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Lebanon faces an HIV epidemic concentrated in key populations. The national AIDS programme [NAP] hosted by WHO since 1989 achieved substantial progress towards the 95-95-95 UNAIDS targets. In 2023, we reviewed the programme to guide its planned transition back into the structure of the Ministry of Health [MOH]. In 2023, we reviewed programme documents, epidemiological information and interviewed relevant stakeholders. We compiled national data along with WHO and UNAIDS estimates to describe the evolution of programme and epidemiological indicators, along with the result chain of input, process, output, outcome and impact. Domestic funding for the NAP increased from 73% in 2007 to 97% in 2018, before a drop in 2019 because of the financial crisis, when the NAP became dependent on international funding, including the Global Fund (commodities and services) and WHO (human resources). NAP core functions were governance, capacity building, monitoring and evaluation, anti-retro viral treatment [ART] dispensing and follow up for persons living with HIV [PLHIV] with some involvement in procurement, supply chain and laboratory testing. The NAP provided prevention, diagnosis and treatment services through Civil Society Organizations [CSOs]. In 2022, in Lebanon, 86% of PLHIV were diagnosed, among which 93% were on treatment and 95% virally suppressed. In 2022, NAP reported 232 new HIV infections, a 41% increase since 2010 and a 25% decrease in AIDS-related deaths during the same period. The estimated HIV incidence increased 4.4 times among MSM from 2008 to 2019, remained zero among commercial sex workers, and evolved from 0 to 0.11 per 1,000 to 0.9 per 1,000 in 2021 among PWIDs. Lebanon is on track to achieve the UNAIDS 95-95-95 by 2025 targets. After transition into the MoPH, the NAP will need to [1] identify ways to sustain its sources of domestic funding, [2] build on its collaborations with CSOs to expand prevention activities in key populations, and [3] address the evolving needs of the population, including among transgenders, migrants, displaced people, and refugees, 4) maintain good quality core functions (capacity building, monitoring and evaluation, and medications).

Background In Lebanon, HIV is concentrated in both native and refugee communities of men who have sex with men (MSM). For over 10 years, the National AIDS Program (NAP) has offered HIV voluntary counselling and testing through a partnership with nongovernmental organizations (NGOs). In 2018, implementation of HIV self-tests (HIVST) was introduced, and this self-care intervention has been further scaled up during the coronavirus disease 2019 (COVID-19) pandemic. This paper (1) describes the effectiveness of implementing HIVST in Lebanon, and (2) discusses how the success of HIVST implementation has been reflected during the COVID-19 pandemic. Methods The NAP conducted a series of workshops (July–November 2018) to introduce HIVST services for healthcare workers working at different NGOs. The workshops highlighted that HIVST would be distributed for free, that it would be confidential and voluntary, and that participants were encouraged to notify the NGOs of their results, which would be kept strictly confidential. NGOs collected data anonymously and confidentially from beneficiaries (age, consistency of condom use and HIV testing history), who were asked to call back with the results of their HIVST. At the NAP, data were combined, aggregated and analysed. Results In 2019, the NGOs distributed 1103/1380 (79.9%) HIVST kits to their beneficiaries. The NGOs collected feedback on 111 kit results, of which two were HIV-positive. Feedback about HIVST results from beneficiaries was low (111/1103) due to noncompliance of beneficiaries and the lack of human and financial resources in the NGOs. From January through May 2020, a total of 625/780 HIVST kits (80.1%) were distributed. This period was divided into pre-COVID-19 and during COVID-19. The follow-up with the beneficiaries during COVID-19 was much improved because of the absence of on-site activities, shifting more efforts towards HIVST (449/625). There have been no reports of social harm related to HIVST. Conclusion HIVST implementation in Lebanon serves as an example of introducing a self-care intervention as part of a community-led effort. In order to maintain HIVST services at the same improved level, reorganization of care is needed within each NGO following the adaptation process due to COVID-19, along with continuous monitoring and evaluation of HIVST reported data.

