Glutathione S-transferase M1 and T1 genes deletion polymorphisms and blood pressure control among treated essential hypertensive patients in Burkina Faso

OBJECTIVE

Glutathione S-transferases have been associated with experimental resistance to some drugs. The present study investigated the factors associated with blood pressure control in patients with essential hypertension, especially the role of GSTT1 and GSTM1 genes polymorphisms. This cross-sectional study in Burkina Faso consisted of 200 patients with essential hypertension and under treatment.

RESULTS

In the present study, 57.5% (115/200) of patients had their hypertension under control. No statistically significant difference was found between controlled and uncontrolled groups for anthropometric and biochemical parameters as well as for GSTT1 or GSTM1 gene polymorphisms (all p > 0.05). Current alcohol consumption (OR = 3.04; CI 1.88-6.13; p < 0.001), Physical inactivity (OR = 3.07; CI 1.71-5.49; p < 0.001), severe hypertension before any treatment (Grade III [OR = 3.79; CI 2.00-7.17; p < 0.001]) and heart damage (OR = 3, 14; CI 1.59-6.02; p < 0.001) were statistically more frequent in uncontrolled essential hypertensive patients than controlled hypertensive patients.

Glutathione S-transferase M1 and T1 genes deletion polymorphisms and risk of developing essential hypertension: a case-control study in Burkina Faso population (West Africa)

BACKGROUND

Glutathione S-transferases play a key role in the detoxification of persistent oxidative stress products which are one of several risks factors that may be associated with many types of disease processes such as cancer, diabetes, and hypertension. In the present study, we characterize the null genotypes of GSTM1 and GSTT1 in order to investigate the association between them and the risk of developing essential hypertension.

METHODS

We conducted a case-control study in Burkina Faso, including 245 subjects with essential hypertension as case and 269 control subjects with normal blood pressure. Presence of the GSTT1 and GSTM1 was determined using conventional multiplex polymerase chain reaction followed by gel electrophoresis analysis. Biochemical parameters were measured using chemistry analyzer CYANExpert 130.

RESULTS

Chi-squared test shows that GSTT1-null (OR = 1.82; p = 0.001) and GSTM1-active/GSTT1-null genotypes (OR = 2.33; p <  0.001) were significantly higher in cases than controls; the differences were not significant for GSTM1-null, GSTM1-null/GSTT1-active and GSTM1-null/GSTT1-null (p > 0.05). Multinomial logistic regression revealed that age ≥ 50 years, central obesity, family history of hypertension, obesity, alcohol intake and GSTT1 deletion were in decreasing order independent risk factors for essential hypertension. Analysis by gender, BMI and alcohol showed that association of GSTT1-null with risk of essential hypertension seems to be significant when BMI < 30 Kg/m², in non-smokers and in alcohol users (all OR ≥ 1.77; p ≤ 0.008). Concerning GSTT1, GSTM1 and cardiovascular risk markers levels in hypertensive group, we found that subjects with GSTT1-null genotype had higher waist circumference and higher HDL cholesterol level than those with GSTT1-active (all p <  0.005), subjects with GSTM1-null genotype had lower triglyceride than those with GSTM1-active (p = 0.02) and subjects with the double deletion GSTM1-null/GSTT1-null had higher body mass index, higher waist circumference and higher HDL cholesterol than those with GSTM1-active/GSTT1-active genotype (all p = 0.01).

CONCLUSION

Our results confirm that GSTT1-null genotype is significantly associated with risk of developing essential hypertension in Burkinabe, especially when BMI < 30 Kg/m², in non-smokers and in alcohol users, and it showed that the double deletion GSTM1-null/GSTT1-null genotypes may influence body lipids repartition.

24-Month adherence, tolerance and efficacy of once-a-day antiretroviral therapy with didanosine, lamivudine, and efavirenz in African HIV-1 infected children: ANRS 12103/12167

BACKGROUND

There is no data on long-term benefit of once-a-day antiretroviral therapy (ART) with combination of DDI, 3TC and EFV to allow its use in future therapeutic strategies.

