Detection of HIV antibody and antigen (p24) in residual blood on needles and glass

There is a significant rate of percutaneous injury with needles during the care of patients with acquired immunodeficiency syndrome (AIDS). Following puncture injury, it is recommended that the source of the contaminating blood be checked, and if human immunodeficiency virus-type 1- (HIV-1)-seropositive, zidovudine prophylaxis be considered. As the source of contaminating blood may be unknown, we studied the detectability of HIV-1 antibody and circulating antigen (p24) in the residual blood from needles and pieces of glass at various intervals following exposure to blood. The residual volume of blood remaining in needles varied from 183 +/- 50 microliters for a 20 G needle to 7.8 +/- 1 microliter for a 27 G needle, and the residual blood on small pieces of glass varied from 23 microliters for a piece weighing 558 mg to 2 microliters for a piece weighing 21 mg. Analysis of washed samples of residual blood from all 20 G through 26 G needles and from broken pieces of glass larger than 0.41 g that had been exposed to HIV-1-seropositive blood and left at room temperature for one hour, one day and one week resulted in positive tests for HIV-1 antibody by enzyme-linked immunosorbent assay (ELISA), immunofluorescence and Western blot assays. The circulating antigen was detected in residual blood of 20 G through 26 G needles, but not from contaminated pieces of glass. This technique could be applied to situations where a healthcare worker pricked him- or herself with a needle or with a piece of glass that had been contaminated with blood of unknown seroreactivity.(ABSTRACT TRUNCATED AT 250 WORDS)     

HIV感染者的血液学检测分析与研究

目的:对HIV感染者做相关的血液学检测,分析HIV感染者合并感染乙型肝炎病毒(HBV)、丙型肝炎病毒(HCV)的现状及其预后,为揭示HIV、HBV、HCV混合感染的规律,为预防、治疗及判断HIV混合感染的预后提供科学依据.方法:按照国家检验标准,对我市120例HIV感染者进行CD4 、CD8 T淋巴细胞计数,丙氨酸氨基转移酶(ALT)、门冬氨酸氨基转移酶(AST)检测,HBV五项、抗HCV检测,检测结果做相关性和差异性统计学分析.结果:120例HIV感染者中,合并HBV、HCV感染者71例,占所有HIV感染者的59.17%,其中合并HBV感染者50例,占HIV感染者的41.67%,合并HCV感染者39例,占HIV感染者32.5%.HIV/HBV、HIV/HCV、HIV/HBV/HCV 3种合并感染者的CD4 T淋巴细胞计数明显低于HIV单一感染者(P均＜0.05),HIV/HCV、HIV/HBV/HCV混合感染者的ALT、AST异常比例明显高于HIV单一感染(P均＜0.05).结论:HIV感染者合并HBV、HCV感染现状严重.HIV合并感染肝炎病毒后,可以加速肝脏和免疫系统的损害,导致HIV感染者更高的发病率和死亡率,加快HIV感染者疾病的进程,降低抗逆转录病毒治疗(HAART)的效果,应引起更多的重视,尽早采取措施,提高HIV感染者的防治效果.     

The burden of HIV and AIDS on blood bank reserves in northeast Nigeria

This study was conducted to evaluate the burden of HIV/AIDS on blood bank reserves at the University of Maiduguri Teaching Hospital, Nigeria, during 1995-2005. The number of admissions due to HIV/AIDS rose from 43 in 1995 to 447 in 2005, and the proportion of blood units used in transfusing patients with HIV/AIDS rose steadily from 3% in 1995 to 19% in 2005. The proportion of blood units used in managing obstetric patients was also high and fluctuated between 36% and 50% during the period of study. Controlling the spread of HIV, effective treatment of patients with antiretroviral drugs and setting up a functional national blood transfusion service could lessen the rising burden of transfusion in Nigeria and improve blood availability for maternal and child health care.     

Prevalence of Histoplasmosis among Persons with Advanced HIV Disease,Nigeria

We sought to determine the prevalence of probable disseminated histoplasmosis among advanced HIV disease (AHD) patients in Nigeria. We conducted a cross-sectional study in 10 sites across 5 of 6 geopolitical zones in Nigeria. We identified patients with urinary samples containing CD4 cell counts <200 cells/mm³ or World Health Organization stage 3 or 4 disease who also had >2 clinical features of disseminated histoplasmosis, and we tested them for Histoplasma antigen using a Histoplasma enzyme immune assay. Of 988 participants we recruited, 76 (7.7%) were antigen-positive. The 76 Histoplasma antigen–positive participants had significantly lower (p = 0.03) CD4 counts; 9 (11.8%) were also co-infected with tuberculosis. Most antigen-positive participants (50/76; 65.8%; p = 0.015) had previously received antiretroviral treatment; 26/76 (34.2%) had not. Because histoplasmosis is often a hidden disease among AHD patients in Nigeria, Histoplasma antigen testing should be required in the AHD package of care.     

