Pattern of Maternal Group B Streptococcus (GBS) Colonization in Relation to CD4 Count among HIV Positive Women in Jos

Abstract

Aim: The aim of this study was to determine the prevalence of GBS colonization among HIV positive and HIV negative pregnant women in relation to CD4 cell counts. Materials and Methodology: This was a hospital based descriptive cross-sectional study of 200 pregnant women (100 HIV positive and 100 HIV negative) and 100 non-pregnant women (50 HIV positive and 50 HIV negative) obtaining health care at the Jos University Teaching Hospital between July 2017 and November 2017. Systematic sampling technique and written informed consent were used in recruiting subjects for this study. High vaginal and anorectal swabs were collected from each subject after filling a structured questionnaire. CD4 cell count was also done for all the HIV positive patients at Aids Prevention Initiative in Nigeria (APIN) of Jos University Teaching Hospital (JUTH). The results from the laboratory analysis of the specimens were computed using SPSS version 21. Results: A colonization rate of 7.3% was observed in HIV positive patients compare to 5.3% in HIV negative. The different in colonization rate between the two groups was not statistically significant (X2 = 0.507; P = 0.477) (Table 1). In pregnant women living with HIV, colonization rate was 8.0% compare to 5.0% observed in non-pregnant women living with HIV. This however, was not statistically significant (Table 2) (χ2 = 0.013; P = 0.908). HIV positive subjects with low CD4 counts (<200 cells/μl) were observed to have high colonization rate (20.0%) than patients with high CD4 counts (≥500 cells/μl). Those with CD4 counts between 200-499 cells/μl had 8.1% colonization rate. These findings, though not statistically significant (Table 4) (χ2 = 1.3814; P = 0.2399), the increased colonization rate in low CD4 cell counts may be due to inability of the patient to mount immune response against the organism. Conclusion: There was no statistically significant difference in GBS colonization among HIV positive patients. A higher colonization rate was observed in HIV patients among the age group 21-25 years; ager was not significantly risk factor for GBS colonization in HIV patients. CD4 cell counts seem not to play any significant role in GBS colonization rate. Although, it was observed to be higher in patients with low CD4 cell counts; the different was not statistically significant.