In the last decade, the long-term survival among people living with HIV (PLHIV) has significantly improved. This is accompanied by an increased burden of non-communicable diseases such as hypertension due to the combined effect of the aging population and the metabolic effect of the Human Immuno-deficiency Virus (HIV) virion and antiretroviral therapy. This study aims to assess the prevalence and factors associated with hypertension among people living with HIV in three large health facilities in Nasarawa State, Nigeria. A descriptive cross-sectional study employed a multistage sampling technique to select 309 adults with HIV, 18 years and above, receiving HIV care in three large health facilities in Nasarawa State. The outcome variable was the participants' self-reported history of hypertension, confirmed through a positive history of hypertension treatment. Exposure variables included the participant's socio-demographic characteristics, lifestyle factors, and HIV care and treatment history. Data were presented using frequency tables. Factors associated with hypertension were assessed using binary logistic regression at a 0.05 level of statistical significance. A total of 309 adults living with HIV were sampled. A larger percentage of the participants were married 228 (73.8%), female, 191 (61.8%), within the age group 41 - 50 years, 141 (45.6%). Most of the participants had no family history of hypertension, 188 (60.8%). The prevalence of self-reported hypertension was 11.0% (34/309). Factors associated with hypertension at the bivariate level were age group 21 - 30 years, 41 - 50 years, being widow/widower, divorced, retired from employment or with family history of hypertension. Only participants age group 31 - 40 years [Adjusted Odd Ratio (AOR): 0.18, 95%CI: 0.04 - 0.91, p = 0.04] and family history of hypertension [(AOR): 83.44, 95%CI: 15.75 - 442.11, p < 0.01] were found to predict hypertension among the study participants after adjusting for confounders. In conclusion, Hypertension remains a public health issue among PLHIV. Factors associated with hypertension among PLHIV include age and family history of hypertension. Regular screening for hypertension, its appropriate treatment and optimal control are essential in PLHIV.
Introduction: Life expectancy improvement for people living with Human Immunodeficiency Virus (HIV) is coming up against the problems associated with aging and chronic diseases. Frailty is a concern affecting a growing number of patients, particularly the elderly in this population. Our study aimed to determine the prevalence of frailty and its predictors on people living with HIV aged 50 years and older followed at the Outpatient Treatment Clinic (CTA) in Dakar. Methodology: We conducted a cross-sectional study of descriptive and analytic purposes ranging from November 2022 to August 2023, in CTA, Dakar (Senegal). We included people living with HIV aged 50 years and older under antiretroviral therapy for at least 6 months (≥6 months). Frailty was considered according to Fried criteria with a score ≥3. To identify the predictors of frailty, we performed a multivariate logistic regression analysis using STATA software version 18. Results: We included 199 patients. The median age at the moment of the study was 58 years old [50 - 91] with a sex ratio (M/F) of 0.58. The most representative age group was that of [50 - 59] years (59.3%). HIV-1 profile was most common in 89.45%. The median duration under antiretroviral therapy was 180 months [6 - 284] and 94% of patients received a Tenofovir Disoproxil Fumarate (TDF)-containing regimen with 43% of them for at least 10 years. Viral load was undetectable (≤40 copies/ml) in 98% of cases. WHO Stage III was more common at inclusion and 55.78% had nadir TCD4+ Lymphocyte counts < 200 elements/mm3. In our study, 80% of patients underwent at least one comorbidity (≥1) and 31% of patients had polymedication (≥5). Nutritional disorder was found in 65 patients. Frailty and prefrailty appeared in 28% and 36% of cases respectively. In multivariate analysis, nutritional disorder [aOR = 3.8 (2.3 - 6.4)], length of TDF-containing regimen exposure ≥10 years [aOR = 29.03 (9.5 - 89.7)], and polypharmacy [aOR = 1.53 (1.1 - 2.12)] were associated with frailty. Conclusion: Our study confirms the high prevalence of frailty among older people living with HIV. Its prevention should consider the management of comorbidities and the implementation of non-pharmacological interventions such as nutrition.
