Open Access Original Research Article

Viral Skin Infections in Adult Patients with HIV/AIDS in a Tropical Rural Practice in Nigeria

T. A. T. Salami, P. Echekwube

International STD Research & Reviews, Page 33-39
DOI: 10.9734/ISRR/2015/15371

Background: The skin, like all organs in the body is affected by several diseases in patients with HIV/AIDS. This is particularly so with viral skin disorders where impaired cellular immunity seems to be a common pathway of susceptibility. There are however few documented studies of these conditions in Nigeria and some other neighbouring west African countries.

This study aims to identify these skin disorders in patients attending the adult outpatient clinic in a rural/suburban health centre in the southern part of Nigeria and collate the differences and similarities to other related studies.

Methods/Design: This was done among HIV infected adult patients in the outpatient HIV clinic. It was a prospective observational study done in Irrua Specialist Teaching Hospital Irrua Edo State Nigeria. The study was done over a 12 months period. All patients with skin complaints were included in the study while those without were excluded.

Results: Nine thousand, four hundred and sixty patients were seen during this period including new and old patients returning for follow up visits. Four hundred and ninety had different dermatologic complaints during these visits giving a prevalence of 5.17%. The male:female ratio was 1:1.4 and a mean age of 38±10 years.

One hundred and eighty two of these patients had clinical features of cutaneous viral infections giving a prevalence of 37.1% of cutaneous complaints. Herpes Zoster (27%), Genital warts (19.2%), Plain viral warts (15.4%) and Herpes Simplex (15.4%) are the commonest cutaneous viral pathologies encountered. Others include Pityriasis Rosea (11.5%), Molluscum contagiosum (7.7%), and Varicella zoster (chicken pox - 3.8%).

Conclusion: Viral skin infections are very common in the HIV/AIDS population and they constitute a significant cause of morbidity in these patients.

Open Access Original Research Article

Lime Juice Induces Ovarian Follicle Degeneration and Reduces Serum Gonadotrophin Level in Rats Model

B. J. Dare, O. Beremako, O. D. Omotoso, O. T. Olaniyan, M. O. Shafe, S. C. Ifeonu

International STD Research & Reviews, Page 45-51
DOI: 10.9734/ISRR/2015/8709

Background: Lime juice possesses antimicrobial and anti-proliferative property and caused reduced sperm motility in animals. This study aimed at investigating the anti-proliferative effect of lime juice on the ovarian cortex of adult Wistar rats.

Methods: Twenty (20) adult Female Wistar rats weighing between 160 - 190 g were divided into 4 groups (n= 5). Group 1, 2 and 3 received 1 ml/kg, 1.5 ml/kg and 2.23 ml/kg body weight of undiluted lime juice respectively; Group 4 received 0.5 ml of distilled water for period of ten (10) days. Administration was done by gavages oro-gastrically daily using metal oral canula. Animals were sacrificed by cervical dislocation 24 hours after the last administration of lime juice; ovary was dissected out following abdominal incision, fixed in 10% formo-saline for histological observation using H/E stains and blood sample was collected for hormonal (reproductive hormones) assay.

Results: Plasma concentration of FSH and LH significantly (p < 0.05) lowered in the lime –treated rats compared with control rats, histological observation revealed degeneration in the follicular cells, stroma hyperplasia and immature follicles in the animals treated with the undiluted lime juice compared with the control group; that revealed follicular cells at different stages of development.

Conclusion: Low plasma concentration of FSH and LH observed with consequent degeneration of follicular cells expressed in the ovarian cortex demonstrate anti fertility potential of lime juice.

Open Access Original Research Article

Coreceptor Usage of Human Immunodeficiency Virus Type 1 Strains in Ibadan, Nigeria

E. Donbraye, G. N. Odaibo, D. O. Olaleye

International STD Research & Reviews, Page 52-62
DOI: 10.9734/ISRR/2015/16131

Aims: To evaluate HIV-1 Coreceptor usage in Nigeria.

Study Design: Cross-sectional study.

Place and Duration of Study: Department of Virology, College of Medicine, University College Hospital, Ibadan from January 2004 to December 2006.

Methodology: Genomic DNA was extracted from blood samples of 85 (42 males, 43 females; age range 18-58 years) consenting HIV-1 infected antiretroviral therapy-naïve individuals presenting at a voluntary counseling and testing centre. The env C2-V3 region of HIV-1 proviral DNA was amplified by nested PCR, successfully sequenced, manually edited and evolutionary relationships determined by maximum likelihood using MEGA 5.03R from 64 of the blood samples of the HIV-1 infected patients. HIV-1 coreceptor usage was predicted based on genotypic analysis of HIV-1 env V3 loop sequences.

Results: Phylogenetic analysis showed HIV-1 subtypes A, G, CRF02_AG, CRF06_cpx, and CRF35_AD among the study participants The V3 loop region of the viruseshad amino acid sequence conservation in the base positions 1-8 and 26-35 and tip regions and sequence variability, including mutations and deletions at positions 9-25. Most (76.6%) of the sequences had the GPGQ crown motif while the GPGQ/L/R/K substitution was observed in 18.8%. The number of N-linked glycosylation sites ranged from 0 to 4 per env C2-V3 amino acid sequence with only 37.5% of the sequences having all 4 N-linked glycosylation sites. Predicted frequencies for CCR5 and CXCR4 genotypes were 31.2% and 68.8%, respectively, while 10% of the CCR5-tropic viruses showed Maraviroc-associated resistant mutations.

Conclusion: CXCR4-tropic viruses predominate among the studied population irrespective of HIV-1 subtype and and it is associated with multiple amino acid deletions and mutations in V3 and the loss of one or more N-linked glycosylation sites. This data suggest the need for further studies involving a larger sample size prior to introduction of coreceptor inhibitors like Maraviroc for management of HIV infection in Nigeria

Open Access Original Research Article

Trends in Hysterectomy for Pelvic Inflammatory Disease - Experience From Low Resource Settings

S. Chhabra, Manjiri Podder, Yojana Yadav, Sonali Mehta

International STD Research & Reviews, Page 63-68
DOI: 10.9734/ISRR/2015/13106

Background: Genital infections are increasing. So more women are likely to have sequelae, which sometimes leads to hysterectomy. Continuous research is essential to prevent sequelae and morbidities related to therapy for sequelae.

Objective: Present study was done to find out trends of hysterectomies for pelvic inflammatory disease (PID) in women of a low resource region.

Methods: Case records of abdominal hysterectomy with salpingo oopherectomy performed either for PID as only indication or PID as major problem with other benign gynaecological disorders, were analyzed. During study period of two decades from January 1989 to 2008 December, 4829 women had undergone abdominal hysterectomy with salpingo-oopherectomy, 2984 done for benign gynaecological disorders including PID, 251 (8.4%) women had hysterectomy only for PID and 512 (17.15%) for PID with other disorders, but main indication was PID, making 763 (25.57%) study subjects. These Cases were mostly peri or post menopausal women.

Results: In first half of analysis (over 10 years) 4.35% women had abdominal hysterectomy only for PID compared to 6.65% in second half, PID with other gynaecological disorders was the  indication in 11.5% cases in first half and 38.5% in second half, trends increasing significantly in both groups.

Conclusion: Hysterectomies for PID are increasing. So it is essential to prevent, treat timely, appropriately, so that such sequelae do not occur.

Open Access Original Research Article

Specific Issues in the Management of Hepatocellular Carcinoma in Hepatitis B Virus/Hepatitis C Virus-Human Immunodeficiency Virus Co-infected Patients

Emanuele Pontali, Giovanni Cenderello, Giovanni Cassola, Augusta Torresin

International STD Research & Reviews, Page 69-83
DOI: 10.9734/ISRR/2015/17781

Hepatocellular carcinoma (HCC) has become in recent years a leading cause of morbidity and mortality in patients with HIV who are co-infected with HBV/HCV. The aim of this review is to describe the peculiarities of HCC occurring in this highly demanding scenario, covering all topics from diagnosis to treatment. The epidemiology of co-infection with hepatitis B and C is covered. The following sections deal with suggestions and recommendations about screening, diagnosis and treatment. The key role of liver ultrasound imaging and serum alpha-fetoprotein determination for HCC early diagnosis in patients at high risk for HCC development is underscored. All current treatments of HCC in this special population are described and commented, i.e. surgical resection, percutaneous ethanol injection, radiofrequency ablation, transarterial chemoembolization, targeted therapy, liver transplant. Special consideration has been given to the issues hindering the access of HIV patients with HCC to liver transplantation programmes. We hint to the much awaited availability of highly efficacious anti-HCV Directly Active Antivirals. In fact, the advent of these molecules is likely to produce a deep impact on and a dramatic improvement of the natural history of HIV/HCV co-infections. In summary, HCC incidence in patients with HIV who are co-infected with HBV/HCV is on the rise. Early diagnosis is essential to treat patients with the most efficacious treatment options. Treatment of all three viral infections is the key intervention to prevent occurrence of HCC in this population. Nevertheless, large prospective trials are badly needed to assess the optimal management of patients who have cleared HCV but still risk to develop a liver malignancy.

Open Access Case Study

Prevalence of HBV, HCV and Syphilis among the People of Ekiti in South-Western Nigeria

Tolulope Adekoya-Benson, Peter Ojo Famoni, Olugbenga Ajala, Thompson Joseph Akinbolaji, Oluwasegun Christopher Adeosun, Adegboyega Agbaje, Omobolanle Olatimehin, Haleem Olujuwon Ibraheem

International STD Research & Reviews, Page 40-44
DOI: 10.9734/ISRR/2015/15859

This study was carried out to know the prevalence of hepatitis B, hepatitis C and syphilis infections among the people of Ekiti, South-West, Nigeria. This study took place at the Haematology and Blood Transfusion Unit, Ekiti State University Teaching Hospital, Ado-Ekiti. Patients and individuals who visited this unit of the hospital to screen for hepatitis B, hepatitis C and syphilis infections between January to November, 2014 were recruited for this study. Four ml of blood sample was collected from each subject into a plain bottle and was allowed to stand for 1hour for clotting and clot retraction to take place. Sera were separated into khan tubes labeled appropriately and were screened for the presence of antibodies to HBsAg, HCV and syphilis using One-Stage Rapid Test Kits ( DiaSpot Diagnostics) and all were later confirmed using enzyme linked immune sorbent assay (ELISA) (Stat Fax Awareness, England). The results of this study showed the prevalence of hepatitis B, hepatitis C and syphilis infections to be 6.2%, 1.7% and 0.7% respectively with the highest prevalence of the three infections found within the age group 31-40 years followed by age group 21-30 years and males were more infected than the females. Age group 25-40 years is considered to be the most sexually active age group and the age group with the highest prevalence of these infections fall within the sexually active age group indicating that most of the infected people got infected through sexual intercourse with an infected person because the major mode of transmission of these infections is through sexual intercourse even though they can also be transmitted through other means.