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Farid Kurniawan
Faktor prediktor awal kegagalan virologis pada pasien dengan infeksi human immunodeficiency virus yang mendapat terapi antiretroviral lini pertama dengan adherens baik = Early predictive factor of virological failure in hiv patients receiving first line antiretroviral therapy with good adherence
"[ABSTRAK
Latar Belakang: Terapi antiretroviral (ARV) terbukti secara efektif dapat menekan replikasi HIV. Pengukuran viral load (VL) merupakan prediktor yang lebih baik dibanding kriteria klinis atau imunologis untuk menilai kegagalan atau keberhasilan terapi ARV. Karena keterbatasan sumber daya, maka pemeriksaan VL tidak selalu mudah untuk diakses oleh pasien HIV yang mendapat terapi ARV sehingga perlu untuk diketahui faktor-faktor pada pasien yang dapat memprediksi terjadinya kegagalan virologis.
Tujuan: Mengetahui faktor prediktor kegagalan virologis pada pasien HIV yang mendapat terapi ARV lini pertama sesuai paduan ARV terbaru di Indonesia.
Metode: Penelitian ini merupakan studi kohort retrospektif pada pasien HIV rawat jalan dewasa di RSCM yang mulai terapi ARV lini pertama selama periode Januari 2011-Juni 2014. Pasien HIV yang mempunyai data VL 6-9 bulan setelah mulai terapi ARV dengan kepatuhan berobat baik dimasukkan sebagai subjek penelitian. Kegagalan virologis dinyatakan sebagai nilai VL ≥ 400 kopi/mL setelah minimal 6 bulan terapi ARV dengan kepatuhan berobat baik. Paduan ARV yang digunakan terdiri dari dua NNRTI (salah satu dari TDF/AZT/d4T ditambah 3TC) dengan satu NNRTI (NVP atau EFV). Usia, faktor risiko penularan HIV, stadium klinis HIV menurut WHO, ko-infeksi TB, indeks massa tubuh, kadar hemoglobin, dan jumlah CD4 awal terapi serta basis paduan terapi ARV merupakan variabel yang diteliti pada penelitian ini.
Hasil: Terdapat 197 pasien sebagai subjek penelitian ini. Kegagalan virologis didapatkan pada 21 pasien (10,7%). Semua variabel yang diteliti belum terbukti dapat memprediksi kegagalan virologis pada pasien HIV yang mendapat terapi ARV lini pertama dengan adherens baik. Terdapat peningkatan risiko kegagalan virologis pada pasien dengan usia yang lebih muda, faktor risiko penasun, stadium klinis lanjut, adanya ko-infeksi TB, dan paduan ARV TDF+3TC+NVP tetapi tidak bermakna secara statistik.!!
Simpulan: Dari variabel yang diteliti, tidak didapatkan variabel yang terbukti sebagai prediktor awal kegagalan virologis pada pasien HIV yang mendapat terapi ARV lini pertama dengan adherens baik.
ABSTRACT
Background: Antiretroviral therapy (ART) effectively suppress HIV replication. Viral load (VL) measurement is better predictor than clinical or immunological criteria to evaluate failure or success of ART. However, in the country with limited resources, VL measurement is not easily accessible by HIV patients receiving ARV therapy therefore it is necessary to know which factors in the patients that can predict virological failure.
Objectives: To know early predictive factor of virological failure in HIV patients receiving recent first line ARV therapy regimen in Indonesia
Methods: This study was a retrospective cohort study among adult HIV patients in Out-patient Clinic of Cipto Mangunkusumo General Hospital that started ARV therapy during periode January 2011-June 2014. HIV patients with good adherence that have VL data 6-9 months after initiation of ARV therapy were included in this study. Virological failure was defined as VL ≥ 400 copies/mL after minimum of 6 months therapy with good adherence. ARV regimen used in this study consist of two NRTI (one of TDF/AZT/d4T plus 3TC) combined with one NNRTI (NVP or EFV). Age, risk factor for HIV infection, HIV clinical stage, HIV- TB co-infection, baseline CD4 value, hemoglobin level, body mass index, and ARV therapy regimen at the time of initiation were among the variables that analyzed in this study.
Results: There are 197 patients as subjects in this study. Virological failure was found in 21 patients (10,7%). All the variables included in this study can not predict virological failure in HIV patients receiving first line ART with good adherence. There is increase risk of virological failure in patients with younger age, IDU as risk factor for HIV infection, late clinical stage, TB co-infection, and ARV regimen TDF+3TC+NVP but not reaching statistically significant.
