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

AIDS-related Kaposi sarcoma (KS) progresses rapidly with early mucosal and systemic involvement. Early diagnosis and treatment are crucial as they significantly impact the outcome. This is a case of disseminated cutaneous and gastrointestinal KS in a 24-year-old Filipino male living with HIV, presenting with hyperpigmented violaceous subcutaneous nodules, odynophagia, progressive dysphagia, and symptomatic anemia. Capsule endoscopy demonstrated utility in diagnosing gastrointestinal KS lesions, highlighting its crucial role when conventional upper endoscopy was challenging due to oropharyngeal involvement. Diagnostic limitations, mainly the unavailability of human herpesvirus-8 (HHV-8) immunohistochemical stain, were addressed through high clinical suspicion. Multidisciplinary approach including chemotherapy with liposomal doxorubicin, radiotherapy, and supportive care eventually yielded good clinical response. This case emphasizes the importance of early diagnosis, timely intervention, and long-term surveillance in achieving favorable outcomes for patients with KS despite some diagnostic limitations.
Human ; Sarcoma, Kaposi, HIV, Acquired Immunodeficiency Syndrome, Liposomal Doxorubicin

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

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. 

OBJECTIVES: To explore the effect of quercetin for mitigating HIV-1 gp120-induced astrocyte neurotoxicity and its underlying mechanism. METHODS: Primary rat astrocytes were isolated and treated with quercetin, HIV-1 gp120, or gradient concentrations of quercetin combined with HIV-1 gp120. The formation of stress granules (SGs) in the treated cells was observed with immunofluorescence assay, and the levels of oxidative stress markers and protein expressions were measured using specific assay kits and Western blotting. HIV-1 gp120 transgenic mice were treated with quercetin (50 mg/kg) by gavage for 4 weeks, and the changes in cognitive functions and oxidative stress levels were examined by behavioral assessments, oxidative stress index analysis in serum, and immunohistochemical and Western blotting of the brain tissue. RESULTS: In primary rat astrocytes, treatment with quercetin significantly reduced HIV-1 gp120-induced SG formation, increased the levels of antioxidant indexes, decreased the levels of oxidative substances, and up-regulated protein level associated with SG depolymerization. In the transgenic mouse models, quercetin obviously improved the cognitive function of the rats, reduced oxidative stress levels, and promoted the expression of proteins associate with SG depolymerization in the brain tissues. CONCLUSIONS Quercetin mitigates HIV-1 gp120-induced astrocyte neurotoxicity and cognitive function impairment by inhibiting oxidative stress, enhancing expressions of SG depolymerization-related proteins, and promoting SG disassembly, suggesting the value of quercetin as a potential therapeutic agent for neuroprotection in HIV-associated neurocognitive disorders.
Animals ; Quercetin/pharmacology* ; Astrocytes/metabolism* ; HIV Envelope Protein gp120 ; Oxidative Stress/drug effects* ; Rats ; Stress Granules/drug effects* ; Mice ; Mice, Transgenic ; Rats, Sprague-Dawley ; Cells, Cultured

OBJECTIVES: To explore the effect of A. muciniphila gavage on intestinal microbiota and gut-brain interaction disorders (DGBIs) in gp120tg transgenic mouse models of HIV-associated neurocognitive disorder (HAND). METHODS: Intestinal microbiota was detected by 16S rRNA gene sequencing in 6-, 9-, and 12-month-old wild-type (WT) mice and gp120tg transgenic mice. The 12-month-old WT and transgenic mice were divided into 2 groups for daily treatment with PBS or A.muciniphila gavage (2×10⁸ CFU/mouse) for 6 weeks. After the treatment, immunohistochemistry, ELISA and qPCR were used to detect changes in colonic expression levels of glycosylated mucins, MBP and IL-1β, eosinophil infiltration, serum lipopolysaccharide (LPS) levels, and colonic expressions of occludin, ZO-1, IL-10, TNF-α and INF-γ mRNA. Morris water maze test and immunofluorescence assay were used to assess learning and spatial memory abilities and neuronal damage of the mice. RESULTS: Compared with WT mice, the transgenic mice exhibited significantly lowered Simpson's diversity of the intestinal microbiota with reduced abundance of Akkermansia genus, increased serum LPS levels and decreased colonic expression of glycosylated mucin. A.muciniphila gavage obviously ameliorated the reduction of glycosylated mucin in the transgenic mice without causing significant changes in body weight. The 12-month-old gp120tg mice had significantly decreased cdonic expressions of Occludin and ZO-1 with increased eosinophil infiltration and TNF-β, INF-γ and IL-1β levels and obviously lowered IL-10 level; all these changes were significantly mitigated by A.muciniphila gavage, which also improved cognitive impairment and neuronal loss in the hippocampus and cortex of the transgenic mice. CONCLUSIONS The gp120tg mice have lower intestinal microbiota richness and diversity than WT mice. The 12-month-old gp120tg mice have significantly reduced Akkermansia abundance with distinct DGBIs-related indexes, and A. muciniphila gavage can reduce intestinal barrier injury, colonic inflammation and eosinophil activation, cognitive impairment and brain neuron injury in these mice.
Animals ; Mice, Transgenic ; Gastrointestinal Microbiome ; Mice ; Brain ; HIV Envelope Protein gp120/genetics* ; Akkermansia ; Disease Models, Animal