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   Table of Contents - Current issue
Coverpage
January-June 2016
Volume 4 | Issue 1
Page Nos. 1-26

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REVIEW ARTICLE  

Policy brief on increasing partner disclosure among human immunodeficiency virus-infected persons in stable relationship in Nigeria p. 1
Layi S Babatunde, Oluwaseyi T Babatunde, Susan M Oladeji
DOI:10.4103/2321-9157.210593  
Human immunodeficiency virus (HIV) infection contributes significantly to early death. Rate of partner disclosure is low among HIV-infected person in stable relationship preventing uptake of HIV prevention, treatment, and care by partners. Persons in stable relationship account for about 50% new infection in Nigeria largely resulting from nondisclosure by HIV-infected partner. Partner notification (PN) strategies are available for HIV-infected persons in stable relationship. In spite of the perceived barriers to partner disclosure among HIV-infected persons in stable relationship, there is ample evidence they will positively respond to PN service. The incorporation of PN strategy into the 2014 Integrated National Guideline for HIV Prevention, Treatment, and Care has created a window of opportunity for local action on PN in HIV-infected persons in stable relationship. This evidence brief summarizes available evidence on PN strategies for increasing PN among HIV-infected persons in stable relationship. The evidence brief is intended to contribute to the local implementation strategy on PN in HIV prevention, treatment, and care as specified in the Integrated National Guidelines for HIV Prevention, Treatment, and Care in Nigeria. It is also aimed at senior management teams in state agencies for the control of AIDS and all local government health departments in Nigeria.
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ORIGINAL ARTICLES Top