OBJECTIVES

To assess 24-month immuno-virological, adherence, tolerance, and effectiveness of a once-a-day ART with DDI, 3TC and EFV.

METHODS

A phase 2 open trial including 51 children aged from 30 months to 15 years, monitored a once-a-day regimen for 24 months from 2006 to 2008 in the Departement de Pediatrie du CHUSS, at Bobo-Dioulasso in Burkina Faso. We tested immunological and virological response, adherence, tolerance and resistance of the treatment.

RESULTS

Children with CD4 >25% at 24 months were 67.4% (33/49) CI 95% [54%, 80%]. The proportion of children with viral plasma RNA <300 cp / ml at 24 months of treatment was 81.6 % (40/49) CI [68.0% 91.2%]. Good adherence was obtained with more than 88% adherence > 95% over the 24 months. Drugs were well tolerated.

CONCLUSIONS

Given the limited number of antiretroviral drugs available in Africa and the inadequacy of laboratory monitoring in support program, once-a-day treatment and especially the DDI-based combination strategies could be an attractive operational option.

[Arthropathic and degenerative pathology in rheumatology patients in Burkina Faso]

OBJECTIVE

The purpose of this report is to describe epidemiologic features of arthrosic and degenerative disorders observed during the first two years of rheumatologic practice in Ouagadougou, Burkina Faso.

PATIENTS AND METHODS

The files of all patients examined between March 2006 to February 2008 were reviewed. All patients presenting arthrosic or degenerative disorders were included.

RESULTS

Out of 1,439 patients examined during the study period, 1,078 (74.91%) were included. Spine pain accounted for 33.7% of cases, i.e., 485 patients including 306 with lumbago. The mean age in this group was 47.8 +/- 15.19 years and the M/F sex ratio was 0,75. Osteoarthritis represented 20.43% of cases including osteoarthritis of the knee in 18%. The mean age in this group was 54.66 +/- 12.29 years and the M/F sex ratio was 0.23. Aseptic osteonecrosis (AON) of the femoral head was observed in 1.11% of cases, i.e. 16 patients including 8 with sickle cell disease (SC) The mean age in this group was 40.75 years. Abarticular rheumatism accounted for 15.98% of cases, i.e. 230 patients including 118 cases with tendinitis of the shoulder. The mean age in this group was 48.48 years.

CONCLUSION

Arthrosic and degenerative disorders observed in this series from Ouagadougou presented the same semiological features as in other African series. Primary osteoarthritis of the hip was uncommon.

[Salmonella meningitis in Ouagadougou, Burkina Faso, from 2000 to 2004]

56 strains of Salmonella were isolated from the cerebro-spinal fluids (CSF) from meningitis suspected patients at the Yalgado-Ouédraogo University hospital center in Burkina Faso, from January 2000 to December 2004. 75% of the patients were less than 3 years old; 71.4% of the CSF were purulent, with an average of 523 leucocytes/mm3 and 78% of neutrophile polynuclears. The strains identified belonged mostly to Salmonella O: 4.5 group (51.8%). In vitro, 92.7% of the strains were resistant to ampicillin and this resistance was partially restored with amoxicillin/clavulanic acid; however no strain was resistant to ceftriaxone. For the overall 56 patients, 20 different antibiotherapy regimes were used and they were successful in only 27% cases while 71% of patients died and 2% escaped from the hospital. Neurologic sequels were found in a patient treated with both ceftriaxone and chloramphenicol. These results showed that the illness occurred mainly in infants and was associated with high mortality rate. Most of the Salmonella strains were multi-drug resistant. In spite of strains multi-antibiotics resistance, adequate definition of therapeutic lines and early treatment including ceftriaxone could lead to higher cure rates and may improve the outcome.