Gender and Oral Manifestations of HIV Infection Among Adult Nigerians

Oral manifestations were studied in 305 adult Nigerians with HIV infection. Data collected were demographic (age, sex, marital status, educational status and occupation) and clinical (mode of transmission, general manifestations and oral manifestations of HIV infection). The chi- square test was used in test for significance between variables and p values less than 0.05 were regarded as significant. A total of 47.5% patients had oral manifestations. There were 67.6% females and 32.4% males (p 0.05). The study concluded that similar demographic and clinical characteristics were observed in the occurrence of oral manifestations of HIV infection in both male and female Nigerians. African Journal of Reproductive Health Vol. 10 (2) 2006: pp. 81-8

Cryptosporidiosis Among HIV-infected Patients with Diarrhea in Edo State, Midwesten Nigeria

To determine the prevalence of cryptosporidiosis among HIV infected and HIV non-infected patients with diarrhea in Edo State, Nigeria, as well as the effect of CD4+ lymphocyte count on the prevalence of cryptosporidial infection among the HIV patients. Stool samples were collected from 300 patients consisting of 200 HIV-infected and 100 HIV non-infected patients with diarrhea. Blood samples were collected from the HIV-infected patients. The stool samples were processed to detect Cryptosporidium species using a modified Ziehl-Neelsen stain, as well as other intestinal parasites using saline and iodine preparations. The blood samples were used to determine CD4+ lymphocyte count. The prevalence of intestinal parasites was higher in HIV-infected patients compared with their HIV non-infected counterparts (39% vs 24% respectively, p=0.0097). Cryptosporidiosis was diagnosed only among HIV-infected patients and was the only parasite whose prevalence was significantly different between HIV-infected and HIV non-infected patients. CD4+ lymphocyte count of <200 cells/µL among HIV-infected was a risk factor for acquiring cryptosporidial infection (OR=18.776, 95% CI=6.299, 55.964). A cryptosporidial infection prevalence of 18% among HIV-infected patients was observed and CD4+ count of <200 cells/µL was a risk factor for acquiring the disease. Routine examination of diarrhogenic stools of HIVinfected patients for cryptosporidiosis is advocated

Neurofibromatosis 1: A Clinical Study In The Nigerian African.

Neurofibromatosis 1 is a genetic disorder, inherited in an autosomal dominant fashion. The Neurofibromatosis 1 gene is located on chromosome 17q11. It is characterized by extreme clinical variability, but most patients have multiple neurofibromas, café-au-lait macules and iris harmatomas with increased risk for optic gliomas, osseus lesions and learning disabilities. Reports of the disease in Africans are relatively rare. Patients presenting to the Dermatology unit of the University of Benin Teaching Hospital, Benin City, Nigeria, with a diagnosis of neurofibromatosis – 1 (NF1) over a ten-year period (June 1991 to May 2001) formed the study population. Demographic data and details of clinical lesions were recorded during the clinical examination. Twenty-six patients with Neurofibromatosis 1, representing 0.54% of new dermatological patients were seen during the study period. There were 17 males and 9 females. Most presented in the third decade of life. The mean age at presentation was 26.15 years while the mean age at which symptoms were noticed was 15.41years. All had multiple neurofibromas and café-au-lait macules, while 88.5% had intertriginous freckling and 50% iris nevi. Two patients (7.7%) had a positive family history of the disease. At the time of presentation 88.5% of them were unmarried and only 3.9% could go beyond the secondary level of education. There is need to focus attention on the psychosocial rehabilitative management of these patients and also educate the populace about the non-infectious nature of the disease. Early specialist consultation and appropriate referral as well as long-term follow up will improve the quality of life of affected individuals. Keywords: Neurofibromatosis 1, Africans, Clinical features. Annals of Biomedical Science Vol. 1 (2) 2002: pp. 118-12

Chest radiographic findings in Human Immunodeficiency Virus disease in Benin City, Nigeria.

