Get the complete project »
- The Complete Research Material is averagely 52 pages long and it is in Ms Word Format, it has 1-5 Chapters.
- Major Attributes are Abstract, All Chapters, Figures, Appendix, References.
- Study Level: BTech, BSc, BEng, BA, HND, ND or NCE.
- Full Access Fee: ₦4,000
The introduction of highly active antiretroviral therapy (HAART) has significantly improved life expectancy among HIV positive individuals. However the impact of this treatment on individual micronutrients, other biochemical parameters and cardiovascular risk has not been well elucidated in this environment.
This study evaluated cardiovascular risk factors, selenium, zinc, magnesium, lipid profile, fasting blood sugar, haemoglobin, CD4 count and transaminases
among human immunodeficiency virus (HIV) afflicted Nigerian subjects on
Subjects are HIV afflicted adult patients who presented consecutively at Imo State University Teaching Hospital Orlu, who are HAART naïve and agreed to written consent. A total of 99 volunteers comprising 51 patients and 48 HIV sero-negative adults as control participated. Their body weight, height, blood pressure, arterial pulse rate were measured, 10 ml of fasting venous blood samples were also taken before commencing HAART and at 6 months on
HAART. Samples were analyzed for lipid profile, blood sugar, magnesium, zinc, selenium, haemoglobin and CD4.
Serum magnesium, zinc and selenium were significantly lower in HIV patients before HAART (p < 0.05) compared with control. However, serum levels of these minerals significantly increased after HAART compared to pre-HAART values.
Serum aspartate aminotransferase (AST) concentration was significantly higher after HAART compared with control.
Serum triglyceride (TG) significantly increased following HAART compared to control while high density lipoprotein (HDL) increased compared to pre-HAART values (p<0.05). There was no significant change in total cholesterol before or after HAART compared to control.
CD4 count increased significantly in HIV patients while on HAART compared
to values before HAART. However these values were lower than control value. Haemoglobin (Hb) significantly increased in HIV patients while on HAART when compared to these patients before HAART.
Blood sugar levels were similar in all groups.
In conclusion, HAART was beneficial to the patients as it enhanced CD4 count,
haemoglobin, and HDL but it increased serum triglyceride. HAART also improved low magnesium, zinc and selenium observed in HIV. This study
suggests that the non protease inhibitor-based HAART may however predispose HIV patients to cardiovascular risk and that supplementation of these minerals may not be necessary in HAART.
The introduction of the Highly Active Antiretroviral Therapy (HAART) has spectacularly changed the prognosis of Human Immunodeficiency Virus (HIV) infection by greatly prolonging the life span of subjects. Unfortunately HAART is associated with increased cardiovascular risks resulting in myocardial infarction occurring in younger age groups (SoRelle , 1998; Sklar and Masur, 2003 ) . Poor lipid profile, impaired glucose tolerance and in a few cases frank diabetes mellitus, redistribution of body fat (lipodystrophy) including abdominal obesity have all been reported (Shaw et al, 1998; Green, 2002; Riddler et al, 2003; Domingo et al, 2008 ). Other studies showed similar metabolic changes, although to a lower extent in HIV positive subjects not on any antiretroviral medication and concluded that HIV infection itself was in part responsible for the increased cardiovascular events (Carl and Tien, 2004; Caarr and Ory, 2006; Gross, 2006; Mujawar et al, 2006; Rasheed et al, 2008.). Initially it was thought that the protease inhibitors (PI’s)
were responsible for these changes. It is now known that non PI-based HAART also has the same metabolic effect, although the PI’s are worst, with ritonavir at the lead (Papdopoloulos et al, 1998; Levy et al, 2000; Shahmahesh et al, 2001; Fontas et al, 2004.). A study showed a clear evidence that HIV-1 protein and antiretroviral drugs cause endothelial dysfunction, a key step in cardiovascular disease , although the extent of contribution of each is unclear (Kline and Sutliff, 2008) . Most of these studies were done in advanced countries; a record was found of a study done in Africa, still this was a case report of HAART - induced diabetes mellitus (Bakari et al, 2007). The well documented racial \ ethnic and social variation in cardiovascular risk makes it important to evaluate the changes in cardiovascular risk factors in HIV positive black subjects on HAART in a developing country with racial and social environment widely apart from those of advanced countries. A study had found a strong race / ethnic difference in plasma lipids in HIV-1-infected individuals on antiretroviral therapy (Foulkes et al, 2006).
