Cytomegalovirus Infection Prevalence and Blood Transfusion in Patients with Human Immunodeficiency Virus attending some Retro-Viral Treatment Centers in, North-Central Nigeria

Abstract

Background: Cytomegalovirus (CMV) is a well-known leading cause of opportunistic viral infection in human immunodeficiency virus (HIV). Blood transfusion is a key component of anaemia treatment. Anaemia is often a common complication of HIV/AIDS. Blood transfusion, though useful in the treatment of anaemia which may result from complications of the lethal triad of CMV-HIV coinfection on highly active antiretroviral therapy (HAART), could pose a significant risk for transfusion transmissible CMV infection in HIV-positive patients. Objectives: This study aimed to evaluate the relationship between CMV infection and blood transfusion amongst HIV-positive patients on HAART attending selected Retro-Viral Treatment Centers. Materials and Methods: This was a cross-sectional, descriptive study of 268 confirmed HIV-positive adults, registered and attending HIV clinics at a Tertiary and a Secondary health facility in Nigeria. Relevant biodata and blood samples were collected and analysed with enzyme-linked immunosorbent assay (ELISA) for CMV IgG and IgM antibodies. Results: CMV IgG and IgM seroprevalence were 92.5% (248/268) and 21.3% (57/268) respectively. A total of 73 (60 males and 13 females) were transfused. Of the 73 transfused, 67 (91.8%) and 25 (34.2%) were IgG and IgM positive respectively. Of those transfused and positive, 56 (93.3%) were Males while 11 (84.6%) were females. This was however not statistically significant with a P=0.100. Circulating IgM was highest in younger age groups of 0-19 years with IgM of 7 (38.9%) and 20-39 years with IgM of 32 (26.7%) while IgG was highest in the older age groups 20-39 years with IgG of 114 (95.0%) and 40-59 years with IgG of 110 (94.0%); P=0.004 and 0.015 respectively. Conclusion: Age and blood transfusion were found to be significant risk factors for CMV seropositivity. CMV IgM was found to be significantly higher (recent infection) in younger respondents while IgG was higher (past infection) in the older respondents. While blood transfusion was a significant risk factor for Transfusion Transmissible CMV Infection (TTCI), TTCI risk was not significantly gender biased. We recommend the provision of CMV-negative blood for all cases of HIV patients that may require blood transfusion irrespective of their HAART status as part of measures to reduce CMV infection rate and its complications in immune incompetent populations.