Baseline Laboratory Profile of HIV Positive Patients on Antiretroviral Therapy in Jos North Central Nigeria: Implications for Pre-vention, Treatment, Care and Support

Christian Ogoegbunem Isichei^1,2, Mercy Wakili Isichei^2,3, Jean Emile Njab⁴, Johnson Ibidun Rotimi², Tinuade Abimbola Oyebode^5,6, Charles Ujunwa Anyaka^2,5, Kenneth Emeka Enwerem², Ayuba Ishiaku Affi¹, Lucius Chidiebere Imoh¹, Alexander Ogielu Abu¹, Solomon Abiola Asorose¹, Noel Omuya Amadu¹, Propser Ihenacho Okonkwo⁶, Ngozi Ijeoma Okoro⁴

¹Department of Chemical Pathology, Faculty of Medical Sciences, University of Jos, Jos University Teaching Hospital, Jos, Nigeria.
²Faith Alive Foundation, Jos, Nigeria.
³Department of Surgery, Faculty of Medical Sciences, University of Jos, Jos University Teaching Hospital, Jos, Nigeria.
⁴Department of Chemical Pathology, Bingham University, Jos Campus, Jos, Nigeria.
⁵Department of Obstetrics and Gynaecology, Faculty of Medical Sciences, University of Jos, Jos, Nigeria.
⁶AIDS Prevention Initiative in Nigeria (APIN), Abuja, Nigeria.

DOI: 10.4236/wja.2015.54036                

Abstract

Background: We characterized baseline laboratory data of patients to identify priority treatment areas, most affected populations, anticipated clinical complications and assessed the potential burden of retention in care in Jos, Plateau State—North Central Nigeria. Methods: This study was a cross-sectional design from January 2004 to December 2005 at Faith Alive Foundation (FAF). All participants were HIV-positive and underwent pre-antiretroviral therapy counseling based on the national antiretroviral therapy (ART) guidelines and baseline laboratory testing. Data were captured on Microsoft Excel, validated on Epi Info and analyzed on SPSS version 21 at P < .05 level of significance. Results: Total of 1499 (463 men and 1036 women) participants were evaluated in this study. The age and sex related distribution of participants showed that majority (80.3% for males and 92.5% for females) were 16 - 45 years old. Amylase and creatinine were significantly higher in males than females (P = .02). Anaemia was the most common baseline abnormality (63% for females and 58% for males), while baseline CD4 count was significantly lower in males than females (P < .02) and at one-third had elevated liver enzymes (AST and ALT). Conclusion: The baseline laboratory profile of most HIV positive patients in Jos and environs of North Central–Nigeria was characterized by anaemia, elevated creatinine, and abnormal liver transaminase levels (AST and ALT). This pre-ART laboratory result suggests that HIV-positive individuals have multiple clinical abnormalities which may require more extensive care than just treating the HIV disease.