Besides, the high rate of cellular turnover of the immune system make it a major user of nutrients, hence, immune function depend highly on nutritional status. This nutritional need increases even further in acute or chronic infection including HIV.
This explains in part the deficiencies in nutrients including trace elements widely reported in HIV infected subjects. (Baum et al ,1997; Wellinghausen et al, 2000; Jonenz-Exposito et al, 2002; Foulkes et al, 2006; Jones et al, 2006; Bakari et al, 2007; Khalili et al, 2008.) . The severity of nutrient deficiency has been shown to be a strong determinant of disease progression (Baum et al, 1997).
Selenium deficiency was found to be an independent predictor of survival in HIV infection (Baum et al, 1997). Supplementation of this mineral increased serum concentration by 50% and reduced coronary heart disease risk by 24% (even though this is inconclusive) and also reduced symptoms of heart disease although it did not reverse immunological and heamatological parameters (Cirelli et al, 1991). Another study showed that selenium deficiency worsened cardiovascular risk factors in healthy Saudi males (Alisa et al, 2008). Another team of researchers suggested that selenium supplementation in HIV-infection could be of great interest in protecting cells from oxidative stress and improve survival (Delmas-Beauvleux, 1996).
Zinc deficiency was found in 23% of HIV-infected persons, with serum concentration comparable in treated and untreated patients (Wellinghausen et al,
2000). Another team reported zinc deficiency in 40% men and 36% women on HAART (Jones et al, 2006).
Low plasma and erythrocyte magnesium was reported in HIV, but even lower in HIV subjects who consume alcoholic beverages (regularly) (Bogden et al, 2000 ). In children infected with HIV, however, routine monitoring of serum micronutrients may be unnecessary in the absence of any specific clinical indication of deficiency (Henderson et al, 1997).
Again reports of these nutrient deficiencies on black HIV subjects are very few. Besides, there are no reports on nutrient changes in HIV subjects after HAART is commenced.
Hepatotoxicity is one of the complications of HAART. Life threatening acute toxic hepatitis was reported in Turkey of a HIV positive patient on HAART (Gokengin and Yamazhan, 2002) including nevirapine, a non nucleoside reverse transcriptase inhibitor (NNRTI). Mitochondrial toxicity induced by nucleoside reverse transcriptase inhibitors (NRTI’s) is believed to be responsible for various adverse effects of NRTI’s. The NRTI , didanosine was found to be associated with the lowest peripheral blood mononuclear cells (PBMC’s) mitochondrial DNA (mtDNA) thus with the highest risk of long-term adverse effects (Saitoh et al,
You either get what you want or your money back. T&C Apply
You can find more project topics easily, just search
SIMILAR PUBLIC HEALTH FINAL YEAR PROJECT RESEARCH TOPICS
1. PREVALENCE OF CHLORAMPHENICOL RESIDUES IN COMMERCIAL CHICKEN EGGS IN THE FEDERAL CAPITAL TERRITORY, ABUJA, NIGERIA» SUMMARY Drug residues in foods of animal origin are drugs and their metabolites which are found in edible tissues and milk of animals following their ...Continue Reading »
Item Type & Format: Project Material - Ms Word | 76 pages | Instant Download | Chapter 1-5 | PUBLIC HEALTH DEPARTMENT
2. THE EFFECT OF IONIZING RADIATION ON CHILDREN IN NIGERIA A CASE STUDY OF SHEHU MOHAMMAD KANGIWA MEDICAL CENTRE KADUNA POLYTECHNIC, KADUNA SOUTH LOCAL ...» ABSTRACT Exposure of children to ionizing radiation is most commonly from the environment, chiefly through cosmic x rays and radon, or from medical te...Continue Reading »
