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4 results on '"Kagimu M"'

1. Poor performance of hepatitis C antibody tests in hospital patients in Uganda.

Author

Seremba E, Ocama P, Opio CK, Kagimu M, Thomas DL, Yuan HJ, Attar N, and Lee WM

Subjects
Adolescent, Adult, Aged, Aged, 80 and over, Female, Hospitals, Humans, Immunoassay methods, Male, Middle Aged, Sensitivity and Specificity, Uganda, Young Adult, Hepatitis C diagnosis, Hepatitis C Antibodies blood
Abstract

Most hepatitis C testing in Uganda is performed using commercial rapid strip assays (RSA) to detect antibodies to hepatitis C virus (anti-HCV), rather than enzyme immunoassays (EIA). The prevalence of hepatitis C antibodies in a Ugandan hospital population was determined using both methods to test their accuracy using nucleic acid testing (NAT) as a reference. Sera from 380 consecutive hospitalized Ugandan patients were tested for anti-HCV using an RSA in Uganda, with subsequent automated third-generation EIA testing in the United States, followed by NAT. Recombinant immunoblot assays (RIBA) were used as a supplementary test to detect anti-HCV epitopes. Overall, anti-HCV was detected in 48/380 (13%) by one or both antibody tests. Anti-HCV was detected in 19 (5.0%) patients by RSA and in 33 (8.7%) patients by EIA; only four patients were anti-HCV positive by both methods. Fourteen of the 48 anti-HCV positive patients had detectable serum HCV RNA, 7 each by bDNA assay or by PCR. RSA detected only 7 of 14 HCV RNA positive sera. Of 29 RNA negative but anti-HCV positive patients tested by RIBA, only two were anti-HCV positive; 27 were anti-HCV negative or indeterminate. Anti-HCV testing by RSA and/or EIA was neither sensitive nor specific for detection of ongoing HCV infection in hospitalized Ugandan patients. Our findings underscore the importance of confirmatory nucleic acid testing, which, despite its increased cost, appears essential to manage African patients with HCV., ((c) 2010 Wiley-Liss, Inc.)

Published
2010
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2. Screening for hepatitis C among HIV positive patients at Mulago hospital in Uganda.

Author

Walusansa V and Kagimu M

Subjects
Adolescent, Adult, Cross-Sectional Studies, Female, HIV Infections epidemiology, HIV Seropositivity immunology, Hepatitis C diagnosis, Hepatitis C epidemiology, Humans, Male, Mass Screening, Prevalence, Risk Factors, Socioeconomic Factors, Uganda epidemiology, Young Adult, HIV Infections complications, HIV Seropositivity blood, Hepacivirus immunology, Hepatitis C complications, Hepatitis C Antibodies blood
Abstract

Background: In industrialized countries with more resources, it is recommended that HIV infected patients should be screened for hepatitis C virus (HCV) on entry into the health care system. Implementation of these guidelines in a country like Uganda with limited resources requires some modification after taking into account the prevailing circumstances. These include the prevalence of HCV in HIV positive patients and the cost of HCV testing., Objective: The objective of the study was to estimate the prevalence of HCV in HIV positive patients., Methods: This was a cross sectional study among HIV positive outpatients in Mulago hospital. HCV screening was done using anti-HCV Enzyme Immuno Assay (Roche Diagnostics), Results: Between October 2003 and February 2004, one hundred and twenty two HIV positive patients were enrolled into the study with a mean age of 33.9 years. There were more females 81 (66.4%) than males. Only 4 patients had anti-HCV, giving an estimated HCV prevalence of 3.3%., Conclusion: In view of the low HCV prevalence found in our study and similar studies and considering the high cost of HCV screening, routine HCV testing cannot be recommended among all HIV positive patients in our health care settings with limited resources. We recommend that HCV screening be limited to investigating HIV positive patients with features suggestive of liver disease in order to identify HCV as a possible cause.