Conclusion: There is no variable in this study proved to be early predictive factor for virological failure in HIV patients receiving first line ART with good adherence.;Background: Antiretroviral therapy (ART) effectively suppress HIV replication. Viral load (VL) measurement is better predictor than clinical or immunological criteria to evaluate failure or success of ART. However, in the country with limited resources, VL measurement is not easily accessible by HIV patients receiving ARV therapy therefore it is necessary to know which factors in the patients that can predict virological failure.
Objectives: To know early predictive factor of virological failure in HIV patients receiving recent first line ARV therapy regimen in Indonesia
Methods: This study was a retrospective cohort study among adult HIV patients in Out-patient Clinic of Cipto Mangunkusumo General Hospital that started ARV therapy during periode January 2011-June 2014. HIV patients with good adherence that have VL data 6-9 months after initiation of ARV therapy were included in this study. Virological failure was defined as VL ≥ 400 copies/mL after minimum of 6 months therapy with good adherence. ARV regimen used in this study consist of two NRTI (one of TDF/AZT/d4T plus 3TC) combined with one NNRTI (NVP or EFV). Age, risk factor for HIV infection, HIV clinical stage, HIV- TB co-infection, baseline CD4 value, hemoglobin level, body mass index, and ARV therapy regimen at the time of initiation were among the variables that analyzed in this study.
Results: There are 197 patients as subjects in this study. Virological failure was found in 21 patients (10,7%). All the variables included in this study can not predict virological failure in HIV patients receiving first line ART with good adherence. There is increase risk of virological failure in patients with younger age, IDU as risk factor for HIV infection, late clinical stage, TB co-infection, and ARV regimen TDF+3TC+NVP but not reaching statistically significant.
Conclusion: There is no variable in this study proved to be early predictive factor for virological failure in HIV patients receiving first line ART with good adherence., Background: Antiretroviral therapy (ART) effectively suppress HIV replication. Viral load (VL) measurement is better predictor than clinical or immunological criteria to evaluate failure or success of ART. However, in the country with limited resources, VL measurement is not easily accessible by HIV patients receiving ARV therapy therefore it is necessary to know which factors in the patients that can predict virological failure.
Objectives: To know early predictive factor of virological failure in HIV patients receiving recent first line ARV therapy regimen in Indonesia
Methods: This study was a retrospective cohort study among adult HIV patients in Out-patient Clinic of Cipto Mangunkusumo General Hospital that started ARV therapy during periode January 2011-June 2014. HIV patients with good adherence that have VL data 6-9 months after initiation of ARV therapy were included in this study. Virological failure was defined as VL ≥ 400 copies/mL after minimum of 6 months therapy with good adherence. ARV regimen used in this study consist of two NRTI (one of TDF/AZT/d4T plus 3TC) combined with one NNRTI (NVP or EFV). Age, risk factor for HIV infection, HIV clinical stage, HIV- TB co-infection, baseline CD4 value, hemoglobin level, body mass index, and ARV therapy regimen at the time of initiation were among the variables that analyzed in this study.
Results: There are 197 patients as subjects in this study. Virological failure was found in 21 patients (10,7%). All the variables included in this study can not predict virological failure in HIV patients receiving first line ART with good adherence. There is increase risk of virological failure in patients with younger age, IDU as risk factor for HIV infection, late clinical stage, TB co-infection, and ARV regimen TDF+3TC+NVP but not reaching statistically significant.
Conclusion: There is no variable in this study proved to be early predictive factor for virological failure in HIV patients receiving first line ART with good adherence.]"
2015
T-Pdf
UI - Tesis Membership  Universitas Indonesia Library
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Suzy Maria
Proporsi keberhasilan virologis dan faktor-faktor yang berhubungan pada reintroduksi terapi antiretroviral lini pertama pasca interupsi tidak terencana pada pasien HIV = Proportion of virological success and its associated factors in first line antiretroviral reintroduction after unplanned interruption in HIV patients
"ABSTRAK
Latar Belakang: Hingga saat ini belum ada panduan mengenai paduan terapi
antiretroviral (antiretroviral therapy/ART) terpilih pada pasien HIV dewasa
dengan riwayat interupsi tidak terencana. Kondisi pasien pada saat reintroduksi
ART perlu dievaluasi sebagai dasar pemilihan paduan ART
Tujuan: Mengetahui proporsi keberhasilan virologis pada reintroduksi ART lini
pertama pasca interupsi tidak terencana. Mengetahui hubungan antara berbagai
faktor klinis dan laboratoris dengan keberhasilan virologis pada reintroduksi
tersebut.
Metode: Penelitian kohort retrospektif dilakukan pada pasien HIV yang
mendapatkan reintroduksi ART lini pertama pasca interupsi tidak terencana
selama minimal 1 bulan. Data didapatkan dari rekam medis RS dr. Cipto
Mangunkusumo di Jakarta. Viral load (VL) dinilai 6-18 bulan setelah reintroduksi
ART lini pertama, dinyatakan berhasil bila VL <400 kopi/ml. Dilakukan analisis
terhadap faktor yang berhubungan dengan keberhasilan virologis tersebut.