Item Type & Format: Project Material - Ms Word | 41 pages | Instant Download | Chapter 1-5 | PUBLIC HEALTH DEPARTMENT
3. ASSESSMENT OF THE UTILITY OF SEROLOGICAL DIAGNOSIS AMONG PATIENTS WITH PULMONARY TUBERCULOSIS IN ZARIA, NIGERIA» ABSTRACT Tuberculosis (TB) remains the leading single microbial illness globally, with one third of the world’s population infected with Mycobac...Continue Reading »
Item Type & Format: Project Material - Ms Word | 82 pages | Instant Download | Chapter 1-5 | PUBLIC HEALTH DEPARTMENT
4. DETERMINANTS AND PREVALENCE OF CHILDHOOD LEAD POISONING IN KAWAYE VILLAGE, ANKA LOCAL GOVERNMENT AREA, ZAMFARA STATE; 2013» SUMMARY Lead poisoning remains one of the most significant and prevalent diseases of environmental origin globally, accounting for 0.6% of the global ...Continue Reading »
Item Type & Format: Project Material - Ms Word | 142 pages | Instant Download | Chapter 1-5 | PUBLIC HEALTH DEPARTMENT
5. SOCIO-DEMOGRAPHIC FEATURES AND RISK FACTORS ASSOCIATED WITH SUSPECTED CASES OF TICK-BORNE RELAPSING FEVER IN NORTHERN BORNO STATE NIGERIA» SUMMARY Tick borne relapsing fever (TBRF) is a bacterial disease caused by Borrelia species which is transmitted to humans by infected ticks. The dise...Continue Reading »
Item Type & Format: Project Material - Ms Word | 104 pages | Instant Download | Chapter 1-5 | PUBLIC HEALTH DEPARTMENT
6. THE EFFECT OF POVERTY AND ACCESS TO HEALTH-CARE» ABSTRACT People in poor countries tend to have less access to health services than those in better off countries, and within countries, the poor have ...Continue Reading »
Item Type & Format: Project Material - Ms Word | 48 pages | Instant Download | Chapter 1-5 | PUBLIC HEALTH DEPARTMENT
7. HIV PREVALENCE AND ASSOCIATED RISK FACTORS AMONGST PRISON INMATES IN KUJE FEDERAL PRISON, FEDERAL CAPITAL TERRITORY, ABUJA, NIGERIA, JANUARY, 2013.» Summary In prisons, prevalence of HIV infection, overcrowding and poor prison conditions and diseases are of public health importance. This study was ...Continue Reading »
Item Type & Format: Project Material - Ms Word | 150 pages | Instant Download | Chapter 1-5 | PUBLIC HEALTH DEPARTMENT
8. BARRIERS TO EXCLUSIVE BREASTFEEDING PRACTICE AMONG HIV POSITIVE MOTHERS ATTENDING PREVENTION OF MOTHER TO CHILD TRANSMISSION CLINIC, SAGAMU, OGUN STAT...» ABSTRACT Mother to child HIV transmission occurs during pregnancy, at birth and during breastfeeding and it is the leading cause of infant mortality i...Continue Reading »
Item Type & Format: Project Material - Ms Word | 58 pages | Instant Download | Chapter 1-5 | PUBLIC HEALTH DEPARTMENT
9. ASSESSMENT OF AIR QUALITY IN IDU INDUSTRIAL AREA ABUJA AND IT'S HEALTH IMPLICATIONS ON THE INHABITANTS» CHAPTER ONE INTRODUCTION 1.1 BACKGROUND OF STUDY Interests in the role of air quality in health and disease date back to antiquity. Hippocrates in his...Continue Reading »
Item Type & Format: Project Material - Ms Word | 52 pages | Instant Download | Chapter 1-5 | PUBLIC HEALTH DEPARTMENT
10. PREVALENCE OF LISTERIA SPECIE IN LOCALLY PROCESSED MILK IN NASARAWA STATE, NIGERIA» SUMMARY Listeriosis is an emerging zoonoses requiring continuous surveillance in order to prevent outbreaks in humans. The disease can develop after c...Continue Reading »
Item Type & Format: Project Material - Ms Word | 71 pages | Instant Download | Chapter 1-5 | PUBLIC HEALTH DEPARTMENT