Background: In Nigeria, adolescents and young people (AYP) aged 10 - 24, comprise 22.3% of the population and with HIV prevalence of 3.5%. The AYP living with HIV enrolled at the 68 NARHY, Lagos reflects the national challenges with poor viral suppression. The OTZ program aligns with the UNAIDS 95-95-95 goals. It seeks to empower AYPLHIV to be in charge of their treatment and commit to triple zero outcomes—zero missed appointments, zero missed drugs, and zero viral loads. The purpose of the study was to assess the impact of the OTZ program on viral load suppression among members of the adolescent club in 68 NARHY, Lagos. Method: A cross-sectional retrospective study to evaluate the impact of the OTZ program on the viral load of 53 AYP enrolled in the OTZ program between March 2019 to December 2019 was analyzed. The Percentage of viral load suppression before enrollment compared with 6 and 12 months after enrollment into the OTZ program. The AYP is grouped into 10 - 14, 15 - 19, and 20 - 24 years. Activities conducted were peer driven monthly meetings with the AYP during which the adolescents interacted on issues relating to improving their treatment outcomes, healthcare workers reviewed their clinical status, viral load result, provider peer counseling, and caregivers' engagement to support adherence to medication and ARV refills. Results: Before OTZ, 81% aged 10 - 14 years, 75% aged 15 - 19 years, and 25% aged 20 - 24 years were virally suppressed (VL less than 1000 copies/ml). Six months after enrollment, 94% were virally suppressed—95% aged 10 - 14 years, 96% aged 15 - 19 years, and 66% aged 20-24 years. Twelve months after enrollment, 96% of AYP were virally suppressed—100% aged 10-14 years, 93% aged 15 - 19 years, and 100% aged 20 - 24 years. Males' viral load (VL) suppression improved from 79% to 96% and 92%, while females' VL suppression improved from 69% to 93% and 100% at 6 and 12 months respectively. Conclusion: The OTZ activities contributed to improved viral load suppression in the AYP of the facility.
Context: Despite the new recommendations “Test and Treat”, the virological and molecular parameters remain important information for Antiretroviral Treatment and adequate for monitoring of patients infected with HIV/AIDS. Objective: the Objective of this study is to present the virological and molecular profile of People Living with HIV starting Antiretroviral Therapy in Kinshasa in the era of the Dolutegravir. Methods: This was a transversal study to determine virological and molecular profile of People Living with HIV (PLHIV) starting an ARV Treatment. The patient’s inclusion period was from October 04, 2021 to February 15, 2022. A sample of 5 ml of blood was taken in a tube with EDTA anticoagulant for Molecular Biology analyzes (Viral Load and Sequencing) in all HIV patients, after reading and signing informed consent. The population was made up of adult patients over the age of 18, infected with HIV and starting ART. Results: 119 patients (56.3% of women) were included in this study, thus a sex-ratio of 1.29. The average age of patients included was 39.87 ± 12.36 years. The most represented age group is that of 36 to 45 with 37 patients (31.9%) followed by that from 26 to 35 years with 24 patients (20.7%). Out of 119 patients, 21 patients had an undetectable Viral Load (VL). The median value of VL was 4.16 log10 RNA copies/ml. 114 samples were successfully amplified. Subtype A was dominant with 23 cases (20.2%); followed by the subtype C and CRF02_AG each with 14.0%, and D (10.5 %). K65R (1.8%), T69P/N (4.4%), K70R (7.9%) and M184V (7.0%) mutations were listed as existing mutations for Nucleotide Transcriptase Inhibitors. Conclusion: 38 patients (31.93%) started the TARV with a positive virological prognosis. The subtype A remains dominant in Kinshasa with 23 cases (20.2%); followed by the subtype C and CRF02_AG each with 14.0%. For Inhibitors of Transcriptase Reverse Nucleotide; K65R, T69P/N, K70E/R and M184V mutations were found in patients’ naive of ARV Treatment.