BackgroundWomen who have been forcibly displaced in complex humanitarian settings suffer from poor sexual health, though the association with violence and war trauma is poorly characterised. We investigated sexual health outcomes and their relationship to violence and trauma among women living in a protracted forced displacement setting.MethodsThis cross-sectional study was conducted in an urban refugee camp in Beirut, Lebanon. Participants were Syrian women who are refugees aged 18–49 years. Community health workers conducted door-to-door recruitment and administered a survey to assess violence and trauma. Capillary blood and vaginal swabs were collected for sexually transmitted infection (STI) testing. Sexual health outcomes included gynaecologic symptoms, self-reported lifetime STI history and current STIs. The relationship of sexual health outcomes with violence, trauma and other factors was assessed using Bayesian Gaussian copula models.ResultsRecruitment and data collection were conducted from February to September 2023. Of 305 eligible participants, 250 (82.0%) consented for study participation. The mean age was 30.3 (SD±6.9) years. Over 80% of women disclosed experiencing gender-based violence. Participants experienced a median of 12 (IQR 7) traumatic war events; 197 (78.8%) met criteria for post-traumatic stress disorder (PTSD) and 125 (50.0%) had severe food insecurity. Among a subset (n=216), current gynaecologic symptoms (80.1%) and lifetime STI history (63.4%) were common. We detected one case of Trichomonas vaginalis. By graphical models, gynaecologic symptoms and STI history were significantly associated with sexual violence, which clustered with physical and emotional violence, war trauma, PTSD and severe food insecurity (posterior edge inclusion probability >0.5).ConclusionIn Lebanon, the sexual health of Syrian women who are refugees is closely linked to a syndemic of violence, war trauma, poor mental health and food insecurity. A syndemics-informed approach is urgently needed to address the needs of forcibly displaced women.

The prevalence of Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis was determined among 431 pregnant Syrian refugee women seeking antenatal care in Lebanon. Low prevalence at 0.5% for chlamydia, 0.2% for trichomoniasis and 0.0% for gonorrhoeae was detected, suggesting a low burden of sexually transmitted infection in this population.

Individual differences in IBD illness severity, behavior, progression, and therapy response are evident. Since a break in the intestinal epithelial barrier causes IBD to begin, mucosal gene expression in IBD is crucial. Due to its high sensitivity and dynamic nature, molecular analysis of biomarkers in intestinal biopsies is feasible and provides a reliable means of evaluating localized inflammation. The goal of this investigation was to discover alterations in gene expression in the inflamed mucosa of IBD patients undergoing treatment with 5-amino salicylic acid (5ASA) (N = 39) or anti-TNF drugs (N = 22). The mucosal expression of numerous IBD-related genes was evaluated using qPCR. We discovered that the levels of the proteins Lipocalin-2 (LCN2), Nitric Oxide Synthase 2 (NOS2), Mucin 2 (MUC2), Mucin 5AC (MUC5AC), and Trefoil factor 1 (TFF1), which are overexpressed in untreated IBD patients compared to non-IBD subjects, are decreased by both therapy regimens. On the other hand, anti-TNF medicine helped the levels of ABCB1 and E-cadherin return to normal in IBD patients who were not receiving treatment.

