Seroprevalence of Human Immunodeficiency Virus, Hepatitis B Virus, and Syphilis Infections among Pregnant Women Booked for Antenatal Care at Kogi State Specialist Hospital, Lokoja, Nigeria

Background: Sexually transmitted infections (STIs) among pregnant women are an important health issue in Nigeria, but its prevalence inLokoja is not known. Objective: The objective of this study is to establish the seroprevalence of the human immunodeficiency virus (HIV), hepatitis B virus (HBV), and syphilis infections among pregnant women booked for the antenatal clinic in Kogi State Specialist Hospital, Lokoja, Nigeria, and determine risk factors associated with the infections. Methods: We prospectively screened three hundred pregnant women booked for antenatal care between January 1, 2016, and December 31, 2016, for HIV, HBV, and syphilis. Their demographic data, risk factors, and results of the screening tests were analyzed using the SPSS version 20 and presented in simple charts, tables, and percentages. Results: Thirty nine (13%) out of the 300 pregnant women tested seropositive for either HIV (28, 9.3%), HBV (10, 3.3%), or syphilis (one, 0.3%). The most common identifiable risk factor for these infections was multiple sexual partners which accounted for 38.4%. Conclusions: The seroprevalence of STIs in this study was 13% and the most common risk factor for the infections was multiple sexualpartners. Therefore, effective preventive strategies for HIV, HBV, and syphilis are advocated. Keywords: Hepatitis B virus, human immunodeficiency virus, Nigeria, pregnancy, screening, seroprevalence, syphili

The Effect of Low CD4+ Lymphocyte Count on the Radiographic Patterns of HIV Patients with Pulmonary Tuberculosis among Nigerians

Objective. To assess the radiographic features in patients with Human Immunodeficiency Virus (HIV) complicated by pulmonary tuberculosis (PTB), and the association with CD4 lymphocyte count and sputum smear. Method. A prospective study was carried out on 89 HIV positive patients with PTB. The demographics, smoking history, sputum smear result, chest radiographic findings and CD4 lymphocyte count were documented. Results. Out of the 89 patients recruited in the study, 41 were males and 48 were females. Eighteen (18) patients had typical radiographic features, 60 patients had atypical radiographic features while only 11 of them had normal radiographic films. Sixty eight (68) patients had CD4 count <200 cells/mm3, 19 patients had CD4 count between 200–499 cells/mm3, while only 2 patients had CD4 count from 500 cells/mm3 upwards. The association between low CD4 count and radiographic finding was statistically significant, ( value ). Sixty (60) patients had negative sputum smear for Acid and Alcohol Fast Bacilli (AAFB), while the remaining 29 patients had positive smear. The association between low CD4 count and negative smear was statistically significant ( value ). Conclusion. The radiographic pattern and the result of the sputum smear for AAFB has a significant relationship and association with the immune status of patients with Human Immunodeficiency Virus (HIV) complicated by pulmonary tuberculosis

Seroepidemiology of Lassa virus in pregnant women in Southern Nigeria: A prospective hospital-based cohort study.

