Tetanus antibody in Nigerians living with HIV/AIDS: A preliminary report

Abstract

Background: The aim of this study is to investigate the need for anti-tetanus immunisation by quantifying the serum level of antibody to tetanus organism in Nigerians living with HIV/AIDS Methods: Both symptomatic and asymptomatic consenting Nigerians positive for HIV infection and aged 15 years and above were included in the study. Apparently healthy age- and sex-matched subjects were enrolled as controls. The PCV, WBC, platelet and CD4+ cell counts were done on automated counter. Serum levels of antibody to tetanus were quantitated using standard ELISA method. Results:There was no significant difference (t = 0.138, p = 0.89) in the mean serum levels of antibody to tetanus in patients with HIV/AIDS (0.5 � 0.86 IU/mL) compared with the controls (0.46 � 0.52 IU/mL). About 85.7% (36/42) of patients with HIV/AIDS had protective tetanus antibody and only six (14.3%) had non-protective antibody levels. Based on the number of circulating CD4+ T lymphocytes (greater or less than 200 cells/�L), the mean antibody levels were not significantly different in the two groups. In patients with CD4+ T lymphocytes of <200 cells/�L, the mean anti-tetanus antibody was 0.50 � 0.98 IU/mL, while in those with CD4+ T lymphocytes of >200 cells/�L, it was 0.53 � 0.53 IU/mL (t = 0.1, p = 0.918). The majority of our patients presented in advanced stage with 69% of them having CD4+ T lymphocytes <200 cell/�L. Conclusions:This study found a significant number of Nigerians with HIV/AIDS having protective levels of antibody to tetanus in their sera. We therefore suggest continue efforts at improving on the National Programme on Immunisation, as immunisation in patients with HIV infection may not yield adequate responses and may be fraught with the risk of increase in viral replication.