Hasil: Selama periode Januari 2005 s.d. Desember 2014 terdapat 100 subjek yang
mendapatkan reintroduksi ART lini pertama dan memiliki data viral load 6-18
bulan pasca reintroduksi. Pasca reintroduksi ART didapatkan keberhasilan
virologis pada 55 (55%) subjek. Pada analisis didapatkan dua faktor yang
berhubungan dengan keberhasilan virologis pada reintroduksi ART lini pertama,
yaitu frekuensi interupsi satu kali (adjusted OR/aOR 5,51; IK95% 1,82-16,68;
p=0,003), nilai CD4 saat reintroduksi ≥200 sel/mm
xi
3
(aOR 4,33; IK95% 1,1416,39,
p=0,031).
Simpulan:
Proporsi keberhasilan virologis pada reintroduksi ART lini pertama
pasca interupsi tidak terencana adalah 55%. Pasien dengan frekuensi interupsi 1
kali dan pasien dengan nilai CD4 saat reintroduksi ≥200 sel/mm
3
memiliki kecenderungan untuk mencapai keberhasilan virologis pada reintroduksi ART.
ABSTRACT
There is no guideline concerning antiretroviral therapy (ART) of
choice for adult HIV patients after unplanned interruption. Hence, patients?
conditions at time of ART reintroduction need to be evaluated as a basis for
selecting ART regiment.
Objectives: To know the proportion of virological success of first line ART
reintroduction after unplanned interruption. To know the association between
either clinical or laboratory factors and virological success in reintroduction.
Methods: We conducted a retrospective cohort study in HIV patients that were
reintroduced to first line ART after having unplanned interruption for at least one
month period. The data were collected from medical records of Dr. Cipto
Mangunkusumo Hospital in Jakarta. Viral load (VL) was evaluated at 6-18
months after first line ART reintroduction, declared as a success if VL <400
copies/mL. Analysis was done to factors associated with such virological success.
Results: Between January 2005 and December 2014, 100 subjects were
reintroduced to first line ART and having VL data in 6 to 18 months after the
reintroduction. Virological success was achieved in 55 (55%) subjects. In the
analysis we found that virological success was associated with interrupted once
(adjusted OR/aOR 5.51%, 95%CI 1.82-16.68, p=0.003) and CD4 ≥200 cell/mm
xii
Universitas Indonesia
3
at the time of reintroduction (aOR 4.33, 95%CI 1.14-16.39, p=0.031).
Conclusions: Proportion of virological success on first line ART reintroduction
after unplanned interruption was 55%. Patients who were having interrupted once
and patients with CD4 ≥200 cell/mm
3
at the time of reintroduction would have
higher odds of virological success on first line ART reintroduction.
;Background: There is no guideline concerning antiretroviral therapy (ART) of
choice for adult HIV patients after unplanned interruption. Hence, patients?
conditions at time of ART reintroduction need to be evaluated as a basis for
selecting ART regiment.
Objectives: To know the proportion of virological success of first line ART
reintroduction after unplanned interruption. To know the association between
either clinical or laboratory factors and virological success in reintroduction.
Methods: We conducted a retrospective cohort study in HIV patients that were
reintroduced to first line ART after having unplanned interruption for at least one
month period. The data were collected from medical records of Dr. Cipto
Mangunkusumo Hospital in Jakarta. Viral load (VL) was evaluated at 6-18
months after first line ART reintroduction, declared as a success if VL <400
copies/mL. Analysis was done to factors associated with such virological success.
Results: Between January 2005 and December 2014, 100 subjects were
reintroduced to first line ART and having VL data in 6 to 18 months after the
reintroduction. Virological success was achieved in 55 (55%) subjects. In the
analysis we found that virological success was associated with interrupted once
(adjusted OR/aOR 5.51%, 95%CI 1.82-16.68, p=0.003) and CD4 ≥200 cell/mm
xii
Universitas Indonesia
3
at the time of reintroduction (aOR 4.33, 95%CI 1.14-16.39, p=0.031).
Conclusions: Proportion of virological success on first line ART reintroduction
after unplanned interruption was 55%. Patients who were having interrupted once
and patients with CD4 ≥200 cell/mm
3
at the time of reintroduction would have
higher odds of virological success on first line ART reintroduction.
;Background: There is no guideline concerning antiretroviral therapy (ART) of
choice for adult HIV patients after unplanned interruption. Hence, patients?
conditions at time of ART reintroduction need to be evaluated as a basis for
selecting ART regiment.
