Human immunodeficiency virus (HIV)-infected individuals have been shown to have a high prevalence of sleep disturbances. Both the effects of the virus and the antiretroviral drugs may cause sleep disturbances. We sought to determine the prevalence and predictors of sleep disorders among HIV seropositive adult subjects presenting at an outpatient hospital setting. One hundred and fifty six subjects were recruited for the study by using a sleep disorder screening questionnaire. The mean ages of the participants were 38.7 6 9.23 and 39.5 6 9.23 for those with and those without sleep disorder, respectively. The prevalence rate of sleep disorders was 46.2%. Elevated systolic blood pressure, lower CD4 count levels, and being on the highly active antiretroviral therapy combination TDF/3TC/ATZ/lpvr were associated with sleep disorders. The high prevalence rate observed necessitates routine screening for sleep disorders among HIV/AIDs patients.

BackgroundThe introduction of highly active antiretroviral therapy (HAART) has remarkably improved the prognosis of human immunodeficiency virus (HIV)-infected patients, at the expense of the development of long-term complications such as cardiovascular and renal diseases. Hypertension (HTN) is a major risk factor for cardiovascular diseases and its associated mortality. In this study, we aimed to determine the prevalence of HTN and to identify possible predictors among HIV-infected patients attending the HIV Special Treatment Clinic at the University of Calabar Teaching Hospital, Calabar.Materials and methodsA cross-sectional study was carried out over a 5-month period from February to July 2016. A total of 112 HIV-infected persons were consecutively recruited and their blood pressures were measured in two consecutive clinic visits. They were compared with the HIV-negative control group (n=309). Data collected were analyzed with SPSS 18, and statistical significance was set at P<0.05.ResultsThere was a female preponderance in both the HIV-infected individuals and HIV-negative control group (57.5% vs. 57.4%). The mean ages were 39.3 and 33.9 years in HIV-infected and HIV-negative subjects, respectively. The risk factors that were associated with HTN in both groups were older age (>40 years), increased weight and body mass index (BMI), and presence of obesity. Male sex and duration of exposure to HAART and CD4 count levels >200 cells/mm3 were associated with HTN in HIV-infected patients, whereas the absence of family history of HTN was significantly associated with HTN in both groups. However, in a multivariate logistic regression, the predictors of HTN in both groups are absence of family history of HTN and older age in HIV-infected patients and HIV-negative subjects, respectively.ConclusionTraditional risk factors such as older age, increased BMI, and obesity were linked to HTN in both HIV-infected and HIV-negative subjects, but higher CD4 count level and cumulative HAART exposure were associated with HTN in HIV-positive individuals. In a multivariate logistic regression, the predictors of HTN in both groups are absence of family history of HTN and older age in HIV-infected patients and HIV-negative subjects, respectively.

Introduction Haemodialysis (HD) which is a form of renal replacement therapy commonly prescribed for patients with chronic kidney disease (CKD). However, it is not without deleterious haemodynamic responses which may occur either during or immediately after the termination of the procedure. These may include hypotension or hypertension. Methods This was a retrospective study that reviewed chronic kidney disease (CKD) patients on maintenance haemodialysis at the renal unit of University of Calabar Teaching Hospital, Calabar, Nigeria. In all, 71 patients were reviewed but only 64 patients had complete data for analysis. Socio-demographic, clinical and biochemical data were obtained from the records in the dialysis unit. Results There were more males 38 (59.4%) than females 26 (40.6%) in the study. The mean age was 51.71±15.43 years and 43.04±14.03years for males and females respectively. The prevalence of intradialysis hypertension 29 (45.3%) was higher than that of intradialysis hypotension 20 (31.3%) and the commonest cause of CKD requiring haemodialysis was diabetic nephropathy. The factors associated with intradialysis hypotension were lower post-dialysis systolic blood pressure (PDSBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and less number of antihypertensive medications; while the factors associated with intradialysis hypertension were higher post-dialysis systolic blood pressure (SBP), MAP, greater number of antihypertensive medications and longer duration of haemodialysis. Conclusion Our study shows that there are several modifiable factors associated with blood pressure fluctuations among CKD patients on maintenance haemodialysis in the renal unit of the University of Calabar Teaching Hospital, Calabar.

Background: The burden of the people living with human immunodeficiency virus (HIV) infection and the acquired immunodeficiency syndrome (AIDS) is largely borne by communities in Sub-Saharan Africa. The rate of kidney disease is increasing amongst HIV patients and occurs more often in patients with advanced stage of the disease with lower CD 4 counts and associated with a high rate of morbidity and mortality. The objective of this study is to determine the prevalence and predictors of chronic kidney disease (CKD) amongst HIV patients on highly active antiretroviral therapy (HAART) at the University of Calabar Teaching Hospital, Calabar. Materials and methods: This was a cross-sectional study that was carried out over a 4-month period from May to August 2018. In all, a total of 118 patients with HIV on HAART were recruited into the study in a consecutive manner and their serum creatinine measured with the calculation of estimated glomerular filtration rate (eGFR). Other data collected were sex, age, weight, height, body mass index (BMI), waist hip ratio (WHR), packed cell volume, CD4 count etcetera. Data collected were inputted and analyzed with SPSS version 18, and statistical significance was taken to be p <0.05. Results: There were more females (69.5%) amongst the HIV participants and the prevalence of CKD was 15.3%. The risk factors seen to be associated with CKD were lower levels of CD4 count below 200 cells/µl, lower PCV, weight, BMI, and eGFR. Also, higher levels of WHR and creatinine were associated with CKD. Factors directly correlated with CKD were weight, BMI and CD4 count levels, while creatinine level was inversely correlated with CKD. However, a logistic regression model showed only creatinine to be a predictor of CKD. Conclusion: HIV patients on antiretroviral therapy, mainly the highly active antiretroviral therapy (HAART) have a relatively high prevalence of CKD of 15.3% and high level of serum creatinine was predictive of CKD in the logistic regression model in our study.

