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Kuti MA, Akinyemi JO, Ogunbosi BO, Kuti KM, Adesina OA, Awolude OA, Michael OS, Adewole IF. HCV co-infection is associated with metabolic abnormalities among HAART naive HIV-infected persons. Niger J Clin Pract 2019; 20:799-803. [PMID: 28791972 DOI: 10.4103/1119-3077.212444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To determine the metabolic abnormalities among Hepatitis C Virus (HCV) co infected HAART naïve HIV infected persons within the adult ARV clinic of the University College Hospital/University of Ibadan, Ibadan, Nigeria Methods: This was a retrospective study involving the review of clinical records of newly recruited HIV-infected persons in the adult antiretroviral (ARV) clinic over a 12 month period (January - December 2006). Baseline results for fasting plasma glucose (FPG) and fasting lipid profile were retrieved. RESULTS Out of the 1,260 HIV infected persons seen during the study period, HCV co-infection was found in 75 (6%) persons. The median values for total cholesterol, LDL-cholesterol and HDL-cholesterol were lower in the HCV co-infected persons. HIV-HCV co-infection was associated with a 0.31 mmol/L depression in Total Cholesterol (TC). The median FPG concentration was significantly higher in HIV-HCV co-infected than HIV only infected persons (5.33mmol/L vs. 5.00mmol/L, p = 0.047). However, regression analysis showed there was no relationship between the HIV-HCV co infected state and fasting glucose levels. CONCLUSION HIV-HCV co-infection may be associated with a predictable decline in plasma cholesterol, but FPG may not be sufficient to demonstrate insulin resistance in these persons.
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Affiliation(s)
- M A Kuti
- Department of Chemical Pathology, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
| | - J O Akinyemi
- Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
| | - B O Ogunbosi
- Department of Pediatrics, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
| | - K M Kuti
- Adult Antiretroviral Clinic, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
| | - O A Adesina
- Department of Obstetrics and Gynaecology, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
| | - O A Awolude
- Department of Obstetrics and Gynaecology, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
| | - O S Michael
- Department of Pharmacology, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
| | - I F Adewole
- Department of Obstetrics and Gynaecology, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
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Ayoade GO, Kuti MA. Defining apolipoprotein B treatment targets. Niger J Clin Pract 2019; 22:355-360. [PMID: 30837423 DOI: 10.4103/njcp.njcp_348_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Apolipoprotein B (apo B) has been widely reported to be a better predictor of cardiovascular risk than low-density lipoprotein cholesterol (LDL-C). This is the reason apo B treatment target values based on the equivalence to LDL-C values in healthy population has been advocated using percentiles from population studies. The aim of this study was to determine the apo B values equivalent to currently used medical decision targets for LDL-C concentration in a population of healthy Nigerians and examine for any demographic influence. Materials and Methods A total of 252 apparently healthy individuals (89 males, 163 females), between the ages of 30 and 65 years were selected from core health workers (medical and nursing staffs) of University College Hospital Ibadan between December 2015 and May 2016. Serum lipids and apo B were measured using enzymatic and immunoturbidimetry method, respectively. Results The mean apo B of the study population were 94 and 98 mg/dL in men and women, respectively. Mean apo B concentration was significantly higher in the female participants in the age groups above 55 years. LDL-C concentrations of 100, 130, 160, and 190 mg/dL corresponded to the 15th, 55th, 87th, and 95th percentile, respectively. The corresponding apo B concentrations were 73 mg/dL (15th percentile), 95 mg/dL (55th percentile), 124 mg/dL (87th percentile), and 145 mg/dL (95th percentile). The group of participants with LDL-C of <130 mg/dL and the group with equivalent apo B of <95 mg/dL has the same clinical and biochemical characteristics in both men and women. Conclusion This study has defined apo B targets that may potentially be used to guide the initiation of therapy in persons with dyslipidemia. It has also demonstrated the population level relationship that exists between apo B and LDL-cholesterol and has shown the gender and age-related influence of apo B distribution in the population.