Malaria and loaisis among blood donors at Ibadan, Nigeria

115 blood donors were screened for the presence of malaria and other blood parasites at the Blood Bank, University College Hospital, Ibadan, between January and July, 1984. 11.3% of these had blood parasites; 7.8% had Plasmodium falciparum with parasitaemias from 0.03-0.2%, and 3.5% had Loa loa microfilaraemia. No other blood parasites were observed. Serological examination by the indirect fluorescent antibody test revealed that 86% of the donors had malaria antibody with reciprocal titres ranging from 16 to 512. There was no significant association between ABO blood group and malaria parasitaemia or antibody titre.     

献血人群HIV抗体检测结果与感染趋势分析

目的了解献血人群HIV感染现状及流行趋势,以降低输血风险。方法首先用两家不同的抗-HIV酶联免疫试剂对某地区献血人群进行初筛,初筛阳性标本采用蛋白印迹法确认。结果近10年石家庄地区献血人群总体初筛HIV阳性率为0.204%,总体确认阳性率为0.004%,从2001年的0.004%上升至2010年的0.011%,呈上升趋势(P<0.05);献血人群HIV感染以男性为主,占总感染例数的88.889%;2008-2010年19～29岁年龄段HIV感染15例,占总感染例数的41.667%,有低龄化的趋势,在感染方式上主要为性传播,性感染占总感染例数的75.000%,2008-2010年异性传播9例,同性传播18例,呈现出由异性传播向同性传播转移的趋势。结论为保证输血安全,必须加强无偿献血者,尤其是年轻献血者健康教育的宣传力度,从低危人群中的无偿献血者采集血液并严格检测,提高血液HIV检测的水平,并严格掌握输血适应证。     

Knowledge and use of HIV counseling and testing services among young persons in Ibadan, Nigeria

AIDS is a major public health problem in Nigeria. HIV counseling and testing (HCT) service is an important component of prevention and control programs. Little information is available about young persons' knowledge and use of HCT services in Nigeria. This study assessed knowledge of HIV/AIDS and use of HCT services among secondary school students and apprentices in Ibadan, Nigeria. Data were collected through 16 focus group discussions (FGD) and administration of a 36-item questionnaire to 1,281 randomly selected male and female secondary school students and apprentices aged 15-25 years. The respondents consisted of 54% apprentices and 46% students. Although virtually all respondents were aware of AIDS, only 15.8% of the sample had heard about HCT. Of those who were aware of HCT, 30.1% knew where to access the service. Students had superior knowledge of HCT than apprentices. Only 7% of those aware of HCT had ever taken the test. The percentage of those who had reportedly taken the test ranged from 11.3% of female apprentices to 6.3% of male students, 5.3% of female students, and 5.2% of male apprentices. The barriers identified by FGD participants to use of HCT services are fear of stigmatization, perceived exorbitant cost of testing, lack of knowledge of where HCT service are available, and belief that HCT is meant for only sexually active persons. However, 82.6% of the entire sample expressed the willingness to take HCT if it is provided free of charge, and there is a guarantee of confidentiality of results. Young persons have limited knowledge of HCT and under-utilize this service. Establishment of new HCT centers, promotion activities using the media, and peer education are recommended to increase uptake of this service among young persons in Nigeria.     

珠海地区无偿献血者 HIV 感染现状

目的了解珠海地区无偿献血者HIV感染状况,以便在无偿献血招募、体检咨询、献血者信息管理、血液检测等方面采取积极有效的应对措施。方法对珠海地区1998~2005年无偿献血者进行HIV检测,分析HIV感染者的流行病学特征。结果1998~2005年珠海地区无偿献血者抗-HIV检测阳性率为0.004%(4/95 410)。HIV感染者均为青壮年(28~38岁),男女性别比为3∶1,婚姻状况大多不详,职业为服务业、自由职业和无业人员。结论2003年开始在珠海地区无偿献血者中发现HIV感染者。应采取有效应对措施防止输血性传播HIV。     