Objectives: To know the proportion of virological success of first line ART
reintroduction after unplanned interruption. To know the association between
either clinical or laboratory factors and virological success in reintroduction.
Methods: We conducted a retrospective cohort study in HIV patients that were
reintroduced to first line ART after having unplanned interruption for at least one
month period. The data were collected from medical records of Dr. Cipto
Mangunkusumo Hospital in Jakarta. Viral load (VL) was evaluated at 6-18
months after first line ART reintroduction, declared as a success if VL <400
copies/mL. Analysis was done to factors associated with such virological success.
Results: Between January 2005 and December 2014, 100 subjects were
reintroduced to first line ART and having VL data in 6 to 18 months after the
reintroduction. Virological success was achieved in 55 (55%) subjects. In the
analysis we found that virological success was associated with interrupted once
(adjusted OR/aOR 5.51%, 95%CI 1.82-16.68, p=0.003) and CD4 ≥200 cell/mm
xii
Universitas Indonesia
3
at the time of reintroduction (aOR 4.33, 95%CI 1.14-16.39, p=0.031).
Conclusions: Proportion of virological success on first line ART reintroduction
after unplanned interruption was 55%. Patients who were having interrupted once
and patients with CD4 ≥200 cell/mm
3
at the time of reintroduction would have
higher odds of virological success on first line ART reintroduction.
;Background: There is no guideline concerning antiretroviral therapy (ART) of
choice for adult HIV patients after unplanned interruption. Hence, patients?
conditions at time of ART reintroduction need to be evaluated as a basis for
selecting ART regiment.
Objectives: To know the proportion of virological success of first line ART
reintroduction after unplanned interruption. To know the association between
either clinical or laboratory factors and virological success in reintroduction.
Methods: We conducted a retrospective cohort study in HIV patients that were
reintroduced to first line ART after having unplanned interruption for at least one
month period. The data were collected from medical records of Dr. Cipto
Mangunkusumo Hospital in Jakarta. Viral load (VL) was evaluated at 6-18
months after first line ART reintroduction, declared as a success if VL <400
copies/mL. Analysis was done to factors associated with such virological success.
Results: Between January 2005 and December 2014, 100 subjects were
reintroduced to first line ART and having VL data in 6 to 18 months after the
reintroduction. Virological success was achieved in 55 (55%) subjects. In the
analysis we found that virological success was associated with interrupted once
(adjusted OR/aOR 5.51%, 95%CI 1.82-16.68, p=0.003) and CD4 ≥200 cell/mm
xii
Universitas Indonesia
3
at the time of reintroduction (aOR 4.33, 95%CI 1.14-16.39, p=0.031).
Conclusions: Proportion of virological success on first line ART reintroduction
after unplanned interruption was 55%. Patients who were having interrupted once
and patients with CD4 ≥200 cell/mm
3
at the time of reintroduction would have
higher odds of virological success on first line ART reintroduction.
"
Fakultas Kedokteran Universitas Indonesia, 2015
SP-PDF
UI - Tugas Akhir  Universitas Indonesia Library
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Nurvika Widyaningrum
Efek samping obat antiretroviral lini pertama dan pengaruhnya terhadap kepatuhan pengobatan pasien HIV/AIDS di RSPI Prof. DR. Sulianti Saroso tahun 2010-2015 = First line antiretroviral drug side effects on adherence to antiretroviral therapy among HIV/AIDS patients
"Terapi antiretroviral mampu menekan replikasi HIV, mencegah morbilitas dan mortalitas. Kepatuhan pengobatan dibutuhkan untuk mencapai kesuksesan terapi, mencegah resistensi obat antiretroviral dan risiko penularan HIVDR ditengah masyarakat. Efek samping obat antiretroviral umumnya terjadi pada 3 bulan pertama setelah inisiasi yang dapat mempengaruhi kepatuhan pengobatan pasien di tahun pertama pengobatan antiretroviral. Penelitian ini bertujuan untuk mengetahui pengaruh efek samping obat antiretroviral lini pertama terhadap kepatuhan pengobatan pasien HIV/AIDS di RSPI Prof. Dr. Sulianti Saroso tahun 2010-2015.
Penelitian ini merupakan studi kohort retrospektif berbasis rumah sakit dimana sebanyak 376 naïve-patient HIV/AIDS dipilih sebagai sampel dan diamati selama 12 bulan setelah inisiasi ART. Kepatuhan pengobatan diukur dengan dua metode yaitu berdasarkan self report dan ketepatan waktu ambil obat. Data dianalisa dengan menggunakan cox proportional hazard regression dengan perangkat lunak STATA12. Hasil penelitian menunjukkan bahwa efek samping obat ARV lini pertama berpengaruh terhadap kepatuhan minum obat (RR12=1,45, 95% CI 1,009?2,021 dan RR34=0,85, 95% CI 0,564-1,273) namun tidak berpengaruh terhadap kepatuhan ambil obat (RR12=1,23, 95% CI 0,851-1,839 dan RR34=0,70, 95% CI 0,437-1,108).
