Effect of hemodialysis on total antioxidant status of chronic renal failure patients in government hospitals in Lagos Nigeria

Background: Renal failure is accompanied by oxidative stress, which is caused by enhanced production of reactive oxygen species and impaired antioxidant defense.Aim: To assess the effect of hemodialysis (by cellulose membrane dialyzer) on plasma total antioxidant status and lipid peroxidation of patients in chronic renal failure before and after dialysis.Objective: The finding would serve as guide to administration or otherwise of supplementary therapeutic antioxidant before or after hemodialysis. Also, it will assist in the choice of antioxidant impregnated over the conventional nonimpregnated dialyzer membrane.Materials and Methods: Twenty-five patients (14 men and 11 women, aged 24-75 years; median 61) with end-stage renal failure who were undergoing hemodialysis for the first time were recruited. Plasma level of potassium (K+), sodium (Na+), blood urea nitrogen (BUN), creatinine, total antioxidant status (TAS), and lipid peroxidation (MDA) were measured, before and after hemodialysis.Results: The mean ± SD of plasma level of TAS (1.10 ± 0.3 mmol/L trolox Eq) for males and (1.09 ± 0.2 mmol/L trolox Eq) for females postdialysis were significantly reduced (P < 0.05) in comparison with (1.72 ± 0.4 mmol/L trolox Eq) for males and (1.83 ± 0.7 mmol/L trolox Eq) for females predialysis, respectively. However, the mean ± SD plasma level of MDA (6.03 ± 0.4 nmol/ml) for males and (6.71 ± 0.7 nmol/ml) for females were significantly increased postdialysis (P < 0.01) compared to predialysis (3.98 ± 0.8 nmol/ml) for males and (4.05 ± 0.9 nmol/ml) for females, respectively.Conclusions: Based on the outcome of this study, it is suggested that antioxidant-impregnated dialysis membranes and/or exogenous supplementary antioxidant would be beneficial to patients with chronic renal failure. Removal of reactive oxygen species could improve the health and general quality of life of uremic patients

Willingness To Seek Human Immunodeficiency Virus (HIV) Voluntary Counselling And Testing (VCT) Among Urban Residents in Osogbo, South-West Nigeria

Background/Objective: Sub-Saharan Africa is home to two-thirds of all people living with HIV/AIDS. Nigeria has the third highest population of People Living with HIV/AIDS (PLWHAs). Voluntary counselling and testing (VCT) is rapidly becoming an important component of HIV/AIDS prevention and care strategy. The objective of this study was to assess the knowledge and perception of HIV/AIDS and the factors that may affect willingness to seek VCT among residents of an urban community in Nigeria. Methodology:  A cross-sectional descriptive study was conducted in Osogbo, Nigeria. Structured questionnaires were used to gather information from 332 residents. A multistage sampling technique was used for the selection of respondents. A total of 350 houses were selected from the 26 wards. Results: A high proportion (97.6%) of the respondents confirmed that they have heard of HIV/AIDS, 91.1% believed that AIDS is real. Knowledge of HIV/AIDS by the respondents was related to their level of educational attainment and their professions. Only 28.4% of the respondents are aware of VCT, but (66.9%) were willing to seek VCT services if the services are available; 66.7% confirmed that they would go ahead even if a fee is attached. However, 47.2% of those that think otherwise are scare of confidentiality, stigmatization and lack of fund. Willingness was also related to level of educational attainment, professionalism and age group. Conclusion: Programme managers should ensure that councillors have good knowledge on how to alleviate the fear of clients. Counselling should be the first step and if necessary test should follow.Journal of Community Medicine & Primary Health vol 23 (1-2) 201

Liver function tests in HIV-1 infected asymptomatic patients and HIV-1 AIDS patients without hepatomegaly in Lagos, Nigeria

Hepatic functions were assessed by serum assays of albumin (ALB), total protein (TP), total bilirubin (TB), conjugated bilirubin (CB), serum activities of alanine transaminase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP) and gamma – glutamyl transferase (GGT) in 51 HIV-1AIDS patients, 38 HIV-1 infected asymptomatic patients and 56 age and sex matched healthy HIV negative controls. The mean ± SEM serum ALB concentration of 23.5 ± 1.2 g/L in AIDS patients was significantly lower (p < 0.001) than those of HIV-1 infected asymptomatic patients and healthy controls; 38.9 ± 3.1g/L and 39.4 ± 2.8g/L respectively. The mean ± SEM TB concentration of 17.8 ± 1.3 &mu;mol/L in AIDS patients was significantly higher (p < 0.01) than 11.7 ± 1.1&mu;mol/L observed in HIV-1 infected asymptomatic patients and 10.8 ± 2.1&mu;mol/L in the controls. Similarly, there was a significant elevation (p < 0.05) in serum CB concentration of 6.5 ± 0.9µmol/L in AIDS patients compared to HIV-I infected patients of 3.8 ± 1.0 &mu;mol/L and controls of 3.1 ± 0.8 &mu;mol/L. The mean ± SEM ALT, AST, ALP and GGT activities (iu/L) of 48.7 ± 3.1, 54.3 ± 3.3, 84.8 ± 4.3 and 47.5 ± 4.1 respectively in AIDS patients were significantly higher (p < 0.001) than 21.3 ± 2.9, 25.6 ± 1.3, 56.4 ± 3.2 and 25.1 ± 1.7 respectively observed for the same enzymes in HIV-1 infected patients and 20.1 ± 3.1, 24.5 ± 2.6, 54.6 ± 4.3 and 24.2 ± 2.1 respectively in the controls. These results provide evidence to suggest that hepatic damage is greater in AIDS patients than in HIV-1 infected asymptomatic patients even in the absence of hepatomegaly. We conclude that this may be due to opportunistic infections that set in at the later part of HIV-1 infection (i.e. at AIDS stage) or increase severity of HIV-1 infection or both. Key Words: HIV-1 infected asymptomatic patient, AIDS, Hepatic functions Afr. J. Clin. Exper. Microbiol. Vol.6(1) 2005: 40-4