New infections and HIV-1 subtypes among febrile persons and blood donors in Oyo State, Nigeria

J Med Virol. 2021 Aug;93(8):4891-4900. doi: 10.1002/jmv.26872. Epub 2021 Mar 1.

Abstract

Purpose: There were approximately 37.9 million persons infected with HIV in 2018 globally, resulting in 770,000 deaths annually. Over 50% of this infection and deaths occur in sub-Saharan Africa, with countries like Nigeria being seriously affected. Nigeria has one of the highest rates of new infections globally. To control HIV infection in Nigeria, there is a need to continually screen high-risk groups for early HIV infection and subtypes using very sensitive methods. In this study, new HIV-1 infection and circulating HIV-1 subtypes among febrile persons and blood donors were determined. Performance characteristics of three commercial EIA kits were also evaluated.

Methods: In total, 1028 participants were recruited for the study. New HIV-1 infection and subtypes were determined using enzyme immunoassays and molecular techniques, respectively. Sensitivity, specificity, predictive values, and agreements were compared among the EIA kits using PCR-confirmed HIV-positive and negative samples.

Results: The overall prevalence of HIV infection in this study was 5.35%. The rate of new HIV infection was significantly different (p < .03674) among 1028 febrile persons (Ibadan: 2.22%; Saki: 1.36%) and blood donors (5.07%) studied. Three subtypes, CRF02_AG, A, and G, were found among those with new HIV infection. Whereas the commercial ELISA kits had very high specificities (94.12%, 100%, and 100%) for HIV-1 detection, Alere Determine HIV-1 antibody rapid kit had the lowest sensitivity score (50%).

Conclusion: Genetic diversity of HIV-1 strains among infected individuals in Oyo State, Nigeria, is still relatively high. This high level of diversity of HIV-1 strains may impact the reliability of diagnosis of the virus in Nigeria and other African countries where many of the virus strains co-circulate.

Keywords: CRF02_AG; ELISA; HIV-1 rapid kits; HIV-1 subtypes; High-risk groups.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Blood Donors / statistics & numerical data*
  • Female
  • Fever / diagnosis
  • Fever / epidemiology*
  • Fever / virology
  • Genetic Variation
  • HIV Infections / diagnosis
  • HIV Infections / epidemiology*
  • HIV Infections / virology
  • HIV-1 / classification
  • HIV-1 / genetics*
  • HIV-1 / immunology
  • HIV-1 / isolation & purification
  • Humans
  • Immunoenzyme Techniques
  • Male
  • Middle Aged
  • Molecular Diagnostic Techniques
  • Nigeria / epidemiology
  • Phylogeny
  • Prevalence
  • Sensitivity and Specificity