Plasma Viral Load of HIV-1 in Microbial Infection and Antimicrobial Resistance among Heterosexual Serodiscordant Couples in Nigeria

Author(s): Otuonye MN, Luo Ma, Chinweokwu C, Aniedobe MN, Okoye RN, Enya VN, Ogbonna FN, Uwandu M, Adedeji A, Ponmark J, Nduaga S, Akindele SK, Liboro GO, Ayoola JB, Adewole EO, Adesesan AA, Ojetunde MM, Musa AZ and Oduukwe NN

Background: This study investigated microbial infections, antimicrobial susceptibility and resistance associated with Heterosexual HIV-1 transmission among serodiscordant couples in Nigeria. Methods: A total of 271 serodiscordant and concordant couples (HIV positive and negative) were enrolled, blood samples were collected from the subjects by venipuncture. Plasma viral load, CD4+ analysis were done on the blood samples collected from the participants. Endocervical/urethral swabs and early morning urine samples were collected from participants who presented with Pelvic Inflammatory Diseases, profuse vaginal discharge (greenish and grey colour), itching, and painful urination. By standard microbiological methods, samples were screened by microscopy, culture, antibiogram, and biochemical tests with a view to identify microbial agents of co-infections with HIV.

Results: The Participants age ranged from ≥ 21- < 50years. The index whose plasma viral loads were 10,001-100,000 copies/ml had microbial infections of 32(60.9% p=0.059). Staphylococcus aureus and Escherichia coli (22.1%) were isolated from the index (HIV positive subject) while 14.5% of Staphylococcus aureus and 27.2% of E coli were isolated from their partners (HIV negative). Staphylococcus aureus from the index showed more sensitivity to Amoxillin/clavulanate (95.4%/90.4%) compared to the partners (55.1%/73.5%) and more resistant to Ceftazidime (81.4%) compared to the partners (69.8%).

Conclusion: The microbial infections isolated from the index were associated with high viral loads and are independent makers to HIV-1 transmission among serodiscordant couples. Amoxillin/clavulanic acid showed more sensitivity to S. aureus and more resistance to Cephalosporin antibiotic among the index addressing the impact of antibiotic-sensitivity and resistance in microbial infections on clinical outcomes.