Leprosy caused by Mycobacterium leprae, primarily manifests with cutaneous and neurological symptoms. Bone marrow (BM) involvement without skin lesions is exceedingly rare, particularly in immunocompromised patients. Here is a case of a 40-year-old HIV-infected man with a nadir CD4 count of 29 cells/mm³ who presented with recurrent anaemia, massive hepatosplenomegaly, and no apparent skin lesions. BM analysis revealed epithelioid granulomas with foamy histiocytes containing acid-fast bacilli, confirmed by Wade-Fite staining. This case highlights the rare presentation of lepromatous leprosy, emphasising the diagnostic challenges posed by the absence of typical cutaneous features.
Leprosy ; HIV

BACKGROUND

The Philippines has been significantly affected by the HIV epidemic in the Asia-Pacific region, with a notable increase in new cases over the past decade. Despite efforts to promote HIV testing, access to treatment, and awareness campaigns, progress has been slow, particularly among youths. Tangere, a market research application, conducted surveys during and after the COVID-19 pandemic to assess HIV knowledge among Filipinos.

This study aimed to evaluate changes in HIV awareness among young Filipinos during and after the COVID-19 pandemic using data collected via Tangere’s surveys. Specifically, it sought to analyze demographic characteristics, sources of HIV information, and knowledge regarding HIV transmission, prevention, and stigma.

Tangere collaborated with the investigators to develop a questionnaire assessing HIV knowledge among young Filipinos. Surveys were conducted during and after the COVID-19 pandemic, targeting subscribers aged 18-35 years, primarily from the National Capital Region and Luzon area. Data analysis involved calculating frequencies and percentages to summarize demographic characteristics and HIV knowledge. An Independent-Samples Proportions procedure was used to compare HIV knowledge during and after the pandemic.

The survey revealed that while respondents generally possessed reasonable knowledge about HIV, there were notable changes in the awareness during and after the pandemic. Social media and television were identified as primary sources of HIV information. Knowledge regarding HIV transmission and prevention increased postpandemic, particularly concerning preventive measures such as pre-exposure prophylaxis (PREP) and motherto-child transmission (MTCT). However, persistent misconceptions and stigma surrounding HIV remained, indicating the need for continued education and advocacy efforts.

The study underscores the importance of utilizing social media platforms for HIV awareness campaigns, especially among youths who are disproportionately affected by the epidemic. Despite improvements in knowledge, the Philippines has yet to achieve global HIV prevention goals. Continued efforts to enhance awareness, particularly regarding recent advancements in HIV prevention and treatment, are essential for curbing the epidemic and improving public health outcomes nationwide.

BACKGROUND AND OBJECTIVE

Long-term treatment of people living with HIV (PLHIV) encounters various challenges, such as medication adherence, stigma, discrimination, and healthcare access. Patient satisfaction with healthcare services is vital for maintaining treatment adherence. Therefore, understanding the factors influencing patient satisfaction is crucial. We conducted a qualitative study to explore these factors in primary HIV care facilities in Metro Manila, Philippines.

In this qualitative study, we interviewed PLHIV aged 18-59 receiving antiretroviral therapy (ART) in primary HIV care facilities in Metro Manila. Data saturation was reached after 19 in-depth interviews. We transcribed all audio files verbatim in Filipino and analyzed the data using deductive and inductive thematic analysis, guided by the SERVQUAL model as a theoretical framework. We employed MAXQDA, a qualitative data analysis software for coding and data management. We illustrated themes and sub-themes with quotes derived from the data.

Six key themes emerged regarding factors influencing patient satisfaction: tangibles, reliability, responsiveness, assurance, empathy, and location. The first five themes aligned with the SERVQUAL model, while location emerged as a new theme. PLHIV preferred accessible clinics, a clean and pleasant ambiance, and positive interactions with healthcare providers. Moreover, they suggested facility improvements, including expansion, better ventilation, enhanced service delivery, and increased healthcare staff.

Enhanced service delivery and positive healthcare interactions, along with favorable physical attributes of primary HIV care facilities, drive patient satisfaction and long-term retention. These modifiable factors contribute to the continuous care of PLHIV, ultimately improving their quality of life.

