Detection of Early HIV-1 Infection among Febrile Persons and Blood Donors in Oyo State, Nigeria

AbstractAbout 37.9 million persons are infected with HIV globally resulting in 770,000 deaths. Over 50% of this infection and deaths occur in Sub-Saharan Africa with countries like Nigeria greatly affected. The country also has one of the highest rate of new infections globally. Diverse HIV-1 subtypes have been identified in the country. Febrile persons and blood donors pose a great transmission risk in the country especially during the early stages of infection. HIV-1 rapid kits are routinely used for diagnosis among the general population and high risk groups. However, there is limited information on the usefulness of HIV rapid kits for early detection especially in areas where diverse HIV-1 subtypes circulate. In this study, the prevalence of early HIV-1 infection as well as circulating HIV-1 subtypes among febrile persons and blood donors were determined. Furthermore, the sensitivity of a widely used HIV-1 rapid antibody kit was compared with those of Antigen/Antibody ELISA based methods. Participants were recruited from selected hospitals in Ibadan and Saki, Nigeria. The prevalence of early HIV infection among 1028 febrile persons (Ibadan: 2.22%; Saki: 1.36%) and blood donors (5.07%) studied were significantly different (P<0.03674). CRF02_AG was the predominant subtype detected with more diverse HIV-1 subtypes observed among febrile persons compared to blood donors. About 1.2% of the samples detected on Antibody based ELISA methods were undetectable on the HIV-1 rapid antibody kit. Genetic diversity of HIV-1 strains among infected individuals in Oyo State, Nigeria is still relatively high. This diversity is likely impacting on diagnosis.

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The Role of Phylogenetics in Discerning HIV-1 Mixing among Vulnerable Populations and Geographic Regions in Sub-Saharan Africa: A Systematic Review

Viruses ◽

10.3390/v13061174 ◽

2021 ◽

Vol 13 (6) ◽

pp. 1174

Author(s):

George M. Nduva ◽

Jamirah Nazziwa ◽

Amin S. Hassan ◽

Eduard J. Sanders ◽

Joakim Esbjörnsson

Keyword(s):

Risk Group ◽

Risk Groups ◽

Phylogenetic Inference ◽

Sub Saharan Africa ◽

Transmission Dynamics ◽

Source Attribution ◽

Transmission Networks ◽

Sub Saharan ◽

Hiv 1

To reduce global HIV-1 incidence, there is a need to understand and disentangle HIV-1 transmission dynamics and to determine the geographic areas and populations that act as hubs or drivers of HIV-1 spread. In Sub-Saharan Africa (sSA), the region with the highest HIV-1 burden, information about such transmission dynamics is sparse. Phylogenetic inference is a powerful method for the study of HIV-1 transmission networks and source attribution. In this review, we assessed available phylogenetic data on mixing between HIV-1 hotspots (geographic areas and populations with high HIV-1 incidence and prevalence) and areas or populations with lower HIV-1 burden in sSA. We searched PubMed and identified and reviewed 64 studies on HIV-1 transmission dynamics within and between risk groups and geographic locations in sSA (published 1995–2021). We describe HIV-1 transmission from both a geographic and a risk group perspective in sSA. Finally, we discuss the challenges facing phylogenetic inference in mixed epidemics in sSA and offer our perspectives and potential solutions to the identified challenges.

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Systematic Identification of Correlates of HIV-1 Infection: An X-Wide Association Study in Zambia

10.1101/126052 ◽

2017 ◽

Author(s):

Chirag J. Patel ◽

Jay Bhattacharya ◽

John P.A. Ioannidis ◽

Eran Bendavid

Keyword(s):

