ASSESSMENT OF KIDNEY FUNCTION, ESTIMATED GLOMERULAR FILTRATION RATE AND BODY MASS INDEX IN HIV SEROPOSITIVE SUBJECTS ON ANTIRETROVIRAL THERAPY IN NNEWI

Objective: Antiretroviral therapy (ART) is anticipated to result in an increase in long-term survival in human immunodeficiency virus (HIV) infected individuals, but may present with the development of associated complications including kidney damage. The present study aimed at assessing the kidney function estimated glomerular filtration (eGFR) rate and body mass index (BMI) of HIV seropositive subjects with or without HAART at Nnewi, Nigeria.Methods: A total of 90 subjects were recruited comprising of 30 HIV-seropositive on highly antiretroviral therapy (HAART), 30 HIV-seropositive drug naive, and 30 HIV-seronegative (control subjects). Anthropometric parameters of the subjects were assessed using a well-structured questionnaire. Five millilitres of blood sample was collected from the patients and used for the estimation of urea, creatinine, uric acid, serum total protein and cluster of differentiation (CD4) T-cell counts using diacetyl monoxime method, Jaffe-slot method, Caraway phosphotungstic acid method, refractometry and flow cytometric method respectively.Results: The result shows significantly higher mean serum urea, creatinine and uric acid levels in HIV seropositive drug-naive subjects and HIV seropositive subjects on HAART when compared with control (p<0.05). Similar observation were made with same parameters between HIV seropositive drug-naive subjects and HIV subjects on HAART (p<0.05). However, total protein and CD4 T-cells counts were significantly lower in HIV seropositive drug-naive subjects compared with HIV subjects on HAART and controls (p<0.05). Based on the chronic kidney disease epidemiology collaboration (CKD-EPI) equation, 6 (20.0%) of HIV seropositive subjects on antiretroviral therapy had a mild renal impairment, while 2 (6.6%) had a moderate renal impairment. Based on the modification of diet in renal disease (MDRD) equation, 7 (23.3%) of HIV subjects on therapy had mild renal impairment while 2 (6.6%) had a moderate renal impairment. Among the HIV drug naïve subjects, 8(26.7%) had mild renal impairment based on both equations. However, there were no significant differences in BMI and eGFR between HIV seropositive subjects on therapy and HIV seropositive drug-naive subjects.Conclusion: The present study shows evidence of significant alterations in serum urea, creatinine, and uric acid levels with mild and moderate state of renal impairment in HIV infected subjects with or without therapy. The significantly lower CD4 count and serum total protein in HIV naive subjects compared with HIV on HAART and control indicates reduced cellular immunity. Routine kidney function test using longitudinal study and more sensitive predictors for renal damage are recommended to ascertain the clearer picture of renal disease burden among HIV subjects in this environment

ASSESSMENT OF SERUM AND URINE URIC ACID LEVEL IN RELATION WITH ANTHROPOMETRIC INDICES IN OVERWEIGHT AND OBESE UNIVERSITY UNDERGRADUATE STUDENTS

Objectives: Elevated uric acid level is related to a variety of adverse metabolic conditions including gout, obesity, and risk factor for cardiovascular diseases. This prospective study designed to assess the serum and urine uric acid level in relation with anthropometric indices in overweight and obese undergraduate students at NAU, Nnewi, Nigeria.Methods: A total of 302 undergraduate students aged between 18 and 40 years were randomly recruited for the present study. They were grouped based on their body mass index (BMI) as overweight, obese, and control participants. 132 participants were males, of which 21 were obese, 34 were overweight while 77 were normal (control) males. 170 participants were females, of which 56 were obese, 62 were overweight while the remaining 52 were normal (control) females. Fasting blood and 24 h urine sample were aseptically collected from all the participants for determination of serum and urine uric acid.Results: The study observed significantly higher serum uric acid level in obese and overweight males than female and control counterparts (p=0.000, respectively). Urine uric acid level was significantly higher in obese males and females than in their overweight and control counterparts (p=0.000). This shows increase production and accumulation of monosodium urate with decreased uric acid excretion which may result in hyperuricemia and hyperuricosuria which may result in gout. Serum and urine uric acid levels were significantly higher among age range (26–32) and (33–40) years compared with those among age range (18–25) (p<0.05) signifying that uric acid level increases with age. Serum and urine uric acid were significantly positively correlated with BMI, waist circumference, and waist hip ratio (p<0.05).Conclusions: High serum uric acid is a prerequisite for gout and also associated with the metabolic syndrome and risk factors for cardiovascular disease. Proper awareness of the implication of hyperuricemia among undergraduate students is necessary

