19V among HIV positive children. Blood specimens were collected from HIV positive children and genomic DNA extracted and assayed for the presence of Parvovirus B19 DNA using polymerase chain reaction and the product detected by gel electrophoresis. Amplicons for positive PCR were purified and sequenced for genotype analysis. For the purpose of comparison (differences in the sequences of the NS1/VP1u region), nine HIV negative children were enrolled in this study. Two (1.3%) of the 158 HIV infected children were positive for Parvovirus B19 DNA. Analysis of the results showed a low prevalence of Parvovirus B19 among HIV positive children but a significant relationship was established between Parvovirus B19 infection and the severity of anaemia (p=0.015). Phylogenetic analysis of the sequence data showed that all the B19 virus isolates detected in this study were genotype 1. This study therefore has been able to give an insight to the prevalence and circulating genotypes of Parvovirus B19 among HIV infected children and also establishing a relationship between anaemia and parvovirus B19 infection.

Mother-to-child transmission of different HIV-1 subtypes among ARV Naïve infected pregnant women in Nigeria.

The rate of mother-to-child transmission (MTCT) of HIV as well as the implications of the circulating multiple subtypes to MTCT in Nigeria are not known. This study was therefore undertaken to determine the differential rates of MTCT of HIV-1 subtypes detected among infected pregnant women before ARV intervention therapy became available in Nigeria. Twenty of the HIV-positive women who signed the informed consent form during pregnancy brought their babies for follow-up testing at age 18-24 months. Plasma samples from both mother and baby were tested for HIV antibody at the Department of Virology, UCH, Ibadan, Nigeria. All positive samples (plasma and peripheral blood mononuclear cells-PBMCs) were shipped to the Institute of Tropical Medicine, Antwerp, Belgium, where the subtype of the infecting virus was determined using the HMA technique. Overall, a mother-to-child HIV transmission rate of 45% was found in this cohort. Specifically, 36.4%, 66.7% and 100% of the women infected with HIV-1 CRF02 (IbNg), G and B, respectively, transmitted the virus to their babies. As far as it can be ascertained, this is the first report on the rate of MTCT of HIV in Nigeria. The findings reported in this paper will form a useful reference for assessment of currently available therapeutic intervention of MTCT in the country.