Haematological Changes Associated with Hepatitis B Virus Infection in Individuals with and without Sickle Cell Disease.

BACKGROUND: Hepatitis B virus infection, a major public health problem that primarily affects the liver, may cause reduction in the levels of haemoglobin, haematocrit and in the extreme, could cause aplastic anaemia. The haematological characteristics could be detected with a complete blood count which could provide invaluable information for diagnosis and management of the disease. AIM: To determine the effect of HBV infection on the blood count of individuals with sickle cell disease (SCD) and apparently normal healthy (Non-SCD). SETTING: Non-SCD participants were recruited from the community while SCD patients in steady state were recruited from SCD routine clinics. METHODS: The study was a cross - sectional study carried out on 1017 non-SCD and 1017 SCD individuals. Haematology Autoanalyzer was used to determine the complete blood count. Granulocyte-to-lymphocyte ratio (GLR), platelet to white blood cell count ratio (PWR) and platelet-to-lymphocyte ratio (PLR) were calculated. ELISA for HBsAg and HBV core antigen IgM antibodies were used to identify participants with HBV. RESULTS: The non- SCD individuals infected with HBV had significantly higher WBC (7.51 ± 5.8 X109/L)) compared to a WBC (6.1 ± 3.4 X109/L) in uninfected individuals (p =0.001). PWR for HBV negative (49.9±28.6) was higher than that for HBV positive participants (41.4±17.6) (p=0.034). Mean platelet volume (MPV) of 9.93 ± 1.1fl in SCD individuals with HBV was significantly higher than 8.30 ± 0.95fl in SCD individuals without HBV (p=.001). CONCLUSIONS: PWR and MPV may be useful as surrogate marker for detection of HBV disease progression in apparently normal healthy non - SCD and SCD populations to institute prompt appropriate ancillary investigation and treatment.

CONTEXTE: L'infection par le virus de l'hépatite B, un problème majeur de santé publique qui affecte principalement le foie, peut entraîner une réduction des taux d'hémoglobine et d'hématocrite et, dans l'extrême, peut provoquer une anémie aplastique. Les caractéristiques hématologiques peuvent être détectées par un hémogramme complet qui pourrait fournirdes informations précieuses pour le diagnostic et la et la gestion de la maladie. OBJECTIF: Déterminer l'effet de l'infection par le VHB sur sanguine complète d'individus atteints de drépanocytose (SCD) et d'individus apparemment normaux en bonne santé (non-SCD). SITE: Les participants de non-SCD ont été recrutés dans la communauté tandis que les patients drépanocytaires en état stable ont été recrutés dans les cliniques de routine de la drépanocytose. MÉTHODES: L'étude était une étude transversale menée sur 1017 personnes non-SCD et 1017 personnes SCD. sur 1017 personnes nonSCD et 1017 personnes SCD. Un autoanalyseur hématologie a été utilisé pour déterminer la formule sanguine complète. Le rapport granulocytes/ lymphocytes (GLR), le rapport plaquettes/blancs (PWR) et le rapport plaquettes/lymphocyte (PLR). ont été calculés. Les tests ELISA pour les anticorps IgM de l'Ag HBs et de l'antigène central du VHB ont été utilisés pour identifier les participants atteints du VHB. RÉSULTATS: Les individus non atteints de DSC et infectés par le VHB présentaient les caractéristiques suivantes un nombre significativement plus élevé de GB (7,51 ± 5,8 X109/L) par rapport à une WBC (6,1 ± 3,4 X109/L) chez les individus non infectés (p =0,001). Le TPM pour lesparticipants négatifs pour le VHB (49,9±28,6) était plus élevé que celuipour les participants positifs au VHB (41,4±17,6) (p=0,034). Le volume moyen des plaquettes Le volume plaquettaire moyen (VPM) de 9,93 ± 1,1fl chez les personnes atteintes de MCS avec VHB était significativement plus élevé que celui des personnes atteintes de MCS sans VHB (8,30 ± 0,95fl) (p=0,001). sans VHB (p=0,001). CONCLUSIONS: Le PWR et le MPV peuvent être utiles comme marqueurs de substitution pour la détection de la progression de la maladie VHB chez population de SCD et Non-SCD apparemment normale, en bonne santé afin d'instituer rapidement les examens complémentaires et le traitement appropriés.

Cytochrome P450 CYP2C19 genotypes in Nigerian sickle-cell disease patients and normal controls.

BACKGROUND AND OBJECTIVE: Subjects with different CYP2C19 genotypes may metabolize proguanil, a pro-drug used for malaria prophylaxis differently and the frequency of the different alleles may be different in patients with sickle-cell disease (SCD) and normal controls. The objective of this study was to evaluate CYP2C19 *1, *2 and *3 allele and genotype frequencies in Nigerian normal controls and SCD patients, and to further compare variant CYP2C19 frequencies in Nigerians with other African populations. METHODS: Genotyping was carried out with PCR and restriction fragment length polymorphism analysis. RESULTS AND DISCUSSION: CYP2C19 *1 (84·3 vs. 84·9%) or *2 allele frequency (15·7 vs. 15·1%) was not significantly different between patients with SCD and normal subjects. No *3 allele was detected in the cohort. The SCD group exhibited a statistically significantly lower frequency of *1/*1 genotype (69·6%) compared with normal controls (74·4%). Frequency of *2/*2 was significantly lower in SCD (0·9%) compared with normal controls (4·7%). Frequencies of *1/*2 (29·6 vs. 20·9%) were no different in SCD and normal controls. CONCLUSION: Prevalence of CYP2C19 polymorphisms was defined for the first time in Nigerian normal and SCD populations. Nigerian SCD patients exhibited significantly lower CYP2C19 *1/*1 and *2/*2 frequencies than normal controls. No differences were detected in CYP2C19 allele or genotype frequencies in normal subjects between this study and previous reports in other African populations.