OBJECTIVE: This study aimed to investigate the prevalence of HIV pretreatment drug resistance (PDR) and the transmission clusters associated with PDR-related mutations in newly diagnosed, treatment-naive patients between 2020 and 2023 in Dehong prefecture, Yunnan province, China. METHODS: Demographic information and plasma samples were collected from study participants. PDR was assessed using the Stanford HIV Drug Resistance Database. The Tamura-Nei 93 model within HIV-TRACE was employed to compute pairwise matches with a genetic distance of 0.015 substitutions per site. RESULTS: Among 948 treatment-naive individuals with eligible sequences, 36 HIV subtypes were identified, with unique recombinant forms (URFs) being the most prevalent (18.8%, 178/948). The overall prevalence of PDR was 12.4% (118/948), and resistance to non-nucleotide reverse transcriptase inhibitors (NNRTIs), nucleotide reverse transcriptase inhibitors (NRTIs), and protease inhibitors (PIs) was 10.7%, 1.3%, and 1.6%, respectively. A total of 91 clusters were identified, among which eight showed evidence of PDR strain transmission. The largest PDR-associated cluster consisted of six CRF01_AE drug-resistant strains carrying K103N and V179T mutations; five of these individuals had initial CD4+ cell counts < 200 cells/μL. CONCLUSION The distribution of HIV subtypes in Dehong is diverse and complex. PDR was moderately prevalent (12.4%) between 2020 and 2023. Evidence of transmission of CRF01_AE strains carrying K103N and V179T mutations was found. Routine surveillance of PDR and the strengthening of control measures are essential to limit the spread of drug-resistance HIV strains.
Humans ; HIV Infections/virology* ; China/epidemiology* ; Drug Resistance, Viral ; Male ; Adult ; Female ; Middle Aged ; HIV-1/genetics* ; Anti-HIV Agents/therapeutic use* ; Myanmar/epidemiology* ; Young Adult ; Prevalence ; Adolescent ; Mutation

Viral infections are one of the main causes of deaths and economic losses around the globe, and effective virus detection methods are essential for epidemic prevention and control. Most existing detection methods have problems such as high false negative/positive rates, slow responses, high costs, and dependence on professional equipment and personnel, which are not conducive to the rapid and accurate detection of viruses. Field effect transistor (FET) biosensors have attracted widespread attention due to their advantages of label-free detection, high sensitivity, fast responses, real-time measurement, low power consumption, and small sizes for portability. This article first briefly describes the basic situation of viruses and the structure and detection principle of FET biosensors. Subsequently, it delves into the research achievements in the application of FET biosensors in the detection of influenza viruses, hepatitis viruses, human immunodeficiency virus, and severe acute respiratory syndrome coronavirus 2. Finally, we make a comprehensive summary and reasonable outlook on the role played by FET biosensors in biomedicine.
Biosensing Techniques/instrumentation* ; Transistors, Electronic ; Humans ; SARS-CoV-2/isolation & purification* ; Viruses/isolation & purification* ; Orthomyxoviridae/isolation & purification* ; Hepatitis Viruses/isolation & purification* ; Virus Diseases/virology* ; HIV/isolation & purification* ; COVID-19/diagnosis*

Bowenoid papulosis (BP) is an uncommon yet clinically significant human papillomavirus (HPV)-associated condition that exhibits features of both condyloma acuminata and carcinoma insitu. We report the case of a 24-year-old Filipino male with multiple pruritic, pigmented penile lesions of 5 months’ duration, confirmed histologically as BP. This case underscores the importance of recognizing HPV-related lesions early and initiating appropriate treatment, not only to prevent progression to malignancy but also to limit transmission. The report also highlights the relevance of offering HPV vaccination, particularly to males, and the critical need for screening for other sexually transmitted infections, especially in light of the growing human immunodeficiency virus epidemic in the Philippines, underscoring that the condition itself may be sexually transmitted in nature.

BACKGROUND

Human immunodeficiency virus infection and acquired immunodeficiency syndrome are significant public health concerns and social issues. Key players in efforts to stop HIV/AIDS as a public threat are healthcare personnel. Research has shown that negative attitudes of healthcare workers towards HIV can negatively influence their practices and these are associated with their level of knowledge about the disease.

This study aims to investigate the baseline knowledge, attitudes, and practices of healthcare workers towards HIV/AIDS and to determine the association between profession and level of knowledge, attitudes and practices among healthcare workers in a tertiary pediatric government hospital.

This study utilized an analytical cross-sectional research design. Data were collected through a written questionnaire administered to 213 healthcare personnel, who were selected via stratified random sampling from January to April 2024. Knowledge, attitude, and practice (KAP) scores were evaluated using Bloom’s cut-off points. Scores below 60% were classified as low level of knowledge, negative attitude, and poor practice. Scores from 60-79% were classified as moderate level of knowledge, neutral attitude and fair practice. Lastly, scores between 80-100% were classified as high level of knowledge, positive attitude and good practice. Descriptive and inferential statistics, specifically Fisher’s test were used whenever appropriate.

Among 213 study participants, 140 (65.73%) demonstrated a high level of knowledge towards HIV/AIDS among doctors, nurses, medical technologists, and radiologic technologists. There were 161 (75.59%) who exhibited positive attitude towards HIV/AIDS and worked as pharmacists, physical therapists, and dentists. About 154 (72.30%) reported having fair practices on HIV/AIDS.

