ABSTRACT
Current HIV/AIDS intervention in diagnosis and treatment do not differentiate HIV patients based on HIV serotypes. Conflicting reports exists on the effect of HIV serotypes on disease progression and relation to opportunistic infections. This study was aimed at determining the distribution of HIV serotypes in Benin City as well as its relationship with asymptomatic urinary tract infection (UTI) and urinary bacterial resistance.
A total of 485 subjects consisting of 335 HIV patients and 150 non-HIV subjects were used for this study. The HIV patients comprised of 251 on HAART and 84 HAART-naïve patients. Blood and urine specimens were collected from all subjects, and a structured questionnaire was used to collect information on socio-demography from the HIV patients. The blood specimens were used to determine HIV serotype and CD4 count using an immunochromatograhic kit and flow cytometry, respectively. Significant microbial isolates were recovered from the urine specimens and disc susceptibility tests were performed on bacterial isolates using standard techniques.
Seroprevalence of 62.09%, 0.30% and 37.61% were observed for HIV-1, HIV-2 and HIV-1/2 respectively. Seroprevalence of HIV-1 was significantly higher in both males and females (p<0.0001). The seroprevalence of HIV-1 was significantly higher among HIV patients on HAART compared with HIV-1/2 (p<0.0001), while among HAART-naïve HIV patients, the seroprevalence of HIV-1/2 was significantly higher (p<0.0001) compared with HIV-1 and HIV-2 mono-infections. The mean CD4 count for HIV-1 patients (519.45±22.09 cells/µL) was significantly (p=0.0187) higher compared with those dually infected with HIV-1/2 (438.38±24.78 cells/µL), and those on HAART had significantly (p<0.0001) higher CD4 count than their HAART-naïve counterparts. The seroprevalence of HIV serotypes among HIV patients did not differ significantly (p>0.05) in relation to CD4 count <200 cells/µL and those ≥200 cells/µL. The distribution of HIV serotypes among HIV patients (irrespective of treatment status) did not differ significantly (p>0.05) in relation to age, level of education, marital status, occupation, location of residence, accommodation type, history of blood transfusion, history of tattoo/scarification, sexual orientation and practice of anal sex.. Only HIV patients on HAART had significantly (p=0.0234) higher prevalence of asymptomatic UTI compared with non-HIV subjects. However, comparing the prevalence of asymptomatic UTI of the various HIV serotypes with that of non-HIV subjects showed only HIV-1 to be significantly (p<0.05) associated with asymptomatic UTI. CD4 count <200 cells/µL was not associated with UTI. Generally, Staphylococcus aureus was the most common aetiologic agent of UTI. Among HIV patients (both HAART-naïve and those on HAART) with HIV-1, Staphylococcus aureus was the most common cause of UTI, while among those with HIV-1/2 dual infection, Escherichia coli predominated. Bacterial isolates from HIV patients were more resistant to the tested antibacterial agents namely nitrofutantoin, amoxicillin-clavulanate, cefuroxime, cefepime, ceftazidime, gentamicin, ciprofloxacin and ofloxacin. There was no significant (p>0.05) association between HIV serotypes and urinary bacterial resistance. Prudent use of antibacterial agents among HIV patients is advocated to stem the tide of high bacterial resistance.