Dose-dependent changes in some haematological parameters during short-term administration of Hibiscus sabdariffa Calyx aqueous extract (Zobo) in Wistar albino rats.

The extract of Hibiscus Sabdariffa L. (MALVACEAE) is popularly consumed and assumed to have haematological benefits, but no scientific investigations are known in the literature to have been conducted to corroborate this claim. The present study was therefore conducted to evaluate the effects of Hibiscus Sabdariffa L. Calyx extract on some haematological parameters (Haemoglobin, haematocrit, total white blood cells and differentials) in rats, with a view to determining its medicinal usefulness in the treatment of anaemia. Proximate analysis on dry matter basis, and mineral clement analysis were carried out on dried calyx of Hibiscus Sabdariffa L. Different doses of aqueous extract of Hibiscus Sabdariffa L calyx extract (200 - 1000 mg/ kg body wt.) were administered orally by intra Ocsophageal cannulation to four groups of six animals (rats) per group for 14 days. Venous blood samples were collected from each animal in all the groups including the control group on days 0 and 14 of the experiment for haematological investigations. Paired stat analysis of day 0 and day 14 results was done for each group using student's T-test. Proximate and mineral analysis of dry calyx confirmed the presence of some nutrients, e.g. protein, mineral elements (potassium) and Vitamin C in the calyx. After 14 days of the extract administration, significant elevations were observed in haematocrit (P = 0.03) and haemoglobin (P = 0.004) in the groups of animals given doses of 200 mg and 400 mg per kg (P < 0.05) while the groups given high doses revealed significant reductions (P 0.031) in the haematocrit but not in haemoglobin. This study suggests that, aqueous extract of Hibiscus Sabdariffa L. calyx used in this experiment had beneficial effects on the red cells at low doses (200 mg-400 mg/kg) which may not be sustained at higher doses. However, the long-term effects and the possible mechanism (s) of action of the extract should be studied before a recommendation could be made.

FOETAL HAEMOGLOBIN (HbF) STATUS IN ADULT SICKLE CELL ANAEMIA PATIENTS IN IBADAN, NIGERIA.

AIM: Elevated HbF, among other biological and environmental factors, is responsible for decrease in mortality in sickle cell anaemia (SCA). This study determined the levels of HbF in adult SCA patients in steady state compared with HbAA controls. HbF was discussed in line with the clinical course of the disease so as to emphasize the relevance of hydroxyurea in the management of adult SCA patients. MATERIALS AND METHODS: The HbF levels of 66 confirmed SCA patients and 31 HbAA controls were estimated using Betke method and HbF percentage was calculated using formula: %HbF percentage = A413 filtrate x 100A413 standard x 20. RESULT: A statistical significant difference in the mean of the levels of HbF in patients (5.16±4.04) compared to controls (1.04±0.44) (p = 0.000) was observed. The mean levels of HbF for males (4.71±3.49) compared to that of females (4.99) were statistically similar (p =0.773). It was also observed that the mean HbF level appears to be declining as age advances. SCA patients were classified to three categories viz: HbF <2% (21.2% SCA patients); HbF of 2.1% -10%, (68.2% SCA patients); and HbF of 10.1% -16%, (10.6% SCA patients). CONCLUSION: Substantial proportion of our patients actually will require treatment with hydroxylurea to stimulate HbF production especially those with HbF percentage of <2 and some with HbF percentage of 2.1 - 10%. HPFH may be considered rare since only 10. 6% had HbF at the range of 10.1-16%. This study showed that in treating our SCA patients in Nigeria we need to adopt and encourage the use of HbF activating agents like hydroxyurea or any other safe agent that will be found to stimulate HbF production in SCD patients.

Human T-cell lymphotropic virus in a population of pregnant women and commercial sex workers in South Western Nigeria.

BACKGROUND: Over 20 million persons are infected with HTLV-I/II globally. The virus is endemic in Africa and it is also transmitted sexually. Continued identification of high risk groups is important for the control of the disease. OBJECTIVES: To determine the prevalence of HTLV infection amongst two highly sexually active groups, pregnant women and CSWs in South Western Nigeria. METHODS: Serum samples were tested for the presence of HTLV-I/II antibodies using the Vironostika HTLV-I/II micro ELISA system. RESULTS: A total of 364 serum samples collected from pregnant women, commercial sex worker (CSW) and secondary school students (control group) from Ibadan. While only 4 (5.1%) of 78 secondary school students (average age: 13 years) were reactive for HTLV infection, 20 (16.7%) of 120 pregnant women (average age: 26 years) and 38 (22.9%) of 166 CSWs (average age: 23 years) were found to have antibodies against HTLV in their sera. The results of this study thus show that HTLV infection is active in the population although higher in pregnant women (although not statistically significant) and CSWs (p>0.05). Pregnant women and CSWs are therefore at a higher risk of HTLV transmission than other members of the population. CONCLUSION: Routine screening for HTLV infection may go a long way to understanding the epidemiology of HTLV infection in Nigeria and subsequently provide tools for its prevention and control.