STUDIES ON THE CO-INFECTIVITY OF HIV AND ATYPICAL MYCOBACTERIA

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ABSTRACT

The increasing global incidence of tuberculosis and nontuberculous mycobacteria (NTM) has been attributed to immunosuppresion due to the Human immunodeficiency virus (HIV) epidemic. The paucity of information on the contribution of NTM to mycobacterial infections in Africa including Nigeria has however been closely associated with limited laboratory culture for its isolation and identification. This study investigated the co-infectivity of HIV and Atypical Mycobacteria in Nsukka L.G.A. Two hundred cases (100 HIV negative: 56 males and 44 females and 100 HIV positive- 39 males and 61 females), between the ages of 15 and 71 years with mean age of 37.5 years participated in the research. HIV antibodies were screened using two HIV test kits: the Determine (Abbot Co Ltd, Japan) for preliminary test and the Gold (Unigold) which was used to check for consistency. CD4+ count was carried out using the cytometry (CyFlow®) , while acid fast bacilli (AFB) were identified by the Ziehl-Neelson staining technique. AFB positive samples were subjected to nested PCR for species identification. T-test was employed to check for statistical significance between the mean prevalence in test and control groups and CD4 count of HIV single infection and co infection with TB. Chi square correlation was also employed to check for relationship between the demographic characteristics and the distribution of the disease.

CHAPTER ONE

INTRODUCTION

Tuberculosis (TB) is an infectious disease that primarily affects lungs causing pulmonary tuberculosis but can also affect meninges, intestine, bones, lymph nodes, skin and other tissues of the body. Worldwide, tuberculosis causes 2.9 million deaths annually (WHO, 1998). An estimated two billion persons are currently infected with Mycobacteriumtuberculosis and other Mycobacterium species. The rates of increase are even greater indeveloping countries, primarily because of increased immigration of people from regions of high endemicity, declining socio-economic conditions in densely populated cities and the increasing number of human immunodeficiency virus (HIV) infected individuals (Szabo, 1990). The total number of tuberculosis cases in the world is increasing and the HIV epidemic is implicated for this increased incidence and an estimated three million persons with tuberculosis worldwide also have AIDS. Over 125 Mycobacterium species have been

characterized and identified (Griffith et al, 2007).

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