Authors:Solomon O. Ugoya, Emmanuel I. Agaba, Nimzing G. Ladep, Fabian H. Puepet and Adesola Ogunniyi
Cognitive dysfunction is a common source of morbidity and mortality, usually observed in late stages of diabetes complications. Dementia is one of the commonest and most disabling late life mental disorders. The fact that data are scanty in the tropic cannot be overemphasized. There is a need to describe the association of cognitive dysfunction among our diabetics and its attendant risks such as duration of DM, age of patient, presence of hypertension and glycaemic control.
a sample size of 180 patients was obtained with 120 diabetic subjects and 60 non-diabetics as controls. The mini-mental state examination (MMSE) was used to grade the severity of cognitive states.
twenty-six (21.7%) of the diabetic subjects had cognitive dysfunction with a score of less than twenty-four based on the mini-mental state examination (MMSE) while 6 (10.0%) of the controls had dementia.
This study clearly shows that in a clinic setting, diabetes is associated with a greater trend toward impairments of cognitive function than in the non-diabetic population.
Authors:Nimzing G. Ladep, Edith N. Okeke, Mustapha S. Umar, Godwin Echejoh and Abraham O. Malu
We compared the diagnostic validity of three non-invasive tests of fibrosis: age to platelet index, aspartate transaminase to platelet ratio index and aspartate transaminase to alanine transaminase ratio to histology fibrosis stage among Africans chronically infected with the hepatitis B virus.
Ninety treatment-naive chronic hepatitis B patients were subjected to liver biopsy. Excluded from the study were patients with HCV and HIV co-infection, and significant alcohol consumption. Staging was performed using the Metavir system, whereas AST, ALT, and platelet count were determined using manual methods, within 4 weeks of liver biopsy. Results of fibrosis score and markers of fibrosis were compared using EPI Info 2005 version 3.3.2.
The mean age of the study population was 31.8 ± 8.9 years. Fibrosis stages and AAR, API and APRI scores were positively correlated, respective correlation coefficients being 0.48, 0.48 and 0.22 (
%lt; 0.0001). Their positive predictive values were 52% (AAR), 63% (API) and 54% (APRI), with sensitivities of 60, 11 and 96%, respectively. The diagnostic accuracy of AAR for cirrhosis was 100%.
Non-invasive fibrosis markers are not as sensitive for diagnosing significant fibrosis in chronic hepatitis B compared to hepatitis C patients and might have a limited utility for use in hepatitis B endemic populations.
Authors:Nimzing G. Ladep, Oche O. Agbaji, Patricia A. Agaba, Muazu A. Mohammed, Godwin E. Imade and John A. Idoko
To determine the relationship between the immunological status and anti-HCV detection of HIV-1 infected individuals in an HIV/AIDS cohort within an African population.
Retrospective study of randomly selected HIV/AIDS patients.
The biodata of 1044 consenting HIV infected patients were analyzed retrospectively. These patients had been enrolled following the confirmation of their HIV status by western blot assay after an initial reactive ELISA. Blood obtained from the patients were subjected to serological tests to determine their anti-HCV antibody status using third generation Enzyme Immunoassay (DIA.PRO Diagnostic, Bioprobes srl, Italy). CD4 count was done by flow cytometry (Partec Cyflow, Germany) and viral load by PCR (Roche Amplicor 1.50). The data were analyzed using the Epi Info 2004 statistical software.
Ninety out of 1044 patients (8.6%) were positive for anti-HCV antibodies. The rate of HCV infection was directly proportional to the CD4+ group (6.8% vs. 15.4% for < 201 and > 800, respectively,
There is an associated higher chance of detecting anti-HCV in sera of the HIV-1 infected patients whose immunological status are better compared to severely immunocompromised ones.
Authors:Oche O. Agbaji, Nimzing G. Ladep, Patricia Agaba, Bitrus P. Badung, Monday L. Danung, Godwin Imade, John A. Idoko, Rob Murphy and Phyllis Kanki
There is a rising trend of hepatitis B co-infection among HIV positive individuals and this may negatively impact their morbidity and mortality. This study analyzed HBsAg prevalence, its demographic distribution and relationship to the immunological and viral load status of HIV positive cohort in Jos.
This was a cross-sectional study conducted at the antiretroviral treatment centre in Jos between August 2004 and April 2005. Biodata of 1042 consenting HIV positive patients were obtained. Blood samples obtained from them were tested for hepatitis B surface antigen by Enzyme Linked Immunosorbent Assay. CD4 cell count was done by flow cytometry (Partec, Germany) and viral load by PCR techniques (Roche Amplicor 1.5). The data obtained were analyzed using Epi Info 2004 statistical software.
One hundred and sixty seven (16%) of the 1042 patients were reactive to HBsAg. Thirteen (22.4%) of 58 divorced patients had the highest co-infection rate. Ninety-seven (14.2%) out of 681 females were co-infected with hepatitis B, while seventy (19.4%) out of 361 males had the co-infection. Most of the patients at the AIDS stage of the HIV infection were co-infected with hepatitis B. The median HIV viral load of HBsAg-positive patients was higher than that of non-HBV co-infected patients.
This study showed a high HBsAg prevalence among our patients with a significant male preponderance. This may have a negative impact on the CD4 recovery and viral load reduction of the patients on treatment.