Quantification of Human Immunodeficiency Virus -1 Viral Load using Nucleic Acid Sequence-based Amplification (NASBA) in North Central Nigeria

Viral load (VL) quantification is considered an integral part of the standard care in human immunodeficiency virus (HIV) infected individuals but in Nigeria as in most of sub-SaharanAfrica, this has not reached themajority of patients. We report the first field application of the NucliSens EasyQ HIV-1 platform for the real time quantification of HIV-1 VL combining NASBAamplification and real time detection with molecular beacons among HIV-1 infected individuals in north central Nigeria where the predominant HIV-1 subtypes are CRF02_AGandG.CD4 countswere enumerated using a fluorescence-activated cell sorter system. Of one hundred and forty nine (n=149) plasma sample from patients with mean age of 32 years andmade up of 77males and 72 females, fifty {n = 50 (37.9%); 28males and 22 females}hadVLs below the lower detection limit (LDL=25 IU/ml) set by the assay while eighty- two {n = 82 (62.1%); 39 males and 43 females}hadVLlevels above the LDL. Furthermore, 13 of 82 (15.9%) patientswith viral loads above the LDL had VLs between 26-1000 IU/ml while 69 (84.1%) had VLs of 1001-2400000 IU/ml. 17 (11.4%) of the samples could not be analyzed due to poor viral amplification. Among individuals with both CD4 and VL results (n=56), those with CD4 of 1-418 cell/μl presented with higher VL usually above 45,000 IU/ml when comparedwith thosewithCD4 of over 500 cell/μl. Our findings highlight the pattern, usefulness and feasibility of VL quantification by NucliSens EasyQinmonitoringHIV-1 patients inNigeria.Keywords: HIV-1,Viral load quantitation,Nigeri

The role of triple infection with hepatitis B virus, hepatitis C virus, and human immunodeficiency virus (HIV) type-1 on CD4+ lymphocyte levels in the highly HIV infected population of North-Central Nigeria

We set out to determine the seroprevalence of hepatitis B and C among human immunodeficiency virus type- 1 (HIV-1) infected individuals in North-Central Nigeria to define the influence of these infections on CD4+ lymphocytes cells among our patients as access to antiretroviral therapy improves across the Nigerian nation. The CD4+ values of 180 confirmed HIV-1 infected individuals were enumerated using a superior fluorescenceactivated cell sorter system. These patients were tested for the presence of hepatitis B surface antigen and antihepatitis C virus (HCV) using third generation enzyme-linked immunosorbent assays. Fifty (27.8%) patients had active hepatitis B virus (HBV) infection while 33 (18.3%) tested positive for anti-HCV antibody. Of these infections, 110 (61.1%), 37 (20.6%), and 20 (11.1%) had HIV only, HBV/HIV-only, and HCV/HIV-only respectively. A HBV/HCV/HIV coinfection prevalence of 7.2% (13 patients) was recorded. Patients coinfected with HIV/HBV/HCV appeared to have lower CD4+ counts (mean = 107 cells/μl; AIDS defining) when compared to HBV/HIV-only (mean = 377 cells/μl), HCV/HIV-only (mean = 373 cells/μl) and patients with mono HIV infection (mean = 478 cells/μl). Coinfection with HBV or HCV is relatively common among HIV-infected patients in Nigeria and should be a big consideration in the initiation and choice of therapy