Abstract

THE IMPACT OF HIV AND MALARIA CO-INFECTION ON CARDIAC BIOMARKERS AND CD4+ T CELL COUNTS IN ADULT HIV SEROPOSITIVES IN NAUTH NNEWI, SOUTH EASTERN, NIGERIA

I.P. Ezeugwunne*, J.E. Ahaneku, E.C. Ogbodo, R.A. Analike, V.N. Oguaka, O.A. Onyegbule, A.K. Amah

ABSTRACT

Aim: To determine the impact of HIV and malaria co-infections on Cardiac biomarkers and CD4+ T cell counts in adult HIV seropositives in NAUTH Nnewi, South Eastern, Nigeria. Methods: A total of 400 subjects aged between 17 and 58 (38 ± 9) years were recruited by convenient sampling technique from patients that attended HIV Clinic, NAUTH, Nnewi for this study. The study design was a case study. Ethical approval was obtained from the Ethics Review Committee from NAUTH, Nnewi. The subjects were grouped based on WHO criteria for staging HIV infection and the presence or absence of malaria as follows: (1) Symptomatic HIV on Antiretroviral therapy (ART) (n = 100) of these, 50 were symptomatic HIV on ART with malaria co-infection. (2) Symptomatic HIV not on ART (n = 100) of these, 50 were symptomatic HIV not on ART with malaria co-infection. (3) Asymptomatic HIV subjects (n = 100) of these, 50 were asymptomatic HIV with malaria co-infection. (4) HIV seronegative control subjects (n = 100) of these, 50 were malaria positive. Enzyme linked Immuno sorbent Assay (ELISA) was used for Myoglobin and Troponin I. Spectrophotometric method was used for enzyme cardiac markers- total creatine kinase (T-CK), CK-MB, lactate dehydrogenase (LDH) and aspartate transaminase (AST) and Cyflow SL-Green for CD4 counts. Student t test was used for data analysis. Results: The results showed that the mean serum CK-MB level was significantly higher in symptomatic HIV on ART with malaria infection compared to symptomatic HIV on ART without malaria infection at P< 0.05. But the mean blood CD4 count was significantly lower in symptomatic HIV on ART with malaria infection compared to symptomatic HIV on ART without malaria infection at P< 0.05. The mean serum Myoglobin level was significantly higher in symptomatic HIV not on ART with malaria infection compared to symptomatic HIV not on ART without malaria infection at P< 0.05. Similarly, the mean serum Troponin I was significantly higher in asymptomatic HIV with malaria parasitaemia compared to asymptomatic HIV without malaria parasitaemia at P< 0.05. Also, the mean serum Myoglobin, Troponin I, T-CK, CK-MB, LDH and AST were significantly higher in Control subjects with malaria parasitaemia compared to Control subjects without malaria parasitaemia at P< 0.05 respectively. Conclusion: Malaria endemicity poses a threat to the improved cardiac function as observed with increased serum levels of CK-MB, myoglobin, and Troponin I in HIV malaria co-infection with or without ART and with the reduction of CD4 count in HIV malaria co-infection with ART. These markers T-CK, CK-MB, LDH, AST, myoglobin, and Troponin I were raised in apparent control groups with malaria parasitaemia. This calls for concern in the management of patients with HIV malaria co-infection as well as in controls with malaria infection.

Keywords: HIV, malaria, Cardiac Biomarkers, CD4+ T cell.