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PREVALENCE OF HIV INFECTION IN CHILDREN AGED 2 TO 10 YEARS WITH SICKLE CELL ANAEMIA AT LAGOS UNIVERSITY TEACHING HOSPITAL, LAGOS
Abstract
Human immunodeficiency virus (HIV) and sickle cell anaemia (SCA) are common health
problems in Nigeria. Sickle cell anaemia patients are at risk of becoming infected with HIV
as a result of transfusion with blood or its products. The current study aimed to determine
the role of blood transfusion and other risk factors including cultural practices in the
transmission of HIV infection in children with sickle cell anaemia.
The subjects were patients with sickle cell anaemia who had a past history of at least one
blood transfusion. The controls are children who had not previously been transfused with
blood. The HIVSav 1/2/0 rapid sero test kit was used to detect antibodies to HIV infection.
Haemoglobin genotype was determined by cellulose acetate paper electrophoresis at pH
8.6.
A total of 229 children aged two to ten years were screened for HIV antibodies between
July and November 2005: 116 were transfused SCA patients while the remaining 113 were
controls.
The mean age of patients in both groups was 71 28.6 months with a male: female ratio of
1.26:1. Genotype distribution in the control group was AA (75.2%), AS (23%), AC (1.8%).
There were a total of 202 transfusions in the SCA subjects: the highest number of blood
transfusions in a single subject was nine. Most (54%) of the transfusions took place in
Teaching/Specialist Hospitals. Three subjects were positive for HIV antibodies but none of
the controls tested positive. The prevalence of HIV infection among the subjects was 2.6%.
The HIV positive subjects had one, three and nine transfusions respectively. The first two
subjects had all their transfusions in private hospitals. Five of the nine transfusions in the
third subject occurred in private hospitals while the remaining four were in a teaching
hospital. All the HIV positive patients had generalized lymphadenopathy.
No relationship was demonstrated between HIV seropositivity and the other horizontal risk
factors like scarification (p = 1), multiple injections (p = 1) and circumcision (p = 0.57).
In conclusion, blood transfusion appears to be the major risk factor for HIV infection in a
population of patients with sickle cell anaemia. It is recommended that measures be put in
place to improve safety of transfusion practice in Nigeria.
