Seroprevalence of Hyperglycaemia in HIV Positive Patients Visiting the Cape Coast Teaching Hospital in Ghana

Background: Hyperglycaemia is a metabolic syndrome and common endocrine disease where there is increased blood glucose level. It can result in long-term damage and failure of different organs, especially the eyes, kidneys, nerves, heart, and blood vessels and finally cause death. This study was conducted to determine the prevalence of hyperglycaemia in HIV subjects visiting the Cape Coast Teaching Hospital (CCTH), Cape Coast and its relationship with Highly Active Antiretroviral Therapy (HAART).  Methods: A cross sectional study was carried out and blood samples of 120 HIV positive subjects of age groups ranging from 2 to 74 were collected for screening and confirmation after an informed consent was obtained from them. The blood glucose level was then tested using OneTouch glucometer and test strips.  The results were analysed using chi square goodness-of-fit and cross tabulation.  Results: A total of 9 patients out of the 120 HIV subjects had an increased glucose level, giving a prevalence rate of 7.5%. They were within the ages of 20-60 years and were significantly lower compared to those without hyperglycaemia (p<0.05), those married (p=0.001) and those divorced (p=0.001).  There was an inverse relationship between the period of living with HIV and the high glycaemia status (r= -0.949, p=0.017). There was also an inverse relationship between the use of HAART and high glycaemia status (r=-0.071, p=0.0028). There was a significant number of participants, who were experiencing increased thirst (p=0.003). Also a significant number of participants experienced increased hunger (p=0.010). Conclusion: The study revealed that there was hyperglycaemia among the study population. This may be reduced during therapy and changes in their lifestyle. Regular monitoring of glucose level in HIV infected patients and counselling on lifestyle changes are recommended. Keywords: Seroprevalence, hyperglycaemia, HI

Options in human papillomavirus (HPV) detection for cervical cancer screening: comparison between full genotyping and a rapid qualitative HPV-DNA assay in Ghana.

BACKGROUND: Modern cervical cancer screening increasingly relies on the use of molecular techniques detecting high-risk oncogenic human papillomavirus (hr-HPV). A major challenge for developing countries like Ghana has been the unavailability and costs of HPV DNA-based testing. This study compares the performance of careHPV, a semi-rapid and affordable qualitative detection assay for 14 hr-HPV genotypes, with HPV genotyping, for the detection of cytological cervical squamous intraepithelial lesions (SIL). METHODS: A study comparing between frequency matched HIV-1 seropositive and HIV-seronegative women was conducted in the Cape Coast Teaching Hospital, Ghana. A systematic sampling method was used to select women attending clinics in the hospital. Cervical samples were tested for HPV by careHPV and Anyplex-II HPV28 genotyping assay, and by conventional cytology. RESULTS: A total of 175 paired results (94 from HIV-1 seropositive and 81 from HIV-seronegative women) were analyzed based on the ability of both tests to detect the 14 hr-HPV types included in the careHPV assay. The inter-assay concordance was 94.3% (95%CI: 89.7-97.2%, kappa = 0.88), similar by HIV serostatus. The careHPV assay was equally sensitive among HIV-1 seropositive and seronegative women (97.3% vs. 95.7%, p = 0.50) and slightly more specific among HIV-seronegative women (85.0% vs. 93.1%, p = 0.10). careHPV had good sensitivity (87.5%) but low specificity (52.1%) for the detection of low SIL or greater lesions, but its performance was superior to genotyping (87.5 and 38.8%, respectively). Reproducibility of careHPV, tested on 97 samples by the same individual was 82.5% (95%CI: 73.4-89.4%). CONCLUSIONS: The performance characteristics of careHPV compared to genotyping suggest that this simpler and cheaper HPV detection assay could offer a suitable alternative for HPV screening in Ghana

Renal dysfunction among adult HIV/AIDS patients on antiretroviral therapy at a tertiary facility in Ghana

Abstract Background Kidney diseases have emerged as significant cause of morbidity and mortality in HIV subject on antiretroviral therapy (ART). In Ghana, routine follow up of HIV positive clients is by estimation of serum creatinine and urea levels. Glomerular Filtration Rate (GFR) is not routinely calculated and proteinuria is not routinely checked. This study sought to investigate the kidney profiles of adult HIV/AIDS patients being managed on ART at the Cape Coast Teaching Hospital (CCTH), Ghana. Methods A hospital-based analytical cross sectional study with a retrospective component was conducted using systematic sampling method to recruit HIV/AIDS who visited the ART clinic. A total of 440 participants of both sexes aged 18 years and above, confirmed as HIV/AIDS positive and on ART were involved in this study. Blood and urine samples were collected from all subjects and the levels of serum creatinine and urea and proteinuria were estimated and eGFR calculated using the Modification of Diet in Renal Disease (MDRD) equations. Data analyses were performed using Stata version 13 software (Stata Corp, Texas USA). Results The mean age (years) of participants was 45.5 years (±11.6) with 288 (65.4%) being on Tenofovir based ART regimen. The mean eGFR was found to decrease from 112.4 ml/min/1.73 m at baseline, to 103.4 ml/min/1.73 m after 6 months on ART and to a mean of 99.4 ml/min/1.73 m at recruitment into this study. Factors which were found to be associated with having eGFR  45 years had the highest odds with OR 2.0 (95% CI: 0.8–5.1), females had higher odds with OR 1.5 (95% CI: 0.5–5.2), and those with CD4 count > 350 had OR of 0.4 (95% CI 0.2–1.3). A total of 30.9% of the participants had proteinuria at recruitment. TDF based ART regimen had no statistically significant effect on serum creatinine and urea levels. Conclusion Estimated GFR decreased after 6 months among patients on ART despite normal serum creatinine and urea levels. This finding suggests that clients in care at HIV/ART clinics in Ghana may benefit from routine estimation of GFR and proteinuria