A Study on Cytomegalovirus Infection among Human Immunodeficiency Virus (HIV) Infected Individuals on Highly Active Anti-retroviral Therapy in North-Central Nigeria | Chapter 9 | Current Topics in Medicine and Medical Research Vol.4

 

Background: Cytomegalovirus (CMV) infection is common among HIV-infected individuals. Its

contribution to morbidity and mortality became more apparent following introduction of highly active

antiretroviral therapy (HAART) which improved survival among HIV-infected individuals.

Objectives: This study aimed at determining the prevalence of both active and latent CMV infections

among HIV-infected individuals on HAART in Ilorin, Nigeria.

Methods: A total of 360 consented HIV-1 patients were recruited for the study. About 5 ml of blood

and sociodemographic data were collected from each patient. Plasma from the blood was tested for

anti-CMV IgM and IgG presence using ELISA.

Results: Of the 360 participants tested, 42 (11.7%) and 265 (73.6%) were respectively anti-CMV IgM

and IgG antibodies positive representing active and latent infection rates respectively. Gender and

age were the correlates of IgM seropositivity while age, occupation and marital status correlated with

IgG seropositivity. Occupation, marital status, use of HAART and CD4+ count were not statistically

associated with IgM level while gender, use of HAART and CD4+ count did not correlate with IgG

level.

Conclusions: This study has demonstrated high level of latent and active CMV infection among

HAART recipients in Ilorin and highlighted the need for incorporation of antiherpes drugs in the

treatment regimen.

 

Author (s) Details

Augustine Udeze

Department of Microbiology, Virology Unit, University of Ilorin, P.M.B 1515 Ilorin, Nigeria.

Mutiat Odebisi-Omokanye

Department of Microbiology, Infectious Disease, Environmental Health and Toxicity Research Group, University of Ilorin, P.M.B 1515 Ilorin Nigeria.

Toluwani Ajileye

Department of Microbiology, Virology Unit, University of Ilorin, P.M.B 1515 Ilorin, Nigeria.

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A Comparative Study on Oral Busulfan and Cyclophosphamide (BU/CY) versus Cyclophosphamide, Melphalan and Vepsid (Etoposide) (CMV) with Autologous Stem Cell Transplant in Patients with Relapsed Non-Hodgkin Lymphomas (NHL) | Chapter 5 | Research Trends and Challenges in Medical Science Vol. 4

Background: High dose chemotherapy with autologous stem cell transplantation (ASCT) is the standard of care and commonly used procedure for patients with relapsed non Hodgkin lymphomas (NHL). There is no clear evidence of superior conditioning regimen and studies that comparing  different high dose regimens regarding the efficacy and toxicity profiles were little. Objectives: To compare efficacy and toxicity profiles of BU/CY and CMV conditioning regimens in patients with relapsed NHL scheduled for ASCT. Patients and Methods: Between June 2013 and January 2017, a total of 50 patients were enrolled in the study, 25 patients received CMV and 25 patients received BU/CY followed by ASCT in Bone Marrow Transplantation Center, Nasser Institute and El Sheikh Zayed Hospitals, Egypt. Results: The median time for both neutrophil and platelet engraftment showed no significant difference between the two groups (p= .4) and (p=.3) respectively. Transplant related mortality (TRM) was less in CMV arm, but p value didn't reach the statistical difference (p= .1). The 3- year DFS and OS were slightly higher in CMV arm. However, they didn't show any significant statistical difference 72.8% and 66.5%, (p =.81) and (p= .07). The toxicities, Grade III / IV mucositis, nausea/vomiting and diarrhea occurred slightly higher in BU/CY than in the CMV (16%, 24%, 8% vs. 12%, 16%, 4% respectively).Pulmonary toxicity was higher in BU/CY (3 patients (12%) in BU/CY arm and 1 patient (4%) in CMV arm). However, the toxicities didn't reach the statistical difference. Conclusion: We found that both BU/CY and CMV regimens are not significantly different in terms of efficacy and toxicity. Although, the small number of patients that were enrolled in our study, we recommend further trial with larger number of patients to confirm the results.

Author(s) Details

 Prof. Ashraf Zedan
 Department of Medical Oncology and Hematological Malignancy, South Egypt Cancer Institute, Assiut University, Egypt

Prof. Raafat Abd El Fattah
 Department of Medical Oncology and Hematological Malignancy, National Cancer Institute, Nasser Institute, Cairo University, Egypt.

Ahmed Mubarak,
Department of Medical Oncology and Hematological Malignancy, South Egypt Cancer Institute, Assiut University, Egypt

Dr. Abeer Ibrahim
Department of Medical Oncology and Hematological Malignancy, South Egypt Cancer Institute, Assiut University, Egypt.

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