1.The Philippine HIV/AIDS epidemic: A call to arms.
Acta Medica Philippina 2010;44(1):60-62
The incidence of HIV/AIDS in the Philippines has been rising to unprecedented levels and we are in the midst of a full-blown epidemic. In 2009, a record number of new cases were diagnosed, with the highest number of new cases ever reported in a month (126) occurring last December. While effective treatment exists for persons living with HIV/AIDS, the number of trained healthcare personnel who are competent to care for these patients is in very short supply. HIV/AIDS treatment is tremendously complex, and requires specialized training in order to maximize the benefit derived from medications. Moreover, antiretroviral drugs are prohibitively expensive, and the potential loss of external funding from the Global Fund which currently supports antiretroviral treatment will be catastrophic. Prevention and awareness campaigns remain by far potentially the most effective means of controlling HIV/AIDS in the Philippines. Clinical capacity building through training of physicians is already in effect, but may need to be ramped up further in the face of accelerating case numbers. In addition, international research collaboration for access to state of the art therapies and approaches will play an important role if we hope to reverse the epidemic. Finally, novel policies including opt-out testing, aggressive case finding, and test and treat strategies need to be explored in order to effectively combat this threat.
Human ; Acquired Immunodeficiency Syndrome ; Art Therapy ; Capacity Building ; Epidemics ; Financial Management ; Incidence ; Philippines ; Physicians ; Research ; Treatment Outcome
2.Benefits and risks of prolonged cotrimoxazole prophylaxis among people living with HIV in immune reconstitution phase: A retrospective cohort study.
Christian N. FRANCISCO ; Marissa M. ALEJANDRIA ; Edsel Maurice T. SALVANA
Acta Medica Philippina 2020;54(3):264-269
OBJECTIVES: To determine the effect of prolonged cotrimoxazole prophylaxis (CP) in reducing hospitalization and opportunistic infection rates among people living with HIV (PLHIV) with CD4 count >200 cells/mm3.
METHODS: We retrospectively reviewed 349 medical charts of PLHIV with CD4 count (or T-cell count) of >200 cells/mm3 enrolled in an HIV treatment hub in Manila, Philippines, from January 2004 to July 2016. Demographic, clinical characteristics and outcomes were extracted. Descriptive statistics were generated. Chi-square test for two proportions was done to compare the difference in outcomes between the CP and non-CP groups.
RESULTS: Of the 349 patients, majority (96.6%) were male with a mean age of 28 years (SD 6.4) and mean CD4 count of 373 cells/mm3 (SD 148). CP was continued in 103 patients (29.5%) with mean duration of 1.7 (SD 1.9) years. The prolonged CP group had more events of adverse drug reactions (p<0.001), specifically minor cutaneous reactions (p<0.001) and immunologic failures (p<0.001), compared to the non-CP group. There were no statistically significant differences in the frequency of hospitalization, PJP (Pneumocystis jirovecii pneumonia), non-PJP, other respiratory illnesses, diarrhea, toxoplasmosis, tuberculosis, stage 3/4 events and mortality, between the prolonged CP and non-CP groups.
CONCLUSION: We did not observe any additional benefit in giving prolonged CP among PLHIV with CD4 count >200 cells/mm3. More adverse effects were also seen in the CP group.
Human ; Hiv