Background: Continental Africa is facing an epidemic of chronic kidney disease (CKD). APOL1 risk variants have been shown to be strongly associated with an increased risk for non-diabetic kidney disease including HIV nephropathy, primary non-monogenic focal and segmental glomerulosclerosis, and hypertension-attributed nephropathy among African ancestry populations in the USA. The world's highest frequencies of APOL1 risk alleles have been reported in West African nations, overlapping regions with a high incidence of CKD and hypertension. One such region is south-eastern Nigeria, and therefore we sought to quantify the association of APOL1 risk alleles with CKD in this region. Methods: APOL1 risk variants were genotyped in a case-control sample set consisting of non-diabetic, CKD patients (n = 44) and control individuals (n = 43) from Enugu and Abakaliki, Nigeria. Results: We found a high frequency of two APOL1 risk alleles in the general population of Igbo people of south-eastern Nigeria (23.3%). The two APOL1 risk allele frequency in the CKD patient group was 66%. Logistic regression analysis under a recessive inheritance model showed a strong and significant association of APOL1 two-risk alleles with CKD, yielding an odds ratio of 6.4 (unadjusted p = 1.2E-4); following correction for age, gender, HIV and BMI, the odds ratio was 4.8 (adjusted p = 5.1E-03). Conclusion: APOL1 risk variants are common in the Igbo population of south-eastern Nigeria, and are also highly associated with non-diabetic CKD in this area. APOL1 may explain the increased prevalence of CKD in this region.

A total of 116 clients sought for PEP services during the study period. The commonest setting of exposure was needle injury (44.8%). Half of the clients presented within 24 hours following exposure. Being a male and knowing HIV status of source patient independently increased the likelihood of early presentation following exposure (P < .05). None of the patients that obtained the PEP drugs came for follow-up visits. Conclusion/Recommendation: Late presentation for PEP services following exposure means that more awareness needs to be created to facilitate early presentation.

BackgroundThe advent of highly active antiretroviral therapy has dramatically extended the life expectancy of people living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome. Despite this increased longevity, HIV disease and its pharmacological treatment can cause long-term and acute health complications, many of which can be treated successfully by physiotherapy. The purpose of this paper is to report the effect of a 12-week rehabilitation program on several health-related markers in a 43-year-old woman living with HIV.MethodsThis case study examined the effect of a 12-week exercise and manual therapy intervention on morphology, pain, cardiopulmonary fitness, strength, neurological balance, immune markers (CD4 cell count), and quality of life in a 43-year-old woman living with HIV.ResultsThe results showed complete elimination of pain and shortness of breath on exertion. There was also a reduction in resting heart rate, waist circumference, exercise duration, muscle strength, and endurance. The patient showed an increase in peak expiratory flow rate, maximal heart rate attained, upper arm, forearm, and thigh circumference, and CD4+ cell count. The patient also showed improvements in the quality of life domains of general health, pain, energy/fatigue, social and physical functioning, and emotional well-being.ConclusionPhysiotherapy interventions consisting of exercise and manual therapy appear beneficial in several areas as an adjunct therapy in HIV management.

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Background: This study generated new information about the outcomes of patients enrolled in antiretroviral treatment programmes, as well as the true outcomes of those lost to follow-up (LTF). Methods: Anonymized data were collected for patients enrolled over a 12-month period from two programmes (public and private) in southeast Nigeria. Estimates of retention, LTF, mortality and transfers were computed. All LTF enrollees (defined as patients who had missed three scheduled visits) whose contact information met pre-defined criteria were traced. Results: A total of 481 (public) and 553 (private) records were included. Median duration of follow-up was about 14 months. Cumulative retention and LTF proportions were 66.5 and 32.8% (public), and 82.6 and 11.0% (private) respectively. LTF rates at third, sixth, ninth and twelfth months were 7.5, 19.3, 25.4 and 29.6% respectively (public), and 4.1, 7.1, 9.0 and 10.0% (private). LTF was higher among males, patients with CD4z cell count (200 and public programme enrollees. For the public facility, 56.7% of 104 traceable patients were dead and 38.8% were alive; the figures were 34.2 and 60.5% of 46 patients respectively for the private. Most deaths had occurred by the third month. Conclusion: Not all patients enrolled for treatment were retained. Though some died, many were LTF, lived within the community, and could develop and transmit resistant viral stains. Most traced patients were dead by the third month and poor contact information limited the effectiveness of tracing. Antiretroviral treatment programmes need to improve documentation processes and develop and implement tracing strategies.