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

The aim of this study is to investigate the need for anti-tetanus immunisation in Nigerians living with HIV/AIDS by quantifying antibody to tetanus organism in them. 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. Immunisation history was recorded in all participants. 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. 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) when 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. 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. The difference was not statistically significant (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. 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.