Association Study ◽

Univariate Analysis ◽

Area Under The Curve ◽

Risk Groups ◽

Sub Saharan Africa ◽

Demographic And Health Surveys ◽

History Of ◽

Nationally Representative ◽

Sub Saharan ◽

Hiv 1

AbstractBackgroundHIV-1 remains the leading cause of death among adults in Sub-Saharan Africa, and over 1 million people are infected annually. Better identification of at-risk groups could benefit prevention and treatment programmes. We systematically identified factors related to HIV-1 infection in two nationally representative cohorts of women that participated in Zambia’s Demographic and Health Surveys (DHS).MethodsWe conducted a comprehensive analysis to identify and replicate the association of 1,415 social, economic, environmental, and behavioral indicators with HIV-1 status. We used the 2007 and 2013-2014 DHS surveys conducted among 5,715 and 15,433 Zambian women, respectively (727 indicators in 2007; 688 in 2013-2014; 688 in both). We used false discovery rate criteria to identify indicators that are strongly associated with HIV-1 in univariate and multivariate models in the entire population, as well as in subgroups stratified by wealth, residence, age, and history of HIV-1 testing.FindingsIn the univariate analysis we identified 102 and 182 variables that are associated with HIV-1 in the 2007 and 2013-2014 surveys, respectively, among which 79 were associated in both. Variables that were associated with HIV-1 status in all full-sample models (unadjusted and adjusted) as well as in at least 17 out of 18 subgroups include being formerly in a union (adjusted OR 2007 2.8, p<10−16; 2013-2014 2.8, p<10−29), widowhood (adjusted OR 2007 3.7, p<10−12; 2013-2014 4.2, p<10−30), history of genital ulcers in the last 12 months (adjusted 2007 OR 2.4, p<10−5; 2013-2014 2.2, p<10−6), and having a woman for the head of the household (2007 OR 1.7, p<10−7; 2013-2014 OR 2.1, p<10−26), while owning a bicycle (adjusted 2007 OR 0.6, p<10−6; 2013-2014 0.6, p<10−8) and currently breastfeeding (adjusted 2007 OR 0.5, p<10−9; 2013-2014 0.4, p<10−26) were associated with decreased risk. Using the identified variables, area under the curve for HIV-1 positivity ranged from 0.76 to 0.82.InterpretationOur X-wide association study in Zambian women identifies multiple under-recognized factors correlated with HIV-1 infection in 2007 and 2013-2014, including widowhood, breastfeeding, and being the head of the household. These variables could be used to improve HIV-1 testing and identification programs.

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Cost effectiveness of single-dose nevirapine regimen for mothers and babies to decrease vertical HIV-1 transmission in sub-Saharan Africa

The Lancet ◽

10.1016/s0140-6736(99)07420-6 ◽

1999 ◽

Vol 354 (9185) ◽

pp. 803-809 ◽

Cited By ~ 43

Author(s):

E Marseille

Keyword(s):

Single Dose ◽

Cost Effectiveness ◽

Sub Saharan Africa ◽

Single Dose Nevirapine ◽

Sub Saharan ◽

Hiv 1

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Active Components from Cassia abbreviata Prevent HIV-1 Entry by Distinct Mechanisms of Action

International Journal of Molecular Sciences ◽

10.3390/ijms22095052 ◽

2021 ◽

Vol 22 (9) ◽

pp. 5052

Author(s):

Yue Zheng ◽

Xian-Wen Yang ◽

Dominique Schols ◽

Mattia Mori ◽

Bruno Botta ◽

...

Keyword(s):

Crude Extract ◽

Female Genital Tract ◽

Binding Activity ◽

Sub Saharan Africa ◽

Active Components ◽

Chemical Structures ◽

3D Space ◽

In Silico Study ◽

Sub Saharan ◽

Hiv 1

Cassia abbreviata is widely used in Sub-Saharan Africa for treating many diseases, including HIV-1 infection. We have recently described the chemical structures of 28 compounds isolated from an alcoholic crude extract of barks and roots ofC. abbreviata, and showed that six bioactive compounds inhibit HIV-1 infection. In the present study, we demonstrate that the six compounds block HIV-1 entry into cells: oleanolic acid, palmitic acid, taxifolin, piceatannol, guibourtinidol-(4α®8)-epiafzelechin, and a novel compound named as cassiabrevone. We report, for the first time, that guibourtinidol-(4α®8)-epiafzelechin and cassiabrevone inhibit HIV-1 entry (IC50 of 42.47 µM and 30.96 µM, respectively), as well as that piceatannol interacts with cellular membranes. Piceatannol inhibits HIV-1 infection in a dual-chamber assay mimicking the female genital tract, as well as HSV infection, emphasizing its potential as a microbicide. Structure-activity relationships (SAR) showed that pharmacophoric groups of piceatannol are strictly required to inhibit HIV-1 entry. By a ligand-based in silico study, we speculated that piceatannol and norartocarpetin may have a very similar mechanism of action and efficacy because of the highly comparable pharmacophoric and 3D space, while guibourtinidol-(4α®8)-epiafzelechin and cassiabrevone may display a different mechanism. We finally show that cassiabrevone plays a major role of the crude extract of CA by blocking the binding activity of HIV-1 gp120 and CD4.

