Growth and Pubertal Development Among HIV Infected and Uninfected Adolescent Girls in Lagos, Nigeria: A Comparative Cross-Sectional Study.

This study aimed to compare growth and pubertal developmental parameters among HIV-infected and uninfected adolescent girls (11-19 years) in Lagos using a cross-sectional approach. Height, weight, BMI Z-scores, sexual maturity rating by Tanner stages and age at menarche, were compared in the 2 groups. The mean age was similar in both groups (13.2 [±2.3] years and 13.6 [±1.6] years for HIV positive and negative respectively [P = .13]). Majority (66.2%) were in Junior Secondary classes and the mean socioeconomic class was 2.5 (±0.9). HIV-infected girls had significantly lower height, weight, and BMI Z scores compared to their uninfected counterparts. The proportion that had attained Tanner stages 3 to 5 were significantly lower among the HIV-positive participants. The study identified lower growth parameters and pubertal delay among HIV-infected adolescent females compared to HIV uninfected girls. Growth and sexual maturation assessment should form part of routine care of adolescents living with HIV.

Invasive lung infection by Scedosporium apiospermum in an immunocompetent individual.

Scedosporium apiospermum previously known as Monospermum apiospermum is a ubiquitous fungus found in soil, polluted water and sewage. It causes broad spectrum of diseases, including soft tissue infections, septic arthritis, osteomyelitis, ophthalmic infections, sinusitis, pneumonia, meningitis, brain abscesses, endocarditis and disseminated infection. In recent years, it has been shown to be pathogenic for both immunocompetent and immunosuppressed patients. It is a significant opportunist with very high levels of antifungal resistance. We report here a case of invasive lung infection due to S. apiospermum in an immunocompetent patient who responded to antifungal therapy and surgical treatment.

Enteric Parasitic Infections in Relation to Diarrhoea in HIV Infected Individuals with CD4 T Cell Counts <1000 Cells/µl in Chennai, India.

AIM: This study was conducted to estimate the prevalence of enteric parasites in HIV patients in Chennai and to correlate with CD4 counts and diarrhoeal status. MATERIAL AND METHODS: Faecal specimens from 100 HIV infected individuals with CD4 < 1000/µl were screened for enteric parasites with wet mounts, modified acid-fast stain for coccidian parasites, modified trichrome stain for Microsporidia, before and after the stool concentration. Agar plate culture for Strongyloides was put up. Chi-square and ANOVA tests were used for statistical analysis. RESULTS: Study group comprised of 38 subjects with acute diarrhoea, 30 with chronic diarrhoea (> 2 weeks) and remaining 32 without diarrhoea. Enteric parasites were detected in 33% of subjects; Isoapora belli (21) being the commonest followed by E.histolyt/Entamoeba dispar (5), Entamoeba coli (2), Cryptosporidium spp (2), Hookworms (2), Strongyloides stercoralis (2), Giardia lamblia (1) and Microsporidium spp (1). There was a significant inverse relation between CD4 counts and duration of diarrhoea. Opportunistic parasites were isolated from the subjects with wide range of CD4 counts and different diarrhoeal status but most commonly from chronic diarrhoea patients. CONCLUSION: The prevalence of intestinal parasitic infections in HIV patients is high in Chennai, India, especially at CD4 <1000/µl, I.belli infection being the commonest. Routine screening of all HIV patients with low CD4 counts for coccidian parasitic infections by using simple stool microscopic techniques can help in early diagnosis and treatment.

Detection of FUR1 Gene in 5-Flucytosine Resistant Candida Isolates in Vaginal Candidiasis Patients.

BACKGROUND AND AIMS: This study was done to detect the prevalence, risk factors for vaginal candidiasis in Chennai and to evaluate different methods for speciation of Candida isolates from vaginal candidiasis patients. This study was also aimed at detecting resistance patterns of Candida spp to common antifungals and at detecting mutant FUR1 genes in 5-Flucytosine (5 FC) resistant isolates. MATERIAL AND METHODS: Two hundred clinically suspected vaginal candidiasis patients were screened for candidiasis and isolated Candida were speciated by standard morphological and biochemical tests (sugar fermentation and assimilation) and by using CHROM agar-Candida medium. Antifungal susceptibility was performed by disk diffusion method (CLSI M44-A) using fluconazole, itraconazole and 5FC disks. Five FC resistant isolates were subjected to PCR for detection of mutant FUR1 genes. RESULTS: A total of 72 (36%) Candida spp. were obtained. Vaginal candidiasis was more prevalent in 31-40 years age group and among those with poor genital hygiene and who wore tight fitting synthetic/nylon underclothes . C.albicans (35), C.tropicalis (8), C.glabrata (21), C.krusei (4) were identified by both carbohydrate assimilation test and by using CHROM agar-Candida medium. C.kefyr (2) and C.parapsilosis (2) could not be identified using CHROM agar-Candida. Resistance to fluconazole, itraconazole and 5-flucytosine was seen in 19.44%, 23.61% and 41.66% of the isolates respectively. Mutant FUR1 gene was detected in all the Candida spp that were resistant to 5FC. CONCLUSION: C.albicans was the commonest species which caused vaginal candidiasis in Chennai. Though CHROM agar-candida medium is a useful differential isolation medium capable of early presumptive identification of Candida species, it could not identify C.kefyr and C.parapsilosis. Azole resistance was low in C. albicans but it was high in non-albicans Candida spp. Prevalence of primary resistance to 5-flucytosine was high in the strains studied and in all of them, it was mediated by mutant FUR1 gene.