Antiretroviral therapy suppresses HIV replication, preventing morbidity and mortality. Adherence to antiretroviral therapy is needed to achieve successful treatment, prevent resistance to antiretroviral drugs and the risk of transmission of HIVDR in the community. The side effects of antiretroviral drugs generally occur in the first 3 months after initiation that could affect adherence in the first year of antiretroviral treatment. The aim of this study analyzed the effect of first-line antiretroviral side effect and adherence of HIV/AIDS patients in RSPI Prof. Dr. Sulianti Saroso period 2010 until 2015.
This study is hospital based retrospective cohort. A total of 376 HIV/AIDS naïve-patient had been selected as samples. Adherence was measured by two methods, based on self report and drug pick-up. Data was analyzed using cox proportional hazard regression with STATA12 software. Based on self report, HIV/AIDS patients who experience first-line ARV drugs side effect significantly associated with non-adherent (RR12=1.45, 95% CI 1.009 to 2.021 and RR34=0.85, 95% CI 0.564 to 1.273). Based on drug pick up, patients who experience first-line ARV drugs side effect not significantly associated with non-adherent (RR12=1.25, 95% CI 0.851 to 1.839 and RR34=0.70, 95% CI 0.437 to 1.108)."
Depok: Fakultas Kesehatan Masyarakat Universitas Indonesia, 2016
T45807
UI - Tesis Membership  Universitas Indonesia Library
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Kartika Maharani
Gambaran neuropati pada pasien HIV dalam terapi antiretroviral non stavudin dan faktor-faktor yang berhubungan = Peripheral neuropathy in HIV patients receiving highly active antiretroviral therapy without stavudine and associated risk factors / Kartika Maharani
"ABSTRAK
Latar Belakang: Neuropati perifer merupakan komplikasi neurologis tersering pada pasien HIV. Stavudin, yang dikaitkan dengan risiko neuropati perifer, mulai ditinggalkan sebagai pilihan pertama terapi antiretroviral. Penelitian ini bertujuan untuk mengetahui angka kejadian neuropati pada pasien HIV dalam terapi antiretroviral non stavudin menggunakan multimodalitas pemeriksaan, dan faktor risiko yang berhubungan.
Metode Penelitian: Penelitian berdesain potong lintang menggunakan data sekunder dari penelitian JakCCANDO ditambah dengan data primer dari pasien HIV dalam terapi antiretroviral non stavudin minimal 12 bulan yang berobat di Unit Pelayanan Tepadu (UPT) HIV Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo (RSUPNCM). Anamnesis dan penelusuran data faktor risiko, skrining klinis Brief Peripheral Neuropathy Screen (BPNS), elektroneurografi, dan Stimulated Skin Wrinkling (SSW) dengan krim lidokain:prilokain 5% dilakukan pada setiap subjek penelitian. Data dianalisis dengan SPSS 17.0.
Hasil: Angka kejadian polineuropati simetris distal (PSD) pada 68 subjek penelitian berdasarkan BPNS, elektroneurografi, SSW, dan kombinasi ketiga modalitas ialah 16,2%, 25%, 29,4%, dan 52,9%. Subjek dengan CD4 nadir kurang dari 50 sel/l memiliki risiko PSD sebesar 2,85 kali lebih tinggi dibandingkan kelompok subjek dengan CD4 nadir yang lebih tinggi (IK 95% 1,99-8,29). Subjek yang memiliki tinggi badan lebih dari sama dengan 170 cm (p<0,03) dan viral load lebih dari sama dengan 35.000 kopi/ml (p<0,05) memiliki rerata kecepatan hantar saraf sensorik tungkai bawah lebih rendah dibandingkan subjek dengan tinggi badan dan viral load yang lebih rendah.
Kesimpulan: Angka kejadian neuropati perifer pada pasien HIV masih cukup tinggi yaitu 52,9% dari subjek penelitian, meskipun stavudin tidak lagi digunakan. Penggunaan multimodalitas pemeriksaan memberikan kemampuan deteksi neuropati lebih banyak dibandingkan modalitas pemeriksaan tunggal. Subjek dengan CD4 nadir kurang dari 50 sel/l, 2,85 kali lebih berisiko mengalami PSD. Penelitian ini juga menunjukkan adanya hubungan antara tinggi badan lebih dari sama dengan 170 cm dan viral load lebih dari sama 35.000 kopi/ml terhadap abnormalitas parameter elektroneurografi saraf sensorik tungkai bawah.