PREVALENCE OF OVERWEIGHT AND OBESITY AND ASSESSMENT OF LIPID PROFILE AND FASTING BLOOD GLUCOSE LEVELS AMONG FEMALE PREMEDICAL STUDENTS AT NNAMDI AZIKIWE UNIVERSITY, NNEWI CAMPUS, NIGERIA

Objective: Obesity is a major public health issue and a significant risk factor for metabolic disorders. This prospective study was aimed at evaluating the prevalence of obesity, lipid profiles, and fasting blood glucose (FBG) among female premedical students of NAU, Nnewi Campus, Nigeria.Methods: A total of 320 female premedical students aged 18–35 years were recruited. The participants were classified using Body mass index(BMI) as underweight (35), overweight (104), obese (26), and control (155). FBG and lipids were estimated using enzymatic methods. Obesity was assessed using BMI and waist circumference. Blood pressure (BP) was measured using accoson sphygmomanometer.Results: The study observed 10.9% underweight, 32.5% overweight, and 8.1% obesity. Underweight was higher among participants aged 18–23 years (48.6%), while overweight and obesity were more among participants aged 24–29 years (57.7% and 53.8%). Central obesity was observed in 28.8% of participants. BPs were higher in obese and overweight participants than in other groups. FBG was higher in obese and overweight participants than in other groups. The mean total cholesterol (TC) and low-density lipoprotein cholesterol (LDLC) were significantly higher in obese and overweight participants, while high-density lipoprotein cholesterol (HDLC) was significantly lower when compared to their corresponding values in underweight and control participants (p<0.05).Conclusions: The study showed high prevalence of underweight, overweight, and obesity among the study population. The significantly higher levels of TC, LDLC, FBG, and elevated BP with significantly lower HDLC in overweight and obese participants compared to control suggests a possible risk of dyslipidemia, diabetes mellitus, and hypertension. The significant correlation between the lipid parameters, FBG, and anthropometric indices suggests high-risk cardiovascular disorders

Evaluation of Zinc and Copper and Immunological Implication in Menstrual Cycle of HIV Infected Females in Nnewi, Nigeria

Zinc and Copper are essential for the immune system and the interaction between reproductive system and immune cells plays important immunoregulatory roles in menstrual cycle of women. It is estimated that nearly 16 million women are living with HIV/AIDS worldwide, making up approximately half of all infections. Importantly, the understanding of the burden of HIV/AIDS lies within resource limited areas particularly Sub-Saharan Africa. This was a prospective study designed to evaluate the immunological implication of Zinc and Copper in menstrual cycle of HIV infected females in NAUTH, Nnewi, Nigeria. The study composed of 120 premenopausal females with regular menstrual cycle (between 27-31 days) and aged 15-45 years. 30 were apparently healthy females recruited as Control group while 90 were HIV infected females grouped as HIV stage 1, HIV stage 2 and HIV stage 2 on ART (n=30 respectively). Blood samples were collected at follicular (7th - 13th day) and luteal (21st -23rd day) phases of menstrual cycle after obtaining their informed consent for determination of Zinc, Copper, Interleukin-6, interleukin-4 and TNF? using AAS and ELISA methods. The result showed significantly lower levels of Zn and Cu  with significantly higher levels of IL-6, IL-4 and TNF? in HIV infected females with or without therapy compared to Control at both phases of menstrual cycle (P<0.05). The Zn levels was significantly higher in stage 2 HIV infected females on ART compared to their counterparts not on ART (P<0.05). The significantly lower levels of Zn and Cu with increased levels of cytokines indicate immunosuppression and active inflammatory response in HIV infected females at both phases of menstrual cycle which was improved in the participants who were placed on ART. Keywords: Copper; Zinc; Immunological Implication; HIV; Menstrual cycle; Reproductive age