Introduction: Anaemia is one of the haematological complications of HIV, and most of the studies in Nigeria and outside Nigeria have shown prevalence above 50%. Also, anaemia in HIV patients has been shown to be associated with morbidity and mortality. Our study therefore aimed to determine the prevalence and the likely risk factors associated with the development of anaemia among HIV patients attending the special treatment clinic in the University of Calabar Teaching Hospital, Calabar, Nigeria.Methods: This was a cross -sectional study conducted over a period of 6 months from June to November, 2010. A total of 321 patients were recruited but only 300 met the inclusion criteria, and their haemoglobin levels were measured with the use of Drabkin Cyanide method. Data obtained was analyzed with SPSS version 20 with statistical significance at p < 0.05.Results: There were more females than males in the study (70.0% vs 30.0%). Majority of the participants were in the 30 -39 years age category (35.0%), closely followed by those in the 40 -49 years age category (21.0%). The overall prevalence of anaemia was 76%. Female sex, living in an Urban Area and low CD4 cell count are risk factors that were associated with anaemia among HIV patients. However, in a multivariate logistic regression analysis, female sex was the only predictor of anaemia . Conclusion:Anaemia is a common complication seen among HIV patients in view of the prevalence rate of 76% observed in our study. The risk factors associated with anemia were female sex, living in urban area and low CD4 cell count.

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Background: The most important risk factor to developing UTI is the presence of an indwelling urethral catheter. Eighty percent of nosocomial UTI was reported to be caused by urethral catheterization. UTIs in health care institutions and in those with frequent antibiotic exposures were frequently caused by multi- drug resistant pathogens. This study sought to determined the antibiogram of isolates from catheterized patients with UTIs with a view to establishing if there were justifications for empiric treatment of this condition in the study area in the absence of quality antibiotic formulary. Materials and Methods: Interviewer administered questionnaires were used to collect socio-demographic data. Specimens were cultured on 5% sheep blood agar (SBA), MacConkey and sabouraud dextrose agar plates and incubated at 37°c for 24 hours in ambient air. Significant bacteriuria was determined on growths from SBA. Growths were identified using standard biochemical techniques. Results: The study established 74.3% (52) prevalence of CAUTIs amongst catheterized patients in the study area with 29 (41.4%) female dominance. Imipenem (93.9%) recorded the highest percentage susceptibility, followed by Amikacin (91.8%) and Piperacillin/ tazobactam (88.8%). E. coli 17(32.7%) was the dominant isolate. Extended spectrum β-lctamase prevalence was 23(44.2%) and MRSA 2(3.8%). There was significant statistical relation between ESBL production and resistance to other classes of antibiotics. Conclusion: There is high percentage prevalence of multidrug resistance (MDR) among isolates of CAUTIs in the study area. We therefore advocate laboratory based prescription practice and de-emphasized empiric treatment pending when there would be in a quality drug formulary founded on regular resistance surveillance.

Cluster differentiation 4 (CD4) count estimation, which is not readily available in most resource poor settings in Nigeria, is an important indexdetermining commencement of antiretroviral therapy (ART). It is imperative for physicians who come in contact with these patients in such settings to recognize other parameters to evaluate these patients. The clinical correlates of diarrhea and gut parasites among human immunodeficiency virus (HIV)-seropositive patients attending our special treatment clinic were studied. Three hundred and forty consenting HIV-positive adult subjects were enrolled. Their stool and blood specimens were collected for a period of three months. Stool samples were analyzed for the presence of diarrhea and gut parasites. The patients were clinically evaluated by physical examination for the presence of pallor, dehydration, oral thrush, wasting lymphadenopathy, dermatitis, skin hyperpigmentation, and finger clubbing. Participants with diarrhea represented 14.1% of the population, while 21.5% harbored one or more parasites. In the subjects with diarrhea, 14.6% harbored gut parasites. The presence of diarrhea was associated with a low CD4 count. Clinically, oral thrush, wasting, and rashes were more reliable predictors of low CD4 count levels; whereas, the presence of pallor, dehydration, wasting, and rashes correlated with the presence of diarrhea. HIV patients presenting with pallor, dehydration, wasting, and rashes should be evaluated for the presence of diarrhea. The clinical variables associated with low CD4 count in this study may guide commencing antiretroviral therapy in resource poor settings.