ABSTRACT
Background: Peripheral neuropathy was a common neurologic complications in HIV patients. Stavudine, which was often associated with neuropathy risk, is no longer used as first line HAART. This study was aimed to determine prevalence of neuropathy in HIV patients receving HAART without stavudine using multi modalities examination, and associated risk factors.
Materials and Method: A cross-sectional study was undertaken using secondary data from JakCCANDO study subjects and primary data from HIV patients receiving antiretroviral therapy without stavudine for minimum 12 months in Integrated HIV Outpatient Clinics of Cipto Mangunkusumo General Hospital. All subjects were performed history taking, Brief Peripheral Neuropathy Screen (BPNS), electroneurography, and Stimulated Skin Wrinkling (SSW) using lidocaine:prilocaine 5% cream. Data analysis was done using SPSS 17.0.
Results:Prevalence of symmetric distal polyneuropathy (DSP) from 68 study subjects based on BPNS, electroneurography, SSW, and combination of three modalities were 16,2%, 25%, 29,4%, and 52,9%. Subjects with nadir CD4 less than 50 cells/l were at increased risk of DSP 2,85 times larger than subjects with higher nadir CD4 (CI 95% 1,99-8,29). Subjects with a height of equal or more than 170 cm (p<0,03) and viral load of equal or more than 35.000 copies/ml (p<0,05) had significantly decrease mean of lower extremities sensory nerve conduction velocities based on electroneurography compared to subjects with lower height and viral load.
Conclusions: Peripheral neuropathy remained a numerous neurological complication, as much as 52,9% of study subjects, even when stavudine was no longer used. Multiple diagnostic tools used in this study gave higher neuropathy number compared to single diagnostic modality. Subjects with nadir CD4 less than 50 cells/l had 2,85 times higher risk of having DSP. There were also correlation between height equal or more than 170 cm and viral load equal or more than 35.000 copies/ml with electroneurographic parameter abnormalities of sensory nerve in lower extremities."
Depok: Fakultas Kedokteran Universitas Indonesia, 2015
T-Pdf
UI - Tesis Membership  Universitas Indonesia Library
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Rahajeng Dewantari
Prevalensi ketaatan minum obat ARV dan faktor-faktor yang berhubungan pada orang dengan HIV/AIDS di UPT HIV RSUPN Cipto Mangunkusumo = Adherence to antiretroviral therapy prevalence and related factors in people living with HIV/AIDS in HIV integrated central unit Cipto Mangunkusumo Hospital
"Ketaatan minum obat dalam penanganan HIV/AIDS dengan pengobatan ARV merupakan faktor yang penting dalam menentukan keberhasilan terapi. Di Indonesia belum ada data yang menyebutkan angka pasti ketaatan minum obat ARV pada ODHA. Ketaatan minum obat ARV dipengaruhi oleh adanya faktorfaktor psikologis (stigma diri dan fungsi kognitif) dan non psikologis yang terdiri dari faktor demografi (umur, waktu tempuh tempat tinggal ke rumah sakit, akses berobat, tingkat pendidikan, pekerjaan, tinggal sendiri atau bersama orang lain, pembiayaan berobat, penggunaan NAPZA) dan faktor obat dan penyakit (kompleksitas regimen obat, adanya infeksi oportunistik, sumber transmisi HIV).
Hasil penelitian ini menunjukkan bahwa prevalensi ketaatan minum obat ARV pada ODHA yang berobat di UPT HIV RSUPN Cipto Mangunkusumo adalah 67,7%, stigma diri memiliki hubungan yang bermakna dengan ketaatan minum obat ARV, sedangkan faktor non psikologis yang diteliti dan fungsi kognitif tidak memiliki hubungan yang bermakna dengan ketaatan minum obat ARV.
Adherence to ARV is an important factor in determining the success of HIV/AIDS treatment. There has been no data about adherence to ARV in plwh in indonesia. Adherence to ARV is influenced by psychological factors (self-stigma and cognitive function) and non-psychological factors consisting of demographic (age, travel time between living place and hospital, access to treatment, level of education, occupation, living alone or with others, treatment payment, illicit drugs use), disease and treatment factor (treatment regimen complexity, opportunistic infections, source of HIV transmission).
The result of this study showed that prevalence of adherence to ARV in plwh coming to HIV integrated service unit Cipto Mangunkusumo hospital is 67,7%, that self-stigma had significant relation with adherence to ARV, while psychological factors and cognitive function had no significant relation with adherence to ARV."