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The HIV transmission risk factors and opportunities for use of mHealth in HIV prevention among emerging adult population in the Sub-Saharan Africa context: a review of the literature

International Journal of Health Promotion and Education ◽

10.1080/14635240.2021.1995464 ◽

2021 ◽

pp. 1-15

Author(s):

Augustine B Kiplagat ◽

Peninnah M Kako ◽

Lucy Mkandawire-Valhmu ◽

Dinah Chelagat ◽

Seok Hyun Gwon ◽

...

Keyword(s):

Risk Factors ◽

Hiv Prevention ◽

Hiv Transmission ◽

Adult Population ◽

Emerging Adult ◽

Sub Saharan Africa ◽

Transmission Risk ◽

Review Of The Literature ◽

Sub Saharan ◽

Hiv Transmission Risk

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A Randomized Switch From Nevirapine-Based Antiretroviral Therapy to Single Tablet Rilpivirine/Emtricitabine/Tenofovir Disoproxil Fumarate in Virologically Suppressed Human Immunodeficiency Virus-1-Infected Rwandans

Open Forum Infectious Diseases ◽

10.1093/ofid/ofw141 ◽

2016 ◽

Vol 3 (3) ◽

Cited By ~ 2

Author(s):

Sean E. Collins ◽

Philip M. Grant ◽

Francois Uwinkindi ◽

Annie Talbot ◽

Eric Seruyange ◽

...

Keyword(s):

Human Immunodeficiency Virus ◽

Antiretroviral Therapy ◽

Tenofovir Disoproxil Fumarate ◽

Sub Saharan Africa ◽

Current Therapy ◽

Virologic Suppression ◽

Open Label ◽

Immunodeficiency Virus ◽

Sub Saharan ◽

Hiv 1

Abstract Background. Many human immunodeficiency virus (HIV)-infected patients remain on nevirapine-based antiretroviral therapy (ART) despite safety and efficacy concerns. Switching to a rilpivirine-based regimen is an alternative, but there is little experience with rilpivirine in sub-Saharan Africa where induction of rilpivirine metabolism by nevirapine, HIV subtype, and dietary differences could potentially impact efficacy. Methods. We conducted an open-label noninferiority study of virologically suppressed (HIV-1 ribonucleic acid [RNA] < 50 copies/mL) HIV-1-infected Rwandan adults taking nevirapine plus 2 nucleos(t)ide reverse-transcriptase inhibitors. One hundred fifty participants were randomized 2:1 to switch to coformulated rilpivirine-emtricitabine-tenofovir disoproxil fumarate (referenced as the Switch Arm) or continue current therapy. The primary efficacy endpoint was HIV-1 RNA < 200 copies/mL at week 24 assessed by the US Food and Drug Administration Snapshot algorithm with a noninferiority margin of 12%. Results. Between April and September 2014, 184 patients were screened, and 150 patients were enrolled; 99 patients switched to rilpivirine-emtricitabine-tenofovir, and 51 patients continued their nevirapine-based ART. The mean age was 42 years and 43% of participants were women. At week 24, virologic suppression (HIV-1 RNA level <200 copies/mL) was maintained in 93% and 92% in the Switch Arm versus the continuation arm, respectively. The Switch Arm was noninferior to continued nevirapine-based ART (efficacy difference 0.8%; 95% confidence interval, −7.5% to +12.0%). Both regimens were generally safe and well tolerated, although 2 deaths, neither attributed to study medications, occurred in participants in the Switch Arm. Conclusions. A switch from nevirapine-based ART to rilpivirine-emtricitabine-tenofovir disoproxil fumarate had similar virologic efficacy to continued nevirapine-based ART after 24 weeks with few adverse events.

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HIV-1 Full-Genome Phylogenetics of Generalized Epidemics in Sub-Saharan Africa: Impact of Missing Nucleotide Characters in Next-Generation Sequences

AIDS Research and Human Retroviruses ◽

10.1089/aid.2017.0061 ◽

2017 ◽

Vol 33 (11) ◽

pp. 1083-1098 ◽

Cited By ~ 9

Author(s):

Oliver Ratmann ◽

Chris Wymant ◽

Caroline Colijn ◽

Siva Danaviah ◽

Max Essex ◽

...