Evaluation of Serum Interleukin 6, Tumor Necrosis Factor-Alpha, and Interferon-Gamma Levels in Relation to Body Mass Index and Blood Pressure in HIV Seropositive Pregnant Women Coinfected with Malaria

Malaria and HIV are leading causes of morbidity and mortality, particularly in sub-Saharan Africa. Both diseases are highly endemic and have a wide geographic overlap with severe impact on pregnancy. This was a case-control study designed to evaluate the levels of interleukin -6 (IL-6), tumor necrosis factor-alpha (TNF-α), and interferon-gamma (IFN-γ) and their relationship with some anthropometric indices such as body mass index (BMI) and blood pressure in HIV-malaria coinfected women attending antenatal clinic at Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Nigeria. 122 pregnant women and 30 nonpregnant women (control) aged between 18 and 42 years were recruited for the study. Screening of HIV antibodies was done using a national algorithm. Peripheral malaria was determined using rapid detection and the Giemsa stain technique. Cytokines were assayed using the enzyme-linked immunosorbent assay technique. HIV-malaria coinfected pregnant women showed significantly higher levels of IL-6, IFN-γ, TNF-α, and blood pressure with reduced BMI value compared with HIV seronegative pregnant and nonpregnant control participants (p≤0.001, respectively). The findings indicated significant cytokine imbalance which suggests an active inflammatory process and reduced cellular immunity. The increased BMI and blood pressure level observed indicate overweight and possible hypertension which could subsequently lead to preeclampsia and other adverse pregnancy outcomes

Univariate and multivariate logistic regression models.

<p>Univariate and multivariate logistic regression models.</p

Impact of thyroid function abnormalities on reproductive hormones during menstrual cycle in premenopausal HIV infected females at NAUTH, Nnewi, Nigeria

<div><p>Background</p><p>This was a prospective study designed to evaluate the impact of thyroid function abnormalities on reproductive hormones during menstrual cycle in HIV infected females at Nnamdi Azikiwe University Teaching Hospital Nnewi, South-East Nigeria.</p><p>Methods</p><p>The study randomly recruited 35 Symptomatic HIV infected females and 35 Symptomatic HIV infected females on antiretroviral therapy (HAART) for not less than six weeks from an HIV clinic and 40 apparently heathy control females among the hospital staff of NAUTH Nnewi. They were all premenopausal females with regular menstrual cycle and aged between 15–45 years. Blood samples were collected at follicular and luteal phases of their menstrual cycle for assay of Thyroid indices (FT3, FT4 and TSH) and Reproductive indices (FSH, LH, Estrogen, Progesterone, Prolactin and Testosterone) using ELISA method.</p><p>Results</p><p>The result showed significantly higher FSH and LH but significantly lower progesterone (prog) and estrogen (E2) in the test females compared to control females at both phases of menstrual cycle (P<0.05). There was significantly lower FT3 but significantly higher TSH value in Symptomatic HIV females (P<0.05). FSH, LH and TSH values were significantly lowered while prog and FT3 were significantly higher in Symptomatic HIV on ART compared to Symptomatic HIV females (P<0.05). FT3, FT4, Prog and E2 were inversely correlated while FSH and LH were positively correlated with duration of HIV infection in HIV females (P<0.05 respectively). There was a direct correlation between CD4+ count and FT3 while inverse correlation was found between CD4+ count and TSH levels (P<0.05).</p><p>Discussion</p><p>The present study demonstrated hypothyroidism with a significant degree of primary hypogonadism in Symptomatic HIV infected females at both follicular and luteal phases of menstrual cycle which tends to normalize on treatments.</p></div

Correlation between thyroid function tests and CD4+ count.

<p>Correlation between thyroid function tests and CD4+ count.</p

Comparison of mean (±SD) serum levels of progesterone and estradiol in test groups and control group at follicular and luteal phases of menstrual cycle.

<p>Key- Progesterone in all Test groups vs Control (C) = P<0.05 at both phases. Estradiol in all test groups vs control (C) = P<0.05 at follicular and luteal phases of menstrual cycle.</p

Correlation of thyroid function tests and sex hormones levels with HIV duration in HIV females.

<p>Correlation of thyroid function tests and sex hormones levels with HIV duration in HIV females.</p