The healthcare workers in our study have a high level of knowledge, positive attitude, and fair practices towards HIV/AIDS with significant differences between professions. There is a significant association between professions with the level of knowledge, attitudes, and practices towards HIV. Doctors, nurses, medical technologists, and radiologic technologists have higher level of knowledge on HIV/AIDS. Positive attitude was higher among pharmacists, physical therapists, and dentists. Lastly, good practices were highest among midwives.

OBJECTIVE

To describe the clinical presentation, management and outcome of a rare case of isolated oculomotor nerve palsy in an immunocompromised adult secondary to a central nervous system (CNS) tuberculoma.

This is a case report.

A Filipino male in his 30s developed severe throbbing headache followed by binocular diplopia and drooping of the right upper eyelid. Findings were compatible with a neurologically-isolated pupil-involving, complete oculomotor nerve palsy on the right. Brain magnetic resonance imaging demonstrated enlargement and contrast enhancement of the cisternal portion of the right oculomotor nerve. Serologic testing was positive for the human immunodeficiency virus (HIV) and syphilis. Cerebrospinal fluid (CSF) analysis showed lymphocytic pleocytosis and elevated protein. CSF polymerase chain reaction was positive for Mycobacterium tuberculosis (TB). The patient was treated with penicillin, quadruple anti-Koch’s, and anti-retrovirals. Eyelid position and ocular motility improved after treatment. Aberrant regeneration of the right oculomotor nerve was observed with elevation of the right eyelid on downgaze (pseudo-Graefe sign).

CNS tuberculoma may present as a neurologically-isolated oculomotor nerve palsy, particularly in immunocompromised individuals. In TB-endemic countries, like the Philippines, it should be considered in the differential diagnosis. Early recognition and appropriate antimicrobial therapy can lead to neurologic improvement.

BACKGROUND

The Philippines faces a significant Human immunodeficiency virus (HIV) burden, but only 13% of pulmonary tuberculosis (PTB) patients are aware of their status. Barriers to testing include cost, access, risk perception, and stigma. 

To determine the barriers to HIV counseling and testing among clinically confirmed pulmonary tuberculosis patients seen at Corazon C. Aquino Hospital.

Cross-sectional research design was employed in this study. Socio-demographic profile and potential barriers to HIV counseling and testing of the respondents was analyzed through descriptive statistics, association was determined through Chi-square. Total enumeration sampling was employed, 33 clinically diagnosed PTB patients was included in this study. 

Results of the study showed 57.58% of respondents lack knowledge about HIV counseling and testing with M < 3.1212. The perceived personal barriers of the respondents are poor knowledge, not perceiving themselves as at risk, and 48.48% not perceiving a benefit in accepting HIV counseling and testing. Socioeconomic barriers include privacy, cost, and fear of rejection from family and friends. Health institutional barriers include unfriendly service providers, privacy issues, queues, delayed results, remote locations, and unavailability. The demographic profile did not significantly correlate with these barriers. 

Increase awareness across all populations is recommended since no correlation with demographic profile was found in this study. Mixed-methods is recommended in this study, to reduce recall bias, validate respondents’ narratives and explore other perceived barriers, increase in sample size is also recommended. 

BACKGROUND AND OBJECTIVE

Long-term treatment of people living with HIV (PLHIV) encounters various challenges, such as medication adherence, stigma, discrimination, and healthcare access. Patient satisfaction with healthcare services is vital for maintaining treatment adherence. Therefore, understanding the factors influencing patient satisfaction is crucial. We conducted a qualitative study to explore these factors in primary HIV care facilities in Metro Manila, Philippines.

In this qualitative study, we interviewed PLHIV aged 18-59 receiving antiretroviral therapy (ART) in primary HIV care facilities in Metro Manila. Data saturation was reached after 19 in-depth interviews. We transcribed all audio files verbatim in Filipino and analyzed the data using deductive and inductive thematic analysis, guided by the SERVQUAL model as a theoretical framework. We employed MAXQDA, a qualitative data analysis software for coding and data management. We illustrated themes and sub-themes with quotes derived from the data.

Six key themes emerged regarding factors influencing patient satisfaction: tangibles, reliability, responsiveness, assurance, empathy, and location. The first five themes aligned with the SERVQUAL model, while location emerged as a new theme. PLHIV preferred accessible clinics, a clean and pleasant ambiance, and positive interactions with healthcare providers. Moreover, they suggested facility improvements, including expansion, better ventilation, enhanced service delivery, and increased healthcare staff.

Enhanced service delivery and positive healthcare interactions, along with favorable physical attributes of primary HIV care facilities, drive patient satisfaction and long-term retention. These modifiable factors contribute to the continuous care of PLHIV, ultimately improving their quality of life.