Seroprevalence and Molecular Detection of Human Cytomegalovirus in HIV Positive Patients Attending Some Selected Hospitals in Kaduna State, Nigeria

Abstract

Aims: The research study aimed to determine the seroprevalence and to molecularly detect cytomegalovirus among HIV patients attending some selected hospitals in Kaduna State, Nigeria. It was also aimed to determine the CD4+ cells counts of the HIV positive patients, screen for the presence of CMV IgG and IgM in HIV positive patients using Enzyme Linked Immunosorbent Assay, detect the CMV DNA in IgM-seropositive samples using polymerase chain reaction (PCR), and to determine the predisposing risk factors associated with CMV infection among HIV positive patients using a structured questionnaire. Place and Duration of Study: The research study was conducted at three selected hospitals located in Kaduna state, Nigeria, between the periods of January, 2015 to May, 2016. Methodology: One hundred and seventy eight (178) blood samples were collected from HIV positive patients from the three selected General hospitals in Kaduna state. The blood samples were examined for the presence of CMV IgG and CMV IgM antibodies by ELISA. Results: A total of 99.4% of HIV infected patients tested positive to CMV IgG antibodies and 11.8% of HIV positive patients tested positive to CMV IgM antibodies. There was no statistically significant difference between human cytomegalovirus infection and CD4+ cells range at p = 0.091 for IgG while there was significant difference between HCMV infection at p = 0.039 for IgM. Across geographical zones infection with HCMV showed no significant difference for IgG (χ2 = 2.081, df = 2, p = 0.353) while significant difference was observed in IgM (χ2 = 12.808, df = 2, p = 0.002). The prevalence of HCMV DNA among HIV seropositive subject was 45%, out of the eleven randomly selected HIV positive samples glycoprotein B gene of CMV was detected in five of the samples following gel electrophoresis of their PCR amplified product. Conclusion: The risk factors found to be associated with CMV infection were the geographical location of the HIV positive patients, marital status, and CD4+ cells range. There was no statistical association between CMV infection and age, sex, occupation, level of education, multiple sexual partner, blood transfusion, and ART. As a result of the high prevalence of CMV infection observed in this study, it is advisable that patients are tested for specific CMV antibodies in order to identify those at risk of CMV disease that are HIV positive with low CD4+  cells count and blood should be properly screened for CMV before transfusion to HIV positive patients.