Depok: Fakultas Kedokteran Universitas Indonesia, 2014
T-Pdf
UI - Tesis Membership  Universitas Indonesia Library
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Dora Syakina Desriana
Kemampuan Infeksi Virus Kimera Simian Human Immunodeficiency Virus (SHIVst) pada Kultur Sel HT-29 = Infectivity of Chimeric Simian Human Immunodeficiency Virus (SHIVst) in HT29 cells
"Simian Human Immunodeficiency Virus (SHIV) merupakan virus kimera yang berasal dari rekombinasi antara HIV yang dapat menginfeksi manusia dan SIV yang dapat menginfeksi primata non manuisa. Pada penelitian ini, dilakukan substitusi sekuens gen virus kimera pada sekuens gen gag, yaitu Cyclophilin A binding domain, gen vif, dan gen nef. Hasil rekombinasi pada virus kimera SHIV diinfeksikan pada sel HT-29 yang memiliki alternatif molekul yang dapat mengenali reseptor gp120, yaitu galaktosilseremida.  Uji infektivitas virus kimera SHIVst ini bertujuan untuk melihat kemampuan infeksi virus kimera melalui analysis keberadaan materi genetik yaitu RNA virus dan protein kapsid, yaitu p24. Hasil yang diperoleh virus kimera dapat dihasilkan melalui transfeksi pada sel CHO terdapat pita RNA virus yang terbentuk pasca amplifikasi. Selain itu, analisis kebaradaan protein p24 juga terkonfirmasi melalui western blot dan ELISA antigen p24 dari supernatant pasca transfeksi. Namun, pada hasil infeksi virus kimera yang dilakukan pada sel HT-29, keberadaan RNA virus melalui tahapan amplifikasi baik PCR konvensional maupun RT PCR tidak menunjukkan terbentuknya pita spesifik RNA virus. Oleh karena itu, virus kimera SHIVst tidak bisa menginfeksi sel HT29.
Simian Human Immunodeficiency Virus (SHIV) is a chimeric virus originating from recombination between HIV which can infect humans and SIV which can infect non-human primates. In this study, chimera virus gene sequences were substituted for gag gene sequences, namely Cyclophilin A binding domain, vif gene, and nef gene. SHIVst was infected with HT-29 cells which have an alternative molecule that can recognize the gp120 receptor, namely galactosylceremide. The infectivity test of the SHIVst chimera virus was aimed at assessing the infectivity of the chimera virus through analysis of the presence of viral RNA and capsid protein, p24. The results obtained by the chimera virus can be produced by transfection in CHO cells, there are viral RNA bands formed after amplification. In addition, analysis of the presence of p24 protein was also confirmed by western blot and p24 antigen ELISA of the post-transfection supernatant. However, in the results of SHIVst infection HT-29 cells, the presence of viral RNA through the amplification stages of both conventional PCR and RT PCR did not show the formation of viral RNA-specific bands. Therefore, the SHIVst chimeric virus could not infect HT29 cells."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2022
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UI - Tesis Membership  Universitas Indonesia Library
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Yeni Fuspita
Pengalaman ibu rumah tangga dengan human immunodeficiency virus dalam melakukan HIV testing di RSUD Dr. H. Abdul Moeloek Lampung = The experience of housewive with human immunodeficiency virus in performing HIV testing at RSUD Dr. H. Abdul Moeloek Lampung
"Jumlah perempuan dengan HIV makin menunjukkan adanya peningkatan. Infeksi HIV tidak hanya pada kelompok dengan perilaku berisiko, namun juga pada kelompok yang tidak memiliki perilaku berisiko. Ibu rumah tangga saat ini menjadi kelompok yang berisiko terinfeksi HIV. HIV-testing merupakan upaya untuk mencegah penyebaran infeksi HIV dan sebagai gerbang pelayanan pengobatan. Tujuan penelitian adalah mengeksplorasi pengalaman ibu rumah tangga dengan HIV di Lampung dalam melakukan HIV-testing. Desain penelitian ini menggunakan penelitian kualitatif fenomenologi dengan wawancara mendalam sebagai teknik pengumpulan data. Jumlah ibu rumah tangga yang terlibat sebanyak 16 orang. Hasil penelitian diperoleh enam tema utama, yaitu HIV-testing yang ldquo;tidak disengaja rdquo;, pengetahuan yang rendah mengenai HIV, persepsi tidak berisiko terinfeksi HIV, kurangnya informasi pada layanan konseling HIV-testing, adanya pengalaman stigma dan tindakan diskriminasi, dan ketidakberdayaan peran ibu. Rekomendasi penelitian ini adalah pentingnya meningkatkan sosialisasi pendidikan HIV dan pentingnya HIV-testing pada kelompok ibu rumah tangga guna mencegah dan mengurangi kejadian penularan infeksi HIV ibu-anak.
