Effect of Dolutegravir regimen against other regimens on some hematological parameters, CD4 count and viral load of people living with HIV infection in South Eastern Nigeria.

BACKGROUND: Appropriate usage of highly active antiretroviral therapy (HAART) suppresses human immunodeficiency virus (HIV) replication. One of such HAART is dolutegravir (DTG) containing regimen which Nigeria included in her national protocol, as the preferred first-line option, with particularly fixed dose combination of tenofovir/lamivudine/dolutegravir (TLD) in 2018. AIM: To access the impact of this regimen as against other regimens on some hematological parameters as well as cluster of differentiation 4 (CD4) count and viral load on people living with HIV infection. METHODS: The study site is a health facility center supported by President Emergency Plan for acquired immunodeficiency syndrome (AIDS) Relief where people living with HIV infection (PLWHIV) visit for their routine management in Abakaliki, Ebonyi State. A hundred and twenty-two (122) subjects participated, 58 PLWHIV and 64 control subjects. CD4 + count by partec cyflow auto analyzer, while the Viral load assay was by Roche COBAS Ampriplep/COBAS TaqMan molecular systems. Full blood count determination was by Sysmex XE-2100 hematology auto analyzer, while the detection of antibody to HAART was by Petz and direct Coombs tests. RESULTS: Mean values of hemoglobin (Hb), Total white cell count, Lymphocytes, Monocytes and CD4 + counts of people living with HIV infection (PLWHIV) were significantly (P = .0001) lower than the control subjects. The Hb level of PLWHIV on Efavirenz combination (TDF/3TC/EFV) are comparable 123 ± 32g/l with those on Ritonavir combination (TDF/3TC/LPV/R) 136 ± 16g/l and Dolutegravir (TLD)134 ± 20.0g/l (P = .307). On the other hand, total white cell count (4.55 ± 1.99 × 109/L) of those on Efavirenz combination (TDF/3TC/EFV) and Dolutegravir (TLD) (4.53 ± 1.31 × 109/L) were significantly higher than those on Ritonavir combination (TDF/3TC/LPV/R) (4.09 ± 1.15 × 109/L). The Viral Load of PLWHIV on Dolutegravir (TLD) was significantly lower 171.57 ± 4.56 copies/mL than those on Efavirenz combination (TDF/3TC/EFV) (86,395.91 ± 27,476.57copies/mL) and Ritonavir combination (TDF/3TC/LPV/R) (81,188.83 ± 13,393.47 copies/mL), respectively. CONCLUSION: Some hematological parameters (such as Hb, total white cell counts and CD4 + count) were lower in people living with HIV than values seen in control group. The 3 regimens used in the management of HIV infection in the locality revealed comparable Packed cell volume and Hemoglobin levels. Total white cell count of those on Efavirenz and DTG is comparable with higher values than those on Ritonavir.

Demographics of Rhesus Phenotype of Blood Donors in Calabar: A Case Study of University of Calabar Teaching Hospital, Calabar, Cross River State, Nigeria.

BACKGROUND: Rhesus antigens have been documented to cause haemolytic disease of the newborn as well as acute and delayed transfusion reactions. This study was performed to evaluate the frequency of rhesus antigens (C, c, D, E, and e) in the studied population. METHOD: This study was a cross-sectional study involving 130 prospective blood donors attending University of Calabar Teaching Hospital (UCTH) donor clinic. Donors were grouped for Rh antisera (anti-E, anti-e, anti-C, anti-c, and anti-D) using the standard serologic technique. RESULT: The most prevalent Rh antigen was "c" (98.5%), followed by "D" (97.7%), while the least was "C" (30.7%). The most prevalent phenotype was cDe/cDe (R0R0). CONCLUSION: This work therefore concludes that the most prevalent rhesus antigen and rhesus phenotype was c and cDe/cDe among blood donors in University of Calabar Teaching Hospital.

Haemostatic Indices as Markers for Monitoring Pulmonary Tuberculosis Treatment.

Tuberculosis (TB) is an infectious disease inducing a state of chronic inflammation which could affect thehaemostatic mechanism as part of host defences against infection. Proper diagnosis and monitoring of tuberculosis patientsundergoing therapy is still a challenge especially in a poor resource country such as Nigeria. This study aims to assess somehaemostatic indices of tuberculosis patients and their possible use as markers in monitoring response to anti-tuberculosistreatment. One hundred and twenty TB patients aged 15-60 years and 120 apparently healthy (control) subjects age andgender-matched were studied. Demographic/bio data was compiled by interview and from patients' case notes. Diagnosis ofTB was by sputum smear microscopy, radiography and clinical assessment. Platelet count (PLT), platelet factor 4 (PF4),prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin clotting time (TCT) and fibrinogen (FIB)were determined using standard techniques. The platelet factor 4, prothrombin time, activated partial thromboplastin timeand fibrinogen levels of TB patients were significantly higher while the thrombin clotting time was significantly lower(P<0.05) when compared with healthy subjects. While PF4, TCT and FIB improved significantly (P<0.05) as antituberculosis therapy progressed, PLT, PT and APTT remained the same. It is concluded that abnormal activation ofhaemostasis occurs in TB condition thus pre-disposing TB patients to bleeding complications. Furthermore, platelet factor4, thrombin clotting time and fibrinogen improved as therapy progressed and therefore may be used as markers for monitoringresponse to anti-tuberculosis therapy.