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Affiliation(s)
- G O Ayoade
- Department of Chemical Pathology, University College Hospital, Ibadan, Nigeria
| | - M A Kuti
- Department of Chemical Pathology, College of Medicine, University of Ibadan, Oyo, Nigeria
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Adetunji AA, Kuti MA, Audu RA, Muyibi SA, Imhansoloeva M, Mosuro OA, Solanke EA, Akpa OM, Irabor AE, Ladipo M, Berzins B, Robertson K, Ogunniyi A, Adewole IF, Taiwo BO. Discordant rapid HIV tests: lessons from a low-resource community. HIV Med 2017; 19:72-76. [PMID: 28758335 DOI: 10.1111/hiv.12541] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVES HIV rapid antibody tests are widely used in Africa, but dual testing sometimes produces discordant results. It is not clear if discordant rapid HIV tests should always heighten suspicion by frontline health workers that early HIV infection is present. Some studies have reported that discordant rapid tests have value for identifying early HIV infection in high HIV prevalence populations. It is not known if rapid test performance influenced this conclusion, or if this observation will hold true for low HIV prevalence populations. We therefore explored the occurrence of discordant rapid HIV tests in a low-resource community. METHODS A cross-sectional sample of HIV status-unaware adults with recent exposure to unsafe sex was assessed using a validated risk-based tool (University of North Carolina (UNC)-Malawi Risk Screening Score) for acute HIV infection. Participants received rapid testing with Determine™ HIV 1/2 and Uni-Gold™ HIV assays, plus plasma HIV-1 antigen testing with the COBAS® Ampliprep/COBAS® Taqman® HIV-1 assay, followed by western blot in those with detected HIV-1 antigen. RESULTS Of 408 participants, 1.0% were confirmed to have established HIV infection. The discordance between rapid tests at initial screening was 2.45 and 2.94% when the two assays were used sequentially and simultaneously, respectively. Discordant rapid tests were strongly associated with risk scores > 2 [odds ratio (OR) 10.88; 95% confidence interval (CI) 2.35-50.43], and with detected HIV-1 RNA (OR 26.06; 95% CI 3.91-173.60). CONCLUSIONS When the sample occurrence of discordance between the first and second tests is below 5%, discordant rapid tests in an adult with sexual risk behaviour should trigger strong suspicion of early HIV infection in low HIV prevalence populations.
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Affiliation(s)
- A A Adetunji
- Department of Family Medicine, University College Hospital, Ibadan, Nigeria
| | - M A Kuti
- Department of Chemical Pathology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - R A Audu
- Human Virology Laboratory, Nigerian Institute of Medical Research, Lagos, Nigeria
| | - S A Muyibi
- Department of Family Medicine, University College Hospital, Ibadan, Nigeria
| | - M Imhansoloeva
- Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - O A Mosuro
- Department of Family Medicine, University College Hospital, Ibadan, Nigeria
| | - E A Solanke
- Department of Family Medicine, University College Hospital, Ibadan, Nigeria
| | - O M Akpa
- Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - A E Irabor
- Department of Family Medicine, University College Hospital, Ibadan, Nigeria
| | - Mma Ladipo
- Department of Family Medicine, University College Hospital, Ibadan, Nigeria
| | - B Berzins
- Division of Infectious Diseases, Center for Global Health, Northwestern University, Chicago, IL, USA
| | - K Robertson
- Department of Neurology, University of North Carolina, Chapel Hill, NC, USA
| | - A Ogunniyi
- Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - I F Adewole
- Department of Obstetrics and Gynaecology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - B O Taiwo
- Division of Infectious Diseases, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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Adeleye JO, Kuti MA. Process and outcome measures of quality of care at the diabetes outpatient clinic, University College Hospital, Ibadan. Niger J Clin Pract 2017; 20:221-225. [PMID: 28091441 DOI: 10.4103/1119-3077.187310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE The study aims to assess the quality of care provided at a diabetes outpatient clinic of a tertiary hospital in Nigeria using quality indicators approved by the National Diabetes Quality Improvement Alliance (NDQIA). MATERIALS AND METHODS The medical records of patients who had visited the clinic at least two times within a 12 months period preceding the index visit were reviewed during a 5 month period. Process measure indicators, approved by the NDQIA (evaluating the functioning of the clinic) and outcome measures, published by the American Diabetes Association, (evaluating the health status of the attending patients) were retrieved from the medical records. RESULTS The 332 records reviewed showed that the most consistently performed process measures were blood pressure and weight measurement (>90%). Foot examination was done infrequently (10.5%). Less than 50% had at least an annual low-density lipoprotein cholesterol (LDL-C) and hemoglobin A1c testing done. The mean (standard deviation) HbA1C (%), LDL-C (mg/dL) systolic blood pressure (SBP) (mmHg), and diastolic blood pressure (DBP) (mmHg) were 7.6 (2.0), 107.3 (31.5), 134.3 (20.8), 79.5 (11.0), respectively. HbA1C >8.0%, LDL-C >130 mg/dL, SBP >130 mmHg, and DBP >90 mmHg) were observed in 34.8%, 21.1%, 40.4%, and 23.8%, respectively. CONCLUSION Although the organization of the outpatient services allowed for good performance with regards to "free" services such as blood pressure and weight measurement, it performed suboptimally for foot examinations. Performance indicators that required payment were consistently underperformed. Regular assessment of the quality of care may help in the identification of opportunities for improvement in the organization and delivery of care.