Keywords

Baseline Laboratory Profile, HIV-Positive Patients, PEPFAR, HTC, Nigeria

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Global Report (2014) UNAIDS Report on Global AIDS Epidemic, 4.
[2]	UNAIDS (2014) Beginning the End of the AIDS Epidemic. The GAP Report, 262-4.
[3]	Dixon, S., McDonald, S. and Roberts, J. (2002) The Impact of HIV and AIDS on Africa’s Economic Development. BMJ, 324, 232-234. http://dx.doi.org/10.1136/bmj.324.7331.232
[4]	Federal Republic of Nigeria (2014) Global AIDS Response Country Progress Report (GARPR).
[5]	Federal Ministry of Health [Nigeria] (2013) National HIV & AIDS and Reproductive Health Survey, 2012 (NARHS Plus). Federal Ministry of Health Abuja, Nigeria, 10.
[6]	Fasakin, K.A., Omisakin, C.T., Esan, A.J., Adebara, I.O., Owoseni, I.S., Omoniyi, D.P., Ajayi, O.D., Ogundare, R.G. and Moronkeji, M.B. (2014) Total and CD4+ T-Lymphocyte Count Correlation in Newly Diagnosed HIV Patients in Resource-Limited Setting. Journal of Medical Laboratory and Diagnosis, 5, 22-28.
[7]	World Health Organization (2006) Patient Monitoring Guidelines for HIV Care and Antiretroviral Therapy. World Health Organization, Geneva.
[8]	Isichei, C.O. and Ammann, A.J. (2015) The Role of Trained Birth Attendants in Delivering PMTCT Services. American Journal of Health Research, 3, 232-238.
[9]	Federal Ministry of Health [Nigeria] (2013) National HIV & AIDS and Reproductive Health Survey, 2012 (NARHS Plus). Federal Ministry of Health Abuja, Nigeria, 276-277.
[10]	Nwokedi, E.E., Ochicha, O., Mohammed, A.Z. and Saddiq, M.N. (2007) Baseline CD4 Lymphocyte Count among HIV Patients in Kano, Norther Nigeria. African Journal of Health Sciences, 14, 3-4.
[11]	Derbe, M., Monga, D.P. and Daka, D. (2013) Immunological Response among HIV/AIDS Patients before and after ART Therapy at Zewuditu Hospital Addis Ababa, Ethiopia. American Journal of Research Communication, 1, 104-115.
[12]	Kamga, H.L.F., Assob, J.C.N., Njunda, A.L., Nde Fon, P., Nsagha, D.S., Atanga, M.B.S., Weledji, P., Puinta, D.P. and Achidi, E.A. (2011) The Kidney Function Trends in Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) Patients at the Nylon District Hospital, Douala, Cameroon. Journal of AIDS and HIV Research, 3, 30-37.
[13]	Agbaji, O.O., Onu, A., Agbaji, P.E., Muazu, M.A., Falang, K.D. and Idoko, J.A. (2011) Predictors of Impaired Renal Function among HIV Infected Patients Commencing ART in Jos-Nigeria. Nigeria Medical Journal, 52, 182-185. http://dx.doi.org/10.4103/0300-1652.86133
[14]	Martin, C., Poudel-Tandukar, K. and Poudel, K.C. (2014) HIV Symptom Burden and Anemia among HIV Positive Individuals: Cross-Sectional Results of a Community Based Positive Living with HIV (POLH) Study in Nepal. PLoS ONE, 9, e116263.
[15]	Takuva, S., Maskew, M., Brennan, A.T., Sanne, I., MacPhail, A.P. and Fox, M.P. (2013) Anemia among HIV-Infected Patients Initiating Antiretroviral Therapy in South Africa: Improvement in Hemoglobin Regardless of Degree of Immunosuppression and the Initiating ART Regimen. Journal of Tropical Medicine, 2013, Article ID: 162950.
[16]	Assefa, M., Abegaz, W.E., Shewamane, A., Medhin, G. and Belay, M. (2015) Prevalence and Correlates of Anemia among HIV Infected Patients on ART at Zewditu Memorial Hospital, Ethiopia. BMC Hematology, 15, 6.
[17]	Zhang, Y.X., Gui, X.E., Zhong, Y.H., Rong, Y.P. and Yan, Y.J. (2011) Cancer in Cohort of HIV-Infected Population: Prevalence and Clinical Characteristics. Journal of Cancer Research and Clinical Oncology, 137, 609-614. http://dx.doi.org/10.1007/s00432-010-0911-y
[18]	Panos, G., Farouk, L., Stebbing, J., Holmes, P., Valero, S., Randell, P., Bower, M., Gazzard, B., Anderson, M. and Nelson, M. (2009) Cryptogenic Pseudo Cirrhosis: A New Clinical Syndrome of Non-Cirrhotic Portal Hypertension (Unassociated with Advanced Fibrosis) That Can Be Detected by Transient Elastography in Patients with HIV. Journal of Acquired Immune Deficiency Syndromes, 52, 525-527. http://dx.doi.org/10.1097/QAI.0b013e3181bb27b1
[19]	Crum-Cianflone, N., Dilay, A., Collins, G., Asher, D., Campin, R., Medina, S., Goodman, Z., Parker, R., Lifson, A., Capozza, T., Bavaro, M., Hale, B. and Hames, C. (2009) Nonalcoholic Fatty Liver Disease among HIV-Infected Persons. Journal of Acquired Immune Deficiency Syndromes, 50, 464-473. http://dx.doi.org/10.1097/QAI.0b013e318198a88a
[20]	Chang, P.E., Miquel, R., Blanco, J.L., Laguno, M., Bruguera, M., Abraldes, J.G., Bosch, J. and Garcia-Pagan, J.C. (2009) Idiopathic Portal Hypertension in Patients with HIV Infection Treated with Highly Active Antiretroviral Therapy. American Journal of Gastroenterology, 104, 1707-1714. http://dx.doi.org/10.1038/ajg.2009.165
[21]	Crane, M., Iser, D. and Lewin, S.R. (2012) Human Immunodeficiency Virus Infection and the Liver. World Journal of Hepatology, 4, 91-98. http://dx.doi.org/10.4254/wjh.v4.i3.91
[22]	Steffan, A.M., Lafon, M.E., Gendrault, J.L., Schweitzer, C., Royer, C., Jaeck, D., Arnaud, J.P., Schmitt, M.P., Aubertin, A.M. and Kirn, A. (1992) Primary Cultures of Endothelial Cells from the Human Liver Sinusoid Are Permissive for Human Immunodeficiency Virus Type 1. Proceedings of the National Academy of Sciences USA, 89, 1582-1586. http://dx.doi.org/10.1073/pnas.89.5.1582