This study was carried out to determine findings on chest radiographs in HIV positive/AIDS patients at the University of Benin Teaching Hospital (UBTH) Benin City. All consecutive HIV positive/AIDS patients, managed at the UBTH between 1991 and 2001 were included in the study. Patients had postero-anterior (PA) chest radiographs done in full inspiration, with a Roentgen 301 radiographic machine (GEC Medical) using the following factors; KVp = 65, focus-film distance = 150cm and 12 – 15mAs. A total of 308 confirmed HIV- positive patients had chest radiographic examinations. Ninety-nine (32.14%) patients had normal findings, while 209 (67.86%) were abnormal. Abnormal findings included, cardiomegaly, 84 (27.27%) patients; radiological features of cardiac failure, 44 (14.28%) patients; lung cavitations, 47 (15.4%) patients; pleural effusions, 40 (13.09%) patients, fibrocystic changes, 40 (13.09%) patients, lobar consolidation, 29 (09.52%) patients, non-specific (atypical) infiltrates 70 (22.62%) patients, and hilar-adenopathy 7 (02.38%) patients. Soft tissue wasting was seen in 47 (15.25%) patients. Chest radiography remains a good instrument for detecting pulmonary and cardiovascular abnormalities even in HIV positive/AIDS patients Keywords: HIV/AIDS patients, Chest radiographic findings Annals of Biomedical Science Vol. 1 (2) 2002: pp. 131-13

Ocular Disorders In Patients Infected With The Human Immunodeficiency Virus At The University Of Benin Teaching Hospital, Benin City, Nigeria

Aims: Ocular diseases occur at all stages of HIV infection. Reports have documented that the prevalence of these diseases vary from region to region. Thus the objective of this study is to determine the prevalence of these ocular disorders among people infected with HIV at the University of Benin Teaching Hospital, Benin City, Nigeria Methods: The study was prospective in design and all patients who tested positive for HIV antibodies over a 5-year period from September 1997 to August 2002 in Dermatology and Ophthalmology Units at the University of Benin Teaching Hospital (UBTH), Benin City, Nigeria, were examined for the presence of ocular disease. Results: Twenty-one of the 526 HIV-positive patients had ocular disease, giving a prevalence rate of 4.0%. Their mean age was 39.5 ± 10.5 years. Fourteen patients (2.7%) had Herpes zoster ophthalmicus, four (0.8%) had Squamuos cell carcinoma, two (0.4%) had Kaposi\'s sarcoma while one (0.2%) had Cytomegalovirus retinitis. The signs seen on ocular examination were vesicular rash (66.7%) diminished vision (57.1%) corneal ulcers (38.0%), conjunctival injection (38.0%), and eyelid nodules (28.6%), preauricular lymphadenopathy (28.6%), purulent eye discharge (19.0), conjunctival nodules (9.5%), papilledema (9.5%), ptosis (9.5%), sudden visual loss in both eyes (9.5%), pupillary dilatation (4.8%), chemosis (4.8%), uveitis (4.8%), and retinal hemorrhage (4.8%). Conclusions: In this study the prevalence of ocular disorders was 4.0% in the 526 HIV-positive patients studied. Herpes zoster ophthalmicus was the commonest ocular disease encountered, occurring in 2.7% of the study population. This is in keeping with reports from other parts of the world. We recommend that young patients presenting with Herpes zoster ophthalmicus, conjunctival Squamuos cell carcinoma and sudden onset bilateral blindness should be screened for HIV infection. Keywords: Ocular Disorders, HIV infection, University of Benin Teaching Hospital, Benin City.Nigerian Journal of Clinical Practice Vol. 10 (4) 2007 pp. 283-28