Colorectal cancer (CRC) remains a leading cause of cancer-related mortality worldwide, underscoring the need for non-invasive biomarkers that can support earlier detection and risk stratification. This exploratory study investigated the combined diagnostic performance of circulating microRNA-155 (miR-155) and vascular endothelial growth factor (VEGF) in CRC, with mechanistic support from molecular docking and integration into an AI-based predictive model. In a case–control design, plasma levels of miR-155 and VEGF were quantified in CRC patients, individuals with benign colorectal conditions, and healthy controls. Diagnostic accuracy was assessed using ROC curve analysis, with comparisons across subgroup analyses (CRC vs benign, CRC vs controls, CRC vs benign + controls). Molecular docking provided comparative predictions of miR-155 interactions with regulatory proteins (IL-13RA1, SOCS1, PTEN, BCL-6, TP53INP1). An AI model (logistic regression with L2 regularization, stratified tenfold cross-validation) integrated biomarkers with clinical factors to evaluate predictive performance. Both miR-155 and VEGF were significantly elevated in CRC patients compared with benign and control groups. Individually, miR-155 achieved an AUC of 0.85 and VEGF an AUC of 0.79; combined analysis improved performance (AUC = 0.93). Subgroup ROC analyses confirmed robust discriminatory power across clinically relevant comparisons. The AI-integrated model achieved the highest accuracy (AUC = 0.96) under cross-validation. Docking suggested preferential interactions of miR-155 with IL-13RA1, SOCS1, and PTEN, supporting their mechanistic involvement. miR-155 and VEGF show promise as synergistic biomarkers for CRC detection, particularly when integrated with clinical risk factors. Molecular docking provides hypothesis-generating mechanistic insights, while AI modeling demonstrates the potential of multi-parametric integration. Given the modest, single-center sample size and lack of external validation, these findings should be considered exploratory. Larger, multi-center validation studies are essential before clinical translation.

The relationship between Helicobacter pylori ( H. pylori ) infection and Portal hypertensive gastropathy (PHG) is still a debatable matter. The aim of this study is to find out how common H. pylori infection is in cirrhotic patients with PHG and to see if there’s a link between H. pylori infection and PHG severity. Out of 340 cirrhotic patients who had upper Gastrointestinal Tract (GIT) endoscopy for early varices screening, 160 cirrhotic patients were selected and divided into 2 groups; 80 cirrhotic patients with PHG (cases) and 80 cirrhotic patients without PHG (controls). Gastric biopsies were taken from all enrolled patients for histological evaluation for the presence or absence of H. pylori infection. H. pylori was found in 44 cirrhotic patients (55%) who had PHG (cases), compared to 22 cirrhotic patients (27.5%) who did not have PHG (controls). The prevalence of H. pylori infection was significantly higher in patients with PHG ( p < 0.001). The severity of PHG was associated with H. pylori infection ( p < 0.001). The response to eradication therapy of H. pylori infection was must better in patients without PHG ( p = 0.045). By multi-variant analysis, H. pylori infection, splenic diameter, and portal vein diameter were independent predictors for PHG presence. After treating H. pylori infection in patients who tested positive for H. pylori , there was a significant reduction in PHG severity ( p < 0.001). Patients with PHG have a greater prevalence of H. pylori infection. PHG is more severe in patients infected with H. pylori . To improve PHG severity, cirrhotic patients must have their H. pylori infection eradicated.

Background and Purpose: The advanced glycation end products (AGEs) have been implicated in different diseases’ pathogenesis, but their role in hepatocellular carcinoma (HCC) is still a matter of debate. This study aims to investigate the association of AGEs with HCC development in patients with hepatitis C-related cirrhosis.Methods: Only 153 of the 181 non-diabetic patients with cirrhosis were consecutively involved in this pilot cohort prospective study, along with 34 healthy control participants. Demographic characteristics, biochemical parameters, clinical data, and AGEs levels in all subjects at the starting point and every year after that for two years were assessed. Multivariable Cox regression analysis was used to settle variables that could predict HCC development within this period.Results: HCC developed in 13 (8.5%) patients. Univariate Cox regression analysis reported that body mass index (P=0.013), homeostatic model assessment-insulin resistance (P=0.006), alpha-fetoprotein (P <0.001), and AGEs levels (P <0.001) were related to HCC development. After adjusting multiple confounders, the multivariable Cox regression model has revealed that AFP and AGEs were the powerful parameters related to the HCC occurrence (all P<0.05). AGEs at a cutoff value of more than 79.6 ng/ml had 100% sensitivity, 96.4% specificity, and 0.999 area under the curve (all P<0.001), using the receiver operating characteristic curve, for prediction of HCC development.Conclusion: This work suggests that AGEs are associated with an increased incidence of HCC, particularly in cirrhosis, which is encouraging in decreasing the risk of HCC in these patients.