血站类型和献血方式对献血员感染HIV的影响

目的 研究血站经营类型和献血方式等因素对有偿献血员感染HIV的影响。方法 根据WHO／UN-AIDS推荐的HIV检测策略Ⅱ，从2002年10月至2003年3月对中国中部某贫困县行政村全部有偿献血员进行HIV筛查和问卷调查。结果 参加筛查的有偿献血员共462人，其中HIV筛查抗体阳性91人，阳性率为19．70％(95％CI16．17％～23．62％)；献血员曾献过血的血站总共75家，献全血和单采血浆次数在个体经营、本县、外县、地区以及部队经营血站间有显著性差异；单因素分析显示，在各种类型血站只献全血的献血员HIV阳性率为0，去个体私营血站献血浆感染HIV的风险显著高于本县血站，本县血站显著高于外县血站；多因素Logistic分析显示，只有到个体私营血站和本县血站献血浆是感染艾滋病病毒的危险因素，调整OR值分别为2．72(95％C11．95～3．79)和1．12(95％C11．06-1．18)；曾经到个体经营血站和本县血站的有偿献血员HIV筛查阳性率分别为72．73％和20．66％。结论 该村有偿献血员感染HIV的主要原因是去个体经营血站和本县血站献血浆；卫生部门应确定“问题血站”并根据献血员在其献血情况来估计感染人数和确定重点干预地区。     

Detection of Legionella pneumophila in water samples by quantitative culture and an antigen detection assay

We evaluated the new Legionella pneumophila antigen detection assay Binax Equate for quantitative determination of legionellae in potable water samples. Seventy-seven water samples from different sources were investigated by Binax Equate and quantitative culture. Our culture assay is able to detect 20 to 40 cfu per 100 ml water. The rates of detection of legionellae were 1% (1 of 77) for the antigen detection assay and 25% (19 of 77) by culture. We were able to detect antigen in one water sample with 28 cfu per ml L. pneumophila serogroup 1. In in-vitro experiments the antigen assay had a sensitivity of about 333 cfu per ml when the bacteria were added directly to the test tubes and about 1000 cfu per ml when a simulated water sample was investigated. None of the water samples positive for L. pneumophila serogroup 2 to 14 was positive in the Binax Equate. The new antigen assay proved to be a valuable tool for investigating heavy L. pneumophila Serogroup 1 contamination in potable water systems but lacks sufficient sensitivity to be used in the surveillance of water supplies.     

HIV risk perception and constraints to protective behaviour among young slum dwellers in Ibadan, Nigeria

This study examined the relationship between HIV/AIDS risk perception and protective behaviour among sexually-active urban young slum dwellers in Ibadan, Nigeria. The multistage sampling techniques were used for selecting 1,600 respondents aged 15-24 years. Of these, 1,042 (65%) respondents who reported unprotected sex in the last three months were selected for analysis. Although the sexually-active respondents demonstrated basic knowledge of HIV/AIDS and high risk perception, risky behaviour was common and protective behaviour was poor. About 48% of 505 males and 12% of 537 females had multiple partners. Similarly, 29% of males and 38% of females were engaged in transactional sex. Only 14% of males and 5% of females used any form of protection, resulting in the high rates of sexually transmitted infections reported by 27% of males and 10% of females. Structural and environmental constraints were identified as barriers to adopting protective behaviour. Therefore, programme and policy interventions should be designed to address the peculiar circumstances of urban young slum dwellers to curtail the HIV epidemic.     

Prevalence and public-health significance of HIV infection and anaemia among pregnant women attending antenatal clinics in south-eastern Nigeria

HIV infection and anaemia are major public-health problems in Africa and are important factors associated with an increased risk of adverse pregnancy outcomes. The objective of this study was to determine the prevalence of HIV infection and anaemia among pregnant women attending antenatal clinics in southeastern Nigeria. To achieve this, a cross-sectional survey was conducted during July 2005-June 2006 using standard techniques. Of 815 pregnant women studied, 31 (3.8%, 95% confidence interval [CI] 2.5-5.1) were HIV-positive. Maternal age and gestational age were not associated with HIV infection (p > 0.05). The prevalence of anaemia (Hb < 11.0 g/dL) was 76.9%, and 15 (1.8%, 95% CI 0.9-2.7) had severe anaemia (Hb <7.0 g/dL). A significantly higher prevalence of anaemia was observed among individuals in their second pregnancy trimester (p < 0.05) and those infected with HIV (p < 0.05). Since HIV and anaemia are preventable, antenatal care services could serve as a pivotal entry point for simultaneous delivery of interventions for the prevention and control of HIV infection and anaemia in pregnant women.     