Clinical Profile Of Atopic Dermatitis In Benin City, Nigeria

Objective: To study the clinical presentation and management problems of atopic dermatitis in Benin City, Nigeria. Design: A 15-year retrospective study from May 1985 to April 2000. Setting: Dermatology clinics of the University of Benin Teaching Hospital, Benin City, Nigeria. Subjects: All new cases of atopic dermatitis presenting to the clinic during the study period. Results: 594 patients suffering from atopic dermatitis, representing 7.92% of new dermatological cases were seen during the study period. There was a slight male preponderance; the male to female ratio was 1.2: 1. Most patients were below 30 years of age with the peak incidence in the 0 9-year age group, with most presenting in the first six months of life. Forty-six percent of the patients had a positive family history of atopy, while 73% also had other atopic disorders. The clinical patterns seen were infantile, childhood and adult forms, which is in keeping with reports from other parts of the world. Precipitating factors were most often obscure; however, high temperatures and humidity were the most common aggravating factors. The important problems encountered were misuse of topical medications, oral antibiotics, anti-fungal drugs and a high follow-up default rate. Conclusion: The clinical characteristics of atopic dermatitis in our study population were similar to the pattern in other parts of the world. There is need for increased awareness of its importance as a cause of morbidity especially in children. Keywords: Atopic dermatitis, Clinical profile,Nigeria.Nigerian Journal of Clinical Practice Vol. 10 (4) 2007 pp. 326-32

Renal sonographic parameters in human immunodeficiency virus - infected subjects and relationship to CD4 cell count

Nephropathy in human immunodeficiency virus (HIV)-infected patient is common and constitutes a major cause of endstage kidney disease. CD4 cell count is a useful parameter in the assessment of the degree of immunosuppression among HIV-infected patients. Manifestations of renal disease are thought to be more profound when CD4 cell counts are low. Sonography is a safe and inexpensive method of evaluating renal disease, including renal sizes and degree of echogenicity. Ultrasound examination was carried out prospectively at the University of Benin Teaching Hospital on 120 HIV-infected patients comprising 45 males (37.5%) and 75 females (63.5%). Renal sizes and degree of echogenicity were assessed. Correlation with CD4 + cell counts of the patients was done. Mean CD4 cell count mean was 18.34 ± 142.18 cells/mm 3 with female patients having a significantly higher cell count compared with males. Seventy-four patients (63.8%) had a cell count of <200 cells/mm 3 . Renal sizes were normal in 85%, small in 7%, and large in 8% of patients. Fifty patients (41.7%) had increased renal echogenicity and 8 (6.7%) had severe increased echo-texture. CD4 cell count did not correlate with renal sizes and echotexture. Results of this study show that large kidneys and marked increase in renal echotexture were not common even in a population of patients where the majority had CD4 cell count < 200 cells/mm 3 . This study shows that increased renal sizes and degree of echogenicity alone are not useful predictors of renal involvement in HIV/AIDS

Robust gene expression changes in the ganglia following subclinical reactivation in rhesus macaques infected with simian varicella virus

Varicella zoster virus (VZV) causes varicella during acute infection and establishes latency in the sensory ganglia. Reactivation of VZV results in herpes zoster, a debilitating and painful disease. It is believed that VZV reactivates due to a decline in cell-mediated immunity; however, the roles that CD4 versus CD8 T cells play in the prevention of herpes zoster remain poorly understood. To address this question, we used a well-characterized model of VZV infection where rhesus macaques are intrabronchially infected with the homologous simian varicella virus (SVV). Latently infected rhesus macaques were thymectomized and depleted of either CD4 or CD8 T cells to induce selective senescence of each T cell subset. After T cell depletion, the animals were transferred to a new housing room to induce stress. SVV reactivation (viremia in the absence of rash) was detected in three out of six CD8-depleted and two out of six CD4-depleted animals suggesting that both CD4 and CD8 T cells play a critical role in preventing SVV reactivation. Viral loads in multiple ganglia were higher in reactivated animals compared to non-reactivated animals. In addition, reactivation results in sustained transcriptional changes in the ganglia that enriched to gene ontology and diseases terms associated with neuronal function and inflammation indicative of potential damage as a result of viral reactivation. These studies support the critical role of cellular immunity in preventing varicella virus reactivation and indicate that reactivation results in long-lasting remodeling of the ganglia transcriptome