BackgroundThere is limited epidemiological evidence on Lassa fever in pregnant women with acute gaps on prevalence, infection incidence, and risk factors. Such evidence would facilitate the design of therapeutic and vaccine trials and the design of control programs. Our study sought to address some of these gaps by estimating the seroprevalence and seroconversion risk of Lassa fever in pregnant women.Methodology/principal findingsWe conducted a prospective hospital-based cohort between February and December 2019 in Edo State, Southern Nigeria, enrolling pregnant women at antenatal clinic and following them up at delivery. Samples were evaluated for IgG antibodies against Lassa virus. The study demonstrates a seroprevalence of Lassa IgG antibodies of 49.6% and a seroconversion risk of 20.8%. Seropositivity was strongly correlated with rodent exposure around homes with an attributable risk proportion of 35%. Seroreversion was also seen with a seroreversion risk of 13.4%.Conclusions/significanceOur study suggests that 50% of pregnant women were at risk of Lassa infection and that 35.0% of infections might be preventable by avoiding rodent exposure and conditions which facilitate infestation and the risk of human-rodent contact. While the evidence on rodent exposure is subjective and further studies are needed to provide a better understanding of the avenues of human-rodent interaction; public health measures to decrease the risk of rodent infestation and the risk of spill over events may be beneficial. With an estimated seroconversion risk of 20.8%, our study suggests an appreciable risk of contracting Lassa fever during pregnancy and while most of these seroconversions may not be new infections, given the high risk of adverse outcomes in pregnancy, it supports the need for preventative and therapeutic options against Lassa fever in pregnancy. The occurrence of seroreversion in our study suggests that the prevalence obtained in this, and other cohorts may be an underestimate of the actual proportion of women of childbearing age who present at pregnancy with prior LASV exposure. Additionally, the occurrence of both seroconversion and seroreversion in this cohort suggests that these parameters would need to be considered for the development of Lassa vaccine efficacy, effectiveness, and utility models

Transplacental transfer of Lassa IgG antibodies in pregnant women in Southern Nigeria: A prospective hospital-based cohort study.

BackgroundEvidence from previous studies suggest that Lassa fever, a viral haemorrhagic fever endemic to West Africa has high case fatalities, particularly in pregnancy. While there have been remarkable innovations in vaccine development, with some Lassa vaccines undergoing early clinical trials. An understanding of Lassa antibody kinetics and immune responses will support vaccine design and development. However, there is currently no evidence on the antibody kinetics of Lassa (LASV) in pregnancy. Our study sought to estimate the efficiency of transplacental transfer of LASV IgG antibodies from the mother to the child.Methodology/principal findingsThe study made use of data from a prospective hospital-based cohort of pregnant women enrolled at the antenatal clinic and followed up at delivery between February and December 2019. Blood samples from mother-child pairs were evaluated for antibodies against Lassa virus. The study demonstrates a transplacental transfer of LASV IgG of 75.3% [60.0-94.0%], with a significant positive correlation between maternal and cord concentrations and a good level of agreement. The study also suggests that transfer may be more variable in women with 'de novo' antibodies compared to those with pre-existing antibodies.Conclusions/significanceThe study shows that maternal antibody levels play an important role in determining transfer efficiency of Lassa antibodies to the new-born; and while the evidence is preliminary, the study also suggests that transfer efficiency may be less stable in acute or recent infection, as such timing of vaccination before pregnancy, that is in women of childbearing age may be more appropriate for protection of both pregnant women and their neonates

Correlation plots for LASV IgG assessed by Spearman’s correlation (r) using linear regression.

Note: +/+ indicates seropositive from baseline. -/+ indicates seroconversion. The dotted black horizontal line indicates the line of efficient transfer (CMR = 1); IV- index value, an arbitrary antibody concentration unit based on manufacturer’s guide; mCMR- median cord maternal ratio; black and red lines are regression lines with the corresponding 95% confidence interval fitted to the regression line.</p

Factors associated with cord LASV IgG seronegativity (cord index value ≤ 0.9).

Factors associated with cord LASV IgG seronegativity (cord index value ≤ 0.9).</p

LASV IgG concentrations and cord maternal ratio by various maternal and neonate characteristics.

LASV IgG concentrations and cord maternal ratio by various maternal and neonate characteristics.</p

Baseline characteristics of mothers and neonates by maternal LASV IgG serostatus.

Baseline characteristics of mothers and neonates by maternal LASV IgG serostatus.</p

Bland-Altman plot showing agreement between maternal and cord Lassa and TT IgG antibodies.

Note: IV- index value; dotted black lines indicate limits of agreement (± 2sddiff); dotted red line indicates mean difference between maternal and cord concentrations; mdiff- mean difference; sddiff- standard deviation of differences.</p

Linear regression analysis of the effect of different factors on the transfer ratio of LASV IgG antibodies.

Linear regression analysis of the effect of different factors on the transfer ratio of LASV IgG antibodies.</p