Published
2009

3. Screening for hepatitis C among HIV positive patients at Mulago Hospital in Uganda

Author

Walusansa, V and Kagimu, M

Subjects
Adult, Male, Adolescent, HIV Infections, Articles, Hepacivirus, Hepatitis C Antibodies, Hepatitis C, Young Adult, Cross-Sectional Studies, Socioeconomic Factors, Risk Factors, HIV Seropositivity, Prevalence, Humans, Mass Screening, Female, Uganda
Abstract

Background: In industrialized countries with more resources, it is recommended that HIV infected patients should be screened for hepatitis C virus (HCV) on entry into the health care system. Implementation of these guidelines in a country like Uganda with limited resources requires some modification after taking into account the prevailing circumstances. These include the prevalence of HCV in HIV positive patients and the cost of HCV testing. Objective: The objective of the study was to estimate the prevalence of HCV in HIV positive patients. Methods: This was a cross sectional study among HIV positive outpatients in Mulago hospital. HCV screening was done using anti-HCV Enzyme Immuno Assay (Roche Diagnostics) Results: Between October 2003 and February 2004, one hundred and twenty two HIV positive patients were enrolled into the study with a mean age of 33.9 years. There were more females 81 (66.4%) than males. Only 4 patients had anti-HCV, giving an estimated HCV prevalence of 3.3%. Conclusion: In view of the low HCV prevalence found in our study and similar studies and considering the high cost of HCV screening, routine HCV testing cannot be recommended among all HIV positive patients in our health care settings with limited resources. We recommend that HCV screening be limited to investigating HIV positive patients with features suggestive of liver disease in order to identify HCV as a possible cause.African Health Sciences 2009; 9(3): 143-146

Published
2009

4. Hepatotoxicity from first line antiretroviral therapy: An experience from a resource limited setting

Author

Kalyesubula, R., Kagimu, M., Opio, K. C., Ronald Kiguba, Semitala, C. F., Schlech, W. F., and Katabira, E. T.

Subjects
Adult, Male, Anti-HIV Agents, Incidence, Alanine Transaminase, HIV Infections, Original Articles, Hepatitis B, Hepatitis C, CD4 Lymphocyte Count, Liver, HAART, Hepatotoxicity, Uganda, Antiretroviral Therapy, Highly Active, Prevalence, Humans, Female, Uganda, Prospective Studies, Chemical and Drug Induced Liver Injury, Follow-Up Studies, Proportional Hazards Models
Abstract

Background: Highly active antiretroviral therapy (HAART) has been associated with liver toxicity. The role of monitoring for liver toxicity has not been well studied in resource-limited settings (RLS).Objectives: To determine the background prevalence and incidence of liver injury and describe the associated signs and symptoms of acute hepatitis after initiating HAART; and to determine the role of liver enzyme tests in monitoring hepatotoxicity.Methods: In this prospective study, in Mulago Hospital AIDS Clinics, we consecutively enrolled adult patients initiated on one of three first line HAART regimens [Stavudine (d4T)-Lamivudine (3TC) and nevirapine (NVP); Zidovudine (AZT)-3TC and Efavirenz (EFV) or d4T-3TC-EFV]. We monitored ALT (alanine aminotransferase) and clinical evidence of acutehepatitis at baseline, 2nd, 6th, 10th and 14th week of therapy.Results: Two hundred and forty HIV-positive HAART- naïve patients were enrolled in the study. The baseline prevalence of transaminitis was 1.7% with an incidence of 4.2% at 14 weeks. Grade 3-4 hepatotoxicity was documented in 1.3%. Jaundice was seen in grade 2-4 ALT elevations. Being on concurrent HAART and antituberculous drugs was associatedwith grade 2-4 toxicity compared to those who were only on HAART [OR; 16.0 (95% CI; 2.4-104.2)].Conclusions: Incidence of severe hepatotoxicity within three months of first-line antiretroviral therapy was low, suggesting that routine measurement of transaminases may not be necessary in all patients initiating HAART in RLS. Routine measurement may be important in following patients on HAART and concurrent TB treatment as well as those with jaundice to avoid missing hepatotoxicity.

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