高中新生乙肝表面抗原及抗体检测分析

目的了解通海县高中入学新生乙型肝炎表面抗原(HBsAg)携带及乙肝表面抗体(抗-HBs)产生情况,探讨预防乙肝的对策与措施。方法对2008—2012年新入学5550名高中学生进行乙肝表面抗原及乙肝表面抗体血清学检测分析。结果乙肝表面抗原阳性率3.39%、乙肝表面抗体阳性率72.81%。结论乙肝表面抗原阳性率呈逐年下降趋势,乙肝表面抗体呈逐年上升趋势,差异有统计学意义。说明乙肝疫苗纳入计划免疫接种以来,有效地控制了乙肝病毒的传播。     

Incidence of hepatitis B antigen among Jordanian volunteer blood donors

Blood samples of 2500 healthy volunteer donors attending the Jordan UniversityHospital Blood Bank were screened for HB_SAg by the R.I.A. and R.P.H.A. methods and revealed the presence of 111 HBP_SAg positive samples (4·4%). A higher positive rate was present among elderly donors from crowded poor areas with low income, education and hygiene.     

Contemporary-use pesticides in personal air samples during pregnancy and blood samples at delivery among urban minority mothers and newborns

We have measured 29 pesticides in plasma samples collected at birth between 1998 and 2001 from 230 mother and newborn pairs enrolled in the Columbia Center for Children's Environmental Health prospective cohort study. Our prior research has shown widespread pesticide use during pregnancy among this urban minority cohort from New York City. We also measured eight pesticides in 48-hr personal air samples collected from the mothers during pregnancy. The following seven pesticides were detected in 48-83% of plasma samples (range, 1-270 pg/g): the organophosphates chlorpyrifos and diazinon, the carbamates bendiocarb and 2-isopropoxyphenol (metabolite of propoxur), and the fungicides dicloran, phthalimide (metabolite of folpet and captan), and tetrahydrophthalimide (metabolite of captan and captafol). Maternal and cord plasma levels were similar and, except for phthalimide, were highly correlated (p < 0.001). Chlorpyrifos, diazinon, and propoxur were detected in 100% of personal air samples (range, 0.7-6,010 ng/m(3)). Diazinon and propoxur levels were significantly higher in the personal air of women reporting use of an exterminator, can sprays, and/or pest bombs during pregnancy compared with women reporting no pesticide use or use of lower toxicity methods only. A significant correlation was seen between personal air level of chlorpyrifos, diazinon, and propoxur and levels of these insecticides or their metabolites in plasma samples (maternal and/or cord, p < 0.05). The fungicide ortho-phenylphenol was also detected in 100% of air samples but was not measured in plasma. The remaining 22 pesticides were detected in 0-45% of air or plasma samples. Chlorpyrifos, diazinon, propoxur, and bendiocarb levels in air and/or plasma decreased significantly between 1998 and 2001. Findings indicate that pesticide exposures are frequent but decreasing and that the pesticides are readily transferred to the developing fetus during pregnancy.     

Obesity and elevated blood pressure among adolescents in Lagos, Nigeria: a cross-sectional study

ABSTRACT: BACKGROUND: Childhood obesity and associated hypertension are major public health concerns globally. This study aimed to determine the prevalence of obesity and the associated risk of high blood pressure among Nigerian adolescents. METHODS: A cross-sectional school-based study of 885 apparently healthy adolescents was performed. Weight, height and blood pressure (BP) were measured using standard methods. Body mass index (BMI) was calculated and categorized by age, sex and percentile. Obesity and overweight were defined as: [greater than or equal to] 95th and 85th to < 95th percentiles, respectively, for age, sex and height. Subjects were sub-categorized into age 10-13 years (A) and 14-17 years (B). The odds ratio for pre-hypertensive and hypertensive range BP by age and BMI were generated. Significance was set at P < 0.05. RESULTS: The prevalence of overweight and obesity were 13.8% and 9.4%, respectively. The prevalence of hypertensive range systolic BP and diastolic BP in obese subjects was 16% compared with 2.3% in normal BMI subjects (P = 0.00), and was 12.1% for females versus 6.4% in males (P = 0.27). The prevalence of hypertensive range diastolic BP was 15.2% in obese subjects versus 3.5% in normal subjects (P = 0.01), and 12% in females versus 1.4% in males (P = 0.00). BMI in group B was significantly associated with pre-hypertensive and hypertensive range systolic BP in overweight (P = 0.01, P = 0.002) and obese subjects (P = 0.00, P = 0.00) and with hypertensive range diastolic BP (P = 0.00) only in obese subjects. The only significant association in group A was between obesity and pre-hypertensive range diastolic BP (P = 0.00). CONCLUSION: The prevalence of hypertensive range BP among obese Nigerian adolescents was high. Screening for childhood obesity and hypertension, and long-term follow-up of obese adolescents into adulthood are recommended.