The human immunodeficiency virus infection is associated with positive iron balance among subjects in Nnewi, South East Nigeria p. 8
Patrick O Manafa, John C Aneke, Chide E Okocha, Stella-Maris C Okeke, Nancy C Ibeh, George O Chukwuma, Ejike K Nwene
DOI:10.4103/jhhr.jhhr_2_17  
BACKGROUND: The human immunodeficiency virus (HIV) infection is associated with a number of metabolic derangements which have a remarkable impact on disease mortality and morbidity. OBJECTIVE: To evaluate the effect of HIV infection on iron status in apparently healthy seropositive adult subjects seen at a tertiary hospital in South East Nigeria. SUBJECTS AND METHODS: A total of eighty subjects were recruited for the study which comprised of randomly selected forty HIV seropositive and seronegative individuals, respectively. Each participant had 5 ml of blood collected for serum ferritin, iron, total binding capacity (TIBC), and percentage saturation of transferrin estimation. Ferritin was determined using the enzyme-linked immunosorbent assay technique while iron and TIBC were measured by spectrophotometry; percentage transferrin saturation was calculated using the standard formula. Statistical analysis was performed using SPSS (version 20), the Student's t-test was used for the comparison of means while the level of statistical significance was set at P< 0.05. RESULTS: The means of serum ferritin and transferrin saturation were significantly higher (164.30 ± 138.52 ng/ml vs. 88.10 ± 57.75 ng/ml; P= 0.002 and 44.67 ± 12.95% vs. 32.42 ± 4.67%; P< 0.001, respectively) while the mean of serum TIBC was significantly lower (346.25 ± 81.83 μg/dl vs. 395.20 ± 66.70 μg/dl; P= 0.004, respectively) in test subjects compared with controls. Serum iron was not significantly different in the two populations of study subjects (P = 0.30). CONCLUSION: Infection with the HIV is associated with significant tissue iron loading; this could have important implications on disease course and morbidity.
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Unmet need for contraception among human immunodeficiency virus-positive women in Jos, Nigeria: A call to integrate family planning and human immunodeficiency virus services p. 13
Tinuade Oyebode, Atiene Sagay, Jonah Musa, Chinedu Ekwempu, Patricia Agaba, John Idoko, Prosper Okonkwo, Phyllis Kanki
DOI:10.4103/2321-9157.210594  
PURPOSE: In the prevention of mother-to-child transmission (PMTCT) of human immunodeficiency virus (HIV), contraception is one of the four strategies proposed by the World Health Organization. Closing the gaps of unmet need for contraception among people living with HIV (PLHIVs) is critical, especially for Nigeria which contributes about 30% of global PMTCT burden. We assessed contraceptive utilization and needs, partner support, and planning of pregnancies among female PLHIVs receiving care at the HIV Treatment Centre of Jos University Teaching Hospital (JUTH). MATERIALS AND METHODS: Structured questionnaires were administered to 350 postpartum women attending the PMTCT Unit of HIV Clinic of the JUTH in 2009 using a convenience sampling method. This was to access their knowledge and utilization of contraception. All were receiving PMTCT follow-up and were within 18 months postpartum. The data were analyzed with the Epi Info Statistical Package version 3.3. RESULTS: The participants' ages ranged 19–44 years and 81.4% were Christians. Most (36.1%) were homemakers and 87.1% were married. About 44.1% were discovered to be HIV positive during antenatal care, and 47.6% of husbands were HIV positive. The previous pregnancies had been planned in 38%, thus 62% of preceding pregnancies were unplanned, while 33.8% did not desire more children. Contraception awareness was high (84.5%) but 87.1% of the participants used no form of female contraception and 81.4% admitted regular sexual activity. Among those who did not desire more pregnancies, only 48.4% used modern female contraception. Majority (80.7%) of the respondents indicated that family planning (FP) would be easily accessed in the HIV clinic while male partners (49.4%) encouraged contraception. CONCLUSION: Among PLHIVs in northern Nigeria, there is a high rate of unintended pregnancy, and high contraceptive awareness did not translate into usage. Integration of HIV and reproductive health services holds potential to improve FP access and usage by PLHIVs.
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Troponin I as marker of subclinical cardiac injury in human immunodeficiency virus-seropositive patients in Sokoto, Nigeria p. 20
Aminu Bello, Abdullah S Mainasara, Hamidu M Liman, Umar Hayatu, Abdullahi F Abubakar, Kasimu Saidu, Bashar Sani, Aminu A Umar
DOI:10.4103/2321-9157.210591  
INTRODUCTION: Myocardial injury remains a challenging health issue among human immunodeficiency virus (HIV)/acquired immuno deficiency syndrome patients, and the importance for the estimation of cardiac troponin I (cTnI) as a tool for early detection of cardiac injury has been proven by many studies. This study examined the specificity of cTnI estimation and other cardiac enzymes in detection of subclinical cardiac injury in HIV-positive patients. MATERIALS AND METHODS: One hundred and forty patients and 70 controls between the ages of 15–80 years were studied. The patients were grouped into three categories: seventy patients on highly active antiretroviral therapy (HAART), seventy on HAART-naïve patients, and seventy were recruited as controls. RESULTS: The values (mean ± standard error of mean) of cTnI, total creatine kinase (TCK), creatine kinase muscle and brain subtype (CKMB), and lactate dehydrogenase (LDH) in patients on HAART were 3.32 ± 0.32 ng/mL, 83.52 ± 9.69 IU/L, 30.79 ± 2.02 IU/L, and 517.4 ± 19.23 IU/L, respectively. For the HAART-naïve patients, the values were 2.37 ± 0.22 ng/mL, 72.53 ± 6.47 IU/L, 51.02 ± 10.86 IU/L, and 439 ± 17.72 IU/L whereas for controls the values were 1.62 ± 0.19 ng/mL, 54.86 ± 5.82 IU/L, 15.60 ± 1.63 IU/L, and 355.30 ± 23.40 IU/L with P values <0.0001, 0.0265, 0.0007, <0.0001 which were statistically significant for cTnI, TCK, CKMB, and LDH, respectively. However, all the parameters studied were found to be elevated in patients than in the controls. CONCLUSIONS: The study showed that about 121 (86.4%) of studied cases had elevated serum cTnI, of which 65 (53.7%) had elevated serum CKMB which strongly suggested subclinical myocardial injury among majority of the HIV-seropositive patients in this study.
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