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The impact of HIV-1 subtypes on virologic and immunologic treatment outcomes at the Lagos University Teaching Hospital: A longitudinal evaluation.

ABSTRACT: INTRODUCTION:HIV is a highly diverse virus with significant genetic variability which may confer biologic differences that could impact on treatment outcomes. MATERIALS AND METHODS:We studied the association between HIV subtypes and immunologic and virologic outcomes in a longitudinal cohort of 169 patients on combination antiretroviral therapy. Participants were followed up for 5 years. Demographic data, CD4 cell count and viral loads (VL) were extracted from medical records. Whole protease gene and codon 1-300 of the reverse transcriptase gene were sequenced and analysed. RESULTS:Sixty-four percent of participants were females with a median age of 35 years. Twelve different subtypes were observed, the commonest being CRF 02_AG (55.0%) and subtypes G (23.1%). All subtypes showed steady rise in CD4 count and there was no difference in proportion who achieved CD4+ cell count rise of ?100 cells/?L from baseline within 12 months' post-initiation of ART, or ?350 cells/?L at 60 months' post-initiation. Median time to attaining a rise of ?350 cells/?L was 24 months (6-48 months). The proportion that achieved undetectable VL at month 6 and 12 post-initiation of ART were comparable across subtypes. At end of 5th year, there was no statistical difference in proportion with virologic failure. CONCLUSION:No association between HIV subtypes and immunologic or virologic response to therapy was observed, suggesting that current first-line ART may have similar efficacy across subtype predominating in South-West Nigeria.

SUBMITTER: Ogbenna AA

PROVIDER: S-EPMC7447033 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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The impact of HIV-1 subtypes on virologic and immunologic treatment outcomes at the Lagos University Teaching Hospital: A longitudinal evaluation.

Ogbenna Ann Abiola AA Meloni Seema S Inzaule Seth S Hamers Raph L RL Sigaloff Kim K Osibogun Akin A Adeyemo Titilope Adenike TA Okonkwo Prosper P Samuels Jay Osi JO Kanki Phyllis J PJ Rinke de Wit Tobias F TF Akanmu Alani Sulaimon AS

PloS one 20200825 8

<h4>Introduction</h4>HIV is a highly diverse virus with significant genetic variability which may confer biologic differences that could impact on treatment outcomes.<h4>Materials and methods</h4>We studied the association between HIV subtypes and immunologic and virologic outcomes in a longitudinal cohort of 169 patients on combination antiretroviral therapy. Participants were followed up for 5 years. Demographic data, CD4 cell count and viral loads (VL) were extracted from medical records. Who ...[more]

PMID: 32841264

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Project description:BACKGROUND:Lead toxicity is a cause of intellectual disability in children and majority of affected children live in developing countries. Its adverse effect on pregnancy outcome has also been documented. OBJECTIVES:To assess the relationship between maternal blood lead levels and umbilical cord blood lead levels in their corresponding newborn infants; to determine factors associated with high blood lead levels and the pregnancy outcome in participants. MATERIALS AND METHODS:This was a cross-sectional descriptive study carried out at a tertiary Teaching Hospital, Lagos, Nigeria. Four hundred and forty pregnant women and their respective newborns delivered at the study centre. Blood samples were obtained from the mothers and umbilical cord of the newborns at delivery and analysed by atomic absorption spectrophotometry. Socio-demographic and obstetric data was obtained by questionnaires administered to the mothers. The anthropometric measurements of the babies were taken at birth and clinical data recorded. Main outcome measures were blood lead levels in mother and baby pair, socio-demographic factors, birth weight, gestational age, length, occipito-frontal circumference. RESULTS:The median maternal and umbilical blood lead level was 64.3μg/dl and 39.2μg/dl respectively. The levels were above 5μg/dl in 75.6% and 66.8% of mothers and umbilical cord respectively. There was a strong positive correlation between the maternal and umbilical cord blood lead levels (rs = 0.80). Use of calcium supplements during pregnancy was significantly associated with a lower maternal blood lead level (p = 0.010) while recent painting and renovation of residential accommodation were associated with a higher umbilical cord blood lead level (p = 0.025). There were no statistically significant associations between the maternal and umbilical cord blood lead levels and the gestational age and anthropometry of the newborns at birth. CONCLUSIONS:The blood lead levels in newborns of women residing in Lagos, Nigeria are high and administration of antenatal calcium is associated with lower blood lead levels.

Project description:IntroductionHE are common acute complications of diabetes mellitus (DM) and include diabetic ketoacidosis (DKA), normo-osmolar hyperglycemic state (NHS) and hyperosmolar hyperglycemic state (HHS). They contribute a lot to the mortality and morbidity of DM. The clinical features include dehydration, hyperglycemia, altered mental status and ketosis. The basic mechanism of HE is a reduction in the net effective action of circulating insulin, resulting in hyperglycemia and ketonemia (in DKA) causing osmotic diuresis and electrolytes loss. Infection is a common precipitating factor. Measurement of serum C-peptide provides an accurate assessment of residual β-cell function and is a marker of insulin secretion in DM patients.Aim and objectivesTo assess the level of pancreatic beta cell function in HE patients, using the serum C-peptide.MethodologyThe biodata and clinical characteristics of the 99 subjects were collated using a questionnaire. All subjects had their serum C-peptide, glucose, electrolytes, urea, creatinine levels, urine ketones determined at admission. Results of statistical analysis were expressed as mean ± standard deviation (SD). A p value <0.05 was regarded statistically significant. Correlation between levels of serum C-peptide and admission blood glucose levels and the duration of DM respectively was done.ResultsThe mean age of the subjects was 51 (SD ± 16) years and comparable in both sexes. Mean duration of DM was 6.3 (SD ± 7.1) years, with 35% newly diagnosed at admission. The types of HE in this study are: DKA (24.7%), NHS (36.1%), and HHS (39.2%). Mean blood glucose in this study was 685 mg/dL, significantly highest in HHS and lowest in NHS. Mean serum C-peptide level was 1.6 ng/dL. It was 0.9 ng/dL in subjects with DKA and NHS while 2.7 ng/dL in HHS (p>0.05). Main precipitating factors were poor drug compliance, new-onset of DM and infection.ConclusionMost (70%) of subjects had poor pancreatic beta cell function, this may be a contributory factor to developing HE. Most subjects with high C-peptide levels had HHS.

Dataset Information

The impact of HIV-1 subtypes on virologic and immunologic treatment outcomes at the Lagos University Teaching Hospital: A longitudinal evaluation.

Publications

The impact of HIV-1 subtypes on virologic and immunologic treatment outcomes at the Lagos University Teaching Hospital: A longitudinal evaluation.

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