CYTOMEGALOVIRUS ANTIBODIES AMONGST HEALTHY BLOOD DONORS AND IMMUNOCOMPROMISED (HIV) PATIENTS AT LAGOS UNIVERSITY TEACHING HOSPITAL (LUTH) IDI-ARABA, LAGOS

Abstract

Objective: The objective is to determine the cytomegalovirus (CMV) antibodies amongst healthy blood donors and immunocompromised (HIV) patients in LUTH. Also to determine whether previous history of blood transfusion is an important cause of CMV transmission. Methods: A cross-sectional study was carried out using HIV Clinic clients and blood donors at Lagos University Teaching Hospital. A total of 10mls of blood sample was collected per consenting participant. Half (5mls) was put in plain bottles for ELISA based CMV IgG/IgM assay of the serum that was collected and stored at -20oC until required sample size was obtained. The remainder was analysed on the same day using Sysmex haematology and the semiautomated Partec cyflometry analysers for full blood and CD4+ counts respectively. Participants’ demography and past history of transfusion were documented. Statistical analysis of results was done using computer softwares namely statistical package for social science (SPSS. 11.0), Microsoft excel, file marker Pro, and EPI-Info 6.0 as appropriate.

Results: A total of 260 participants were recruited consisting of 131 (50.4%) healthy donors and 129 (49.6%) HIV-infected patients. Out of these 125 (95.4%) were males and 4(4.5%) females healthy donors, and 87 (67.4%) were females and 41 (31%) males HIV-infected patients. The results showed 96% of healthy donors were IgG anti-CMV positive and 100% of HIV –infected patients were 1gG anti–CMV positive. There is no statistically significant difference in IgG anti-CMV amongst healthy donors and HIV-infected patients P=0.092. Amongst the healthy donors, 19.5% were IgM anti-CMV positive and 5.8% of HIV-infected patients were IgM antiCMV positive this difference was found to be statistically significant P=0.004. The mean CD4+ cell count (655.58 ± 194.27) of healthy donors was higher than HIV-infected patients (234.07 ± 173.181). The CD4+ cell count (683.22 ± 141.65) was higher for those who were IgM positive than those who were IgM negative (645.19 ± 203.307) amongst blood donors although this not statistically significant P= 0.353. Likewise, those who were IgM positive had a higher CD4 cell count (350.17 ± 160.854) than those who were IgM negative (239.93 ± 192.667) amongst HIV-infected patients. This is also not statistically significant P=0.353. Of the 120 HIV-infected patients, 8 were transfused and 7 (87.51%) of these 8 tested IgM-anti CMV negative of the 112 patients who had not been previously transfused, 105 (93.7%) tested IgM-anti CMV negative. No association was established between history of transfusion and CMV IgM positivity. P=0.43. The entire 8 healthy donors who had been previously transfused were IgM CMV negative (100%) and 87 of the 113 without history of transfusion were IgM CMV negative (76.9%) P= 0.19. Conclusion: The seroprevalence of CMV is very high in the environment both amongst healthy blood donors and HIV-infected
patients. Previous history of blood transfusion is not a significant cause of CMV infection in this environment. The presence of IgM anti-CMV in a quarter of Blood donors is of clinical relevance in the transfusion of neonates and immunocompromised persons.

CYTOMEGALOVIRUS ANTIBODIES AMONGST HEALTHY BLOOD DONORS AND IMMUNOCOMPROMISED (HIV) PATIENTS AT LAGOS UNIVERSITY TEACHING HOSPITAL (LUTH) IDI-ARABA, LAGOS