Keyword(s):

Sub Saharan Africa ◽

Full Genome ◽

Next Generation ◽

Sub Saharan ◽

Hiv 1

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Genetic diversity of trypanosome species in tsetse flies (Glossina spp.) in Nigeria

Parasites & Vectors ◽

10.1186/s13071-019-3718-y ◽

2019 ◽

Vol 12 (1) ◽

Cited By ~ 1

Author(s):

Judith Sophie Weber ◽

Sen Claudine Henriette Ngomtcho ◽

Stephen Saikiu Shaida ◽

Gloria Dada Chechet ◽

Thaddeus Terlumun Gbem ◽

...

Keyword(s):

Genetic Diversity ◽

Protected Areas ◽

National Parks ◽

Sub Saharan Africa ◽

Tsetse Flies ◽

Insect Vector ◽

Limited Information ◽

Sub Saharan ◽

Dynamic Populations

Abstract Background Trypanosomes cause disease in humans and livestock in sub-Saharan Africa and rely on tsetse flies as their main insect vector. Nigeria is the most populous country in Africa; however, only limited information about the occurrence and diversity of trypanosomes circulating in the country is available. Methods Tsetse flies were collected from five different locations in or adjacent to protected areas, i.e. national parks and game reserves, in Nigeria. Proboscis and gut samples were analysed for trypanosome DNA by molecular amplification of the internal transcribed spacer 1 (ITS1) region and part of the trypanosome specific glycosomal glyceraldehyde-3-phosphate dehydrogenase (gGAPDH) gene. Results The most abundant Trypanosoma species found in the tsetse gut was T. grayi, a trypanosome infecting crocodiles. It was ubiquitously distributed throughout the country, accounting for over 90% of all cases involving trypanosomes. Trypanosoma congolense was detected in gut samples from all locations except Cross River National Park, but not in the proboscis, while T. brucei (sensu lato) was not detected at all. In proboscis samples, T. vivax was the most prominent. The sequence diversity of gGAPDH suggests that T. vivax and T. grayi represent genetically diverse species clusters. This implies that they are highly dynamic populations. Conclusions The prevalence of animal pathogenic trypanosomes throughout Nigeria emphasises the role of protected areas as reservoirs for livestock trypanosomes. The genetic diversity observed within T. vivax and T. grayi populations might be an indication for changing pathogenicity or host range and the origin and consequences of this diversity has to be further investigated.

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The risk of hepatitis B virus infection by transfusion in Kumasi, Ghana

Blood ◽

10.1182/blood-2002-04-1084 ◽

2003 ◽

Vol 101 (6) ◽

pp. 2419-2425 ◽

Cited By ~ 102

Author(s):

Jean-Pierre Allain ◽

Daniel Candotti ◽

Kate Soldan ◽

Francis Sarkodie ◽

Bruce Phelps ◽

...

Keyword(s):

Hepatitis B Virus ◽

Hepatitis B ◽

Blood Donors ◽

Hepatitis B Surface Antigen ◽

Hbv Dna ◽

Hbv Infection ◽

Sub Saharan Africa ◽

B Virus ◽

Sub Saharan ◽

Hbv Transmission

The risk of hepatitis B virus (HBV) transmission by transfusion in sub-Saharan Africa is considered to be relatively low, and testing of blood donors is often not done or is done relatively poorly. To re-examine this attitude, we identified HBV chronically infected blood donors from a major hospital in Ghana with a range of hepatitis B surface antigen (HBsAg) assays. Test efficacy was estimated using HBV DNA as a gold standard, and the risk of HBV infection in blood recipients was estimated for different testing strategies. Particle agglutination, dipstick, and enzyme immunoassay (EIA) HBsAg screening detected 54%, 71%, and 97% of HBV infectious donors, respectively. The risk of HBV transmission to recipients less than 10 years old ranged between 1:11 and 1:326 with blood unscreened and screened by EIA, respectively. For older recipients, the risk decreased a further 4-fold because of the high frequency of natural exposure to HBV. A total of 98% of HBsAg-confirmed positive samples contained HBV DNA. HBV DNA load was less than 1 × 104 IU/mL in 75% of HBsAg-reactive samples, most of them anti-HBe reactive. Approximately 0.5% of HBsAg-negative but anti-HBc-positive samples contained HBV DNA. The use of sensitive HBsAg tests is critical to prevent transfusion transmission of HBV infection to young children in a population with a 15% prevalence of chronic HBV infection in blood donors. However, this will not have much effect on the prevalence of this infection unless other strategies to protect children from infection are also advanced in parallel.

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