Coinfections of Human Immunodefiency Virus and Sexually Transmitted Infections Among HIV Seropositive Pregnant Women at Healthcare Centres in Akure, Southwestern Nigeria
Keywords:STDs, Coinfection, HIV, CD4 Cells, Viral Load, Liver Enzymes, Pregnancy.
Background: Sexually transmitted infections (STIs) represent significant risk factors for HIV transmission and adverse fetal complications in pregnancy. We tested 240 pregnant women for their HIV serostatus and for the effects of HIV-STI coinfections on CD4+ cell counts and on HIV plasma viral load. The study was conducted at four antenatal clinics in Akure, Ondo State of Nigeria between November 2014 and December 2015.
Methods: The HIV-1/2 strip was used for preliminary determination of HIV serostatus and this was followed by a confirmatory Abbott enzyme-linked immunosorbent assay (ELISA) procedure. CD4+ T-cell counts were done by cytometric analysis while viral load was determined by COBASÂ® AmpliPrep TaqMan HIV-1 procedure. Liver enzymes were determined by an automated chemistry analyzer. Detection of hepatitis B virus (HBV), hepatitis C virus (HCV), human papilloma virus-6 (HPV-6) and herpes simplex virus type-2 (HSV-2) were determined by ELISA. The syphilis VDRL test was done by the rapid plasma reagin procedure, while Trichomonas vaginalis infection was demonstrated by the wet mount procedure. Infections with Chlamydia trachomatis and Neisseria gonorrhoeae were determined respectively by ELISA and by culture on proteose peptone agar supplemented with 5% serum.
Results: The results show prevalence of STIs in 33.3% of the 240 study participants; 77.5% for HIV seropositive and 22.5% for seronegative subjects. Trichomonas vaginalis constituted the highest isolate Coinfections in 50% of HIV seropositive subjects and 22.2% for seronegative controls. HIV-HBV coinfection occurred among 7 individuals while HIVHBV-TV coinfection occurred in 4 individuals. The results also showed elevated titers of alanine aminotransferase (ALT), creatinine and total bilirubin liver enzymes in both HIV-HBV coinfection and HBV monoinfection. HIV viral loads were twice as high in HIV-HBV coinfection relative to HBV mono- infection.
Conclusion: The prevalence of STIs was significantly high at 54.4% among HIV seropositive pregnant women as compared to 14.3% for HIV seronegative pregnant women. T. vaginalis was the highest isolate at 50% in HIV seropositive subjects and may therefore be a driving factor for HIV transmission and susceptibility as very few T. vaginalis infections were recorded in control subjects.
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