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Affiliation(s)
- J O Adeleye
- Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - M A Kuti
- Department of Chemical Pathology, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
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Odeh OI, Kuti MA, Fasunla AJ, Nwaorgu OG. Sensorineural Hearing Loss and Dyslipidemia: Is There Any Relationship? West Afr J Med 2015; 34:27-31. [PMID: 26902813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND The incidence of dyslipidemia is increasing worldwide due to changes in diet and lifestyle. The aetiological role of dyslipidemia in sensorineural hearing loss (SNHL) is unclear. OBJECTIVE To determine the association between SNHL and dyslipidemia in adult Nigerian population. DESIGN OF THE STUDY This prospective case control study was carried out at ENT Department of University College Hospital Ibadan from August 2013 to May 2014. METHODS The study involved consecutive adult patients (18-60 years) with SNHL. The controls were adults without SNHL matched for age, gender and socioeconomic status. Relevant clinical data were obtained. Hearing threshold was determined by standard method and fasting plasma lipid assayed for triglycerides (TG), total cholesterol (TC), high density and lipoprotein-cholesterol (HDL-C). The low density lipoprotein-cholesterol (LDL-C) was calculated from TG, TC and HDL-C using Freidewald's formulae. The values of <40mg/dl, >200mg/dl, >150mg/dl and >130mg/dl were considered abnormal for HDL-C, TC, TG and LDL-C respectively. Level of statistical significance was P<0.05. RESULTS There were 108 participants, consisting 57 (67.7%) cases and 51 (32.9%) controls with mean age of 37.911.3 years and 37.4 11.3-year respectively (p=0.708). Abnormalities in HDL-C values was the commonly observed in both cases (64.9%) and controls (76.5%).Thirty-six (63.2%) cases had severe to profound hearing loss. There was no significant correlation between lipid parameters and severity of SNHL. CONCLUSION The prevalence of dyslipidemia in adult patients with sensorineural hearing loss is similar to those with normal hearing. There appears to beno causal association between dyslipidemia and sensorineural hearing loss.
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Affiliation(s)
- O I Odeh
- Department of Otorhinolaryngology, University College Hospital, Ibadan, Nigeria
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Otegbayo JA, Kuti MA, Ogunbode O, Irabor AE, Adewoles IF. Livolin ameliorates elevations in alanine transaminase in HIV infected patients commencing highly active antiretroviral therapy. Afr J Med Med Sci 2012; 41:417-422. [PMID: 23672107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND HAART associated hepatoxicity is an important cause of poor adherence to therapy in HIV infected persons. An initial manifestation is elevation in the level ofAlanine Transaminase (ALT) in blood. We sought to evaluate the protective effects of Livolin, a phosphatidylcholine containing preparation, against elevations in this enzyme in persons just commencing HAART. METHODOLOGY All consenting patients deemed eligible for HAART and who were sero-negative for Hepatitis B and C were recruited into the study. Subjects were divided into a test group which received a thrice daily dose of Livolin capsules for 3 months in addition to HAART and a control group that received only HAART. Blood samples were collected at baseline and after 3 months and analysed for ALT, Aspartate aminotransferase, alkaline phosphatase and creatinine. The specific HAART combination, age and gender were also noted. RESULTS Seventy nine (79) persons comprised of 43 test and 36 control subjects completed the study. Sixty six percent (79%) of all subjects were on Nevirapine containing combinations. In total, 8.9% and 11.7% of our patients had elevations at baseline and after 3 months respectively. These were mostly grade I, with grade II toxicity being observed in 3.3% of patients after 3 months of HAART. There was no instance of severe toxicity. For individuals with an elevation in ALT values at baseline, the mean drop at 3 months was significantly more in the test group compared with the control group (34.67 iu/L vs. 14.90 iu/L, p=0.005). Among subjects with on Nevirapine, the mean increment in ALT in the control group was 7.73 iu/L compared with 1.73 iu/L for the test group. CONCLUSION The findings in this study mirror findings in both animal experiments and human studies of a potential benefit of phosphatidylcholine preparations, like Livolin, in protecting against drug induced hepatotoxicity.
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Affiliation(s)
- J A Otegbayo
- Department of Medicine, University College Hospital, Ibadan, Nigeria
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Kuti MA, Abbiyesuku FM, Akinlade KS, Akinosun OM, Adedapo KS, Adeleye JO, Adesina OA. Oral glucose tolerance testing outcomes among women at high risk for gestational diabetes mellitus. J Clin Pathol 2011; 64:718-21. [DOI: 10.1136/jcp.2010.087098] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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