The number of women living with HIV is increasing nowadays. HIV infection is not only in risky group but also in group considered safe. Today, housewive become a risky group of being infected with HIV. HIV testing is the way to prevent the HIV infection spreadings and as the main gate for treatment service. The purpose of this study was to explore the experience of housewive with HIV in Lampung when performing HIV testing. This study used phenomenology qualitative method with indepth interview as the way for collecting data. 16 participants were involved in this study. Six main themes were found, as follows an accidental HIV testing, lack of knowledge of HIV, perception is not at risk of HIV, low HIV testing counseling services, being stigmatized and discriminated, and disempowerment of mother rsquo s role. This study recommended the improvement of the HIV education and the benefit of the test for housewive in order to prevent the mother to child infection."
Depok: Fakultas Ilmu Keperawatan Universitas Indonesia, 2018
T50585
UI - Tesis Membership  Universitas Indonesia Library
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Akhmad Ghozali
Evaluasi Anggaran Berbasis Kinerja pada Pelayanan Dasar Kelompok Berisiko Terinfeksi Human Immunodeficiency Virus (HIV) di Dinas Kesehatan Kota Binjai Tahun 2022 = Performance-Based Budget Evaluation For Basic Services For Groups At Risk Of Being Infected With The Human Immunodeficiency Virus (HIV) at The Binjai Municipality Public Health Office in 2022
"Dinas Kesehatan Kota Binjai bertanggung jawab menyediakan pelayanan dasar pada kelompok berisiko terinfeksi HIV. Total anggaran pada Dinas Kesehatan meningkat dari tahun 2019-2022, namun Kinerja pelayanan dasar HIV mengalami penurunan dari tahun 2019-2021 sebesar 11,8%, 7,07%, 5,2% dari target 100%. Penelitian bertujuan menghitung kesesuaian anggaran berbasis kinerja dengan anggaran yang tersedia serta faktor struktur dan proses yang mempengaruhi penyusunan anggaran berbasis kinerja, sehingga memberikan gambaran masalah dan penyebab kesenjangan anggaran dan kinerja pada pelayanan dasar HIV di Dinas Kesehatan Kota Binjai Tahun 2022. Metode penelitian dilakukan menggunakan pendekatan kualitatif deskriptif dengan desain Rapid Assessment Prosedur (RAP), menggunakan instrumen wawancara mendalam kepada 14 (empat belas) informan dan telaah dokumen untuk melihat secara cepat dan memberikan masukan perbaikan bagi pelaksanaan anggaran berbasis kinerja pada pelayanan dasar kelompok berisiko terinfeksi HIV di Dinas Kesehatan Kota Binjai Tahun 2022. Hasil penghitungan anggaran berdasarkan target kinerja Tahun 2022 sebesar Rp. 648.295.342 dengan alokasi anggaran sebesar Rp.188.202.607. Sementara kesenjangan tersebut dipengaruhi oleh faktor struktur meliputi pemahaman dan kompetensi SDM, dukungan kebijakan, kurang tersedia data dan informasi akurat menggunakan sistem informasi kesehatan. Pada komponen proses kurangnya partisipasi masyarakat, skala prioritas dalam perencanaan dan penganggaran, komunikasi dan koordinasi, sinkronisasi dan fragmentasi penyusunan anggaran, penyerapan anggaran yang belum optimal, efektivitas monitoring dan evaluasi belum dijadikan dasar perbaikan kebijakan anggaran tahun depan. Komitmen daerah masih lemah untuk program pelayanan dasar HIV. Penelitian ini menyimpulkan terdapat ketidaksesuaian anggaran untuk mencapai kinerja yang ditetapkan dengan alokasi anggaran yang tersedia pada pelayanan dasar kelompok berisiko terinfeksi HIV di Dinas Kesehatan Kota Binjai pada Tahun 2022. Diperlukan peningkatan kapasitas dan keterlibatan seluruh komponen organisasi dalam menyusun anggaran berbasis kinerja, menyediakan data dan informasi terintegrasi, mengggunakan sistem informasi seperti Siskobikes dalam proses anggaran, meningkatkan komitmen dan dukungan anggaran dari pemerintah pusat dan daerah sehingga alokasi anggaran dapat memenuhi kebutuhan untuk mencapai kinerja pelayanan dasar bagi kelompok berisiko terinfeksi HIV.
The Public Health Office of Binjai Municipality is responsible for providing basic services to groups at risk of HIV infection. The total budget at the Health Service has increased from 2019-2022, but the performance of basic HIV services has decreased from 2019-2021 by 11.8%, 7.07%, 5.2% of the 100% target. The research aims to calculate the suitability of performance-based budgeting with the available budget as well as the structural and process factors that influence the preparation of performance-based budgeting, so as to provide an overview of the problems and causes of budgetary and performance gaps in HIV basic services at the Binjai