IMPACT OF HIV-ASSOCIATED IMMUNOSUPPRESSION ON PfCRT GENE OF PATIENTS ATTENDING UNIVERSITY OF MEDICAL SCIENCES TEACHING HOSPITAL, AKURE

Abstract

This study evaluated the prevalence of malaria and Plasmodium falciparum Chloroquine Resistant Transporter (PfCRT) mutant gene in HIV patients attending the University of Medical Sciences Teaching Hospital Complex, Akure. This study was carried out between April and June 2019. Three hundred and seventeen (317) patients attending the antiretroviral clinic (ART) were involved, out of which 89 (28.08%) were males and 228 (71.92%) were females. HIV and malaria tests were done using the Unigold® HIV test kit and thick and thin blood smears respectively. CD4 test was done using the Partec® CD4 counter and Polymerase Chain reaction (PCR) was used to detect the presence of Plasmodium falciparum Chloroquine Resistant Transporter (PfCRT) mutant gene. The data obtained from this study were subjected to Pearson’s Chi-square test. The overall result showed low prevalence of malaria (23.03%) in the sampled patients. Highest prevalence of malaria (31.0%) was recorded in HIV-patients with CD4 count between 200-500 cells/μl of blood, with the females and males recording 24.7% and 22.4% malaria prevalence respectively. The age group 61-70 years recorded the highest malaria prevalence of 56.25%. A higher prevalence (86%) of PfCRT mutant gene was recorded, with 100% PfCRT mutant gene prevalence recorded in patients with CD4 count ≤200, with the females recording 87.9% PfCRT mutant gene prevalence. The age groups ≤10 years, 21-30 years and 71-80 years recorded the highest PfCRT mutant gene prevalence of 100%. This shows that the low prevalence of malaria recorded in this study could be credited to good health-seeking attitude of HIV patients and the upscale of HIV care and treatment centres. In conclusion, the high prevalence of PfCRT mutant gene shows that treatment of malaria with chloroquine is still being practised despite the availability of Artemisinin-based Combination Therapy (ACTs) as the recommended regimen for malaria treatment.