Background: For several decades, the introduction of AntiRetrovirals (ARVs) has improved the symptomatology of People Living with HIV (PLHIV), a spectacular reduction in morbidity and mortality, an improvement in life expectancy and quality of life of PLHIV. Objective: The objective of this study was to determine the profile of PLHIV initiating AntiRetroViral Treatment (ART) in the era of Dolutegravir in Kinshasa. Methods: Cross-section of a prospective cohort to determine the profile of PLHIV initiating ART in Kinshasa. The inclusions were from October 04, 2021 to February 15, 2022. Confirmation of the diagnosis was carried out by Nested PCR. The inclusion criteria were: being at least 18 years old, confirmed HIV positive, naïve to ART, consenting and having signed an informed consent. The parameters of interest followed for the present study were: age, sex, religion, level of study, marital status, occupation, height, weight, body mass index (BMI), the clinical profile, the opportunistic infections as well as the para-clinical assessment (biochemistry and molecular biology). Results: 67 (56.3%) women and 52 (43.7%) men were included, thus 119 patients, all confirmed positive for HIV by Nested PCR on the gag, pol and env regions. The average age of the patients included is 39.87 ± 12.36 years and the most represented age group is that of 36 to 45 years with 37 patients (31.9%). The average height was 1.66 ± 0.08 meters, with an average weight of 56.41 ± 13.30 kg, giving an average Body Mass Index (BMI) of 21.54 ± 5.17 kg/m2. The majority of patients were married (46.1%), of Protestant religion (70.7%), with secondary education (66.7%), and working in the informal sector (29.4%). 49 patients (41.5%) were in clinical stage 3 and 55 patients (47.0%) had a normal clinical status. Malaria (45.4%) and tuberculosis (29.4%) were the most common Opportunistic Infections. The mean values of the patients’ assessed biochemical parameters were within the ranges. The median VL value was 4.16 log10 RNA copies/ml. Subtype A (20.2%) is dominant. Mutations K65R (2 cases), T69P/N (5 cases), K70R (9 cases) and M184V (8 cases) were listed. Conclusion: In Kinshasa, PLHIV start ART late. The biochemical parameters evaluated are within normal ranges, with high VLs. Subtype A remains predominant and there are mutations conferring resistance to ART.
Introduction: Viral load suppression is a key determinant of successful anti-retroviral therapy. The study aimed to determine virologic response to Antiretroviral therapy in the large cohort of children and adults living with Human Immune deficiency Virus. Materials and Methods: Viral Load results from the HIV Ribonucleic Acid Polymerase Chain Reaction register of 10,887 children and adults on cART in 4 states in Northern Nigeria between 2017 and 2019 were retrieved and analyzed in the PCR Molecular Laboratory of the Federal Teaching Hospital, Gombe. Results: 10,887 children and adults were analyzed. Males were 28.4% (3094) and 71.6% (7793) females. 2.9% (311); 3.5% (386); 7.3% (797); 65.2% (7098); 14.5% (1583); 5.2% (562) and 1.3% (150) were aged 0 - 9 years, 11 - 18 years; 19 - 25 years, 26 - 45 years; 46 - 55 years; 56 - 65 years and 10 years. The most recent CD4count before viral load request was ≥1000/μL in 7.4% (810/10887); 500 -999/μL in 39.0% (4240); 350 - 499 μL in 22.7% (2466) and 1000 c/mL in 26.5% (821/3094) males and 24.1% (1876/7793) females. Viral load was significantly lower among females (p-value 0.007). 50.5% (157/311); 52.1% (201/386); 28.5% (227/797); 23.5% (1670/7098); 19.9% (315/1583); 17.8% (100/562) and 18.0% (27/150) aged 0 - 9 years, 11 - 18 years; 19 - 25 years, 26 - 45 years; 46 - 55 years; 56 - 65 years and 1000 c/mL respectively. Viral load was >1000 c/mL in 28.2% (229/811) for those on HAART for 6 months - 1 year and 23.6% (1243/5275) after receiving Highly Active Antiretroviral Therapy (HAART) for 1 - 5 years. 26.3% (1072/4075) and 21.1% (153/726) had viral load > 1000 c/mL after receiving HAART for 6 - 10 and >10 years respectively (p-value 0.001). Conclusion: HIV viral suppression was below the WHO recommended threshold.
Background: The burden of COVID-19 and human immunodeficiency virus (HIV) are some of the major and persistent global health challenges of the twenty-first century.HIV and COVID-19 are expected to overlap in high HIV-burden countries, posing several public health challenges as a result.Prisons are overcrowded, have limited space for social distancing and have inadequate ventilation systems, making it difficult to contain the spread of COVID-19 in addition to the high-risk behaviours of inmates which contribute to the spread of HIV within these facilities.This study aimed to determine the prevalence of COVID-19 among inmates in a prison facility with a relatively high HIV burden in Port Harcourt, Nigeria; investigating potential risk factors and co-infection with HIV.Methodology: The study employed a descriptive cross-sectional study design sampling 200 inmates from the Port Harcourt Maximum Security Custodial Centre from July to December 2022.A well-structured questionnaire was administered via interviews in addition to screening for HIV-1/2 antibodies as well as COVID-19 antigens using rapid diagnostic test kits.Descriptive statistics and chi-square were carried out on the GraphPad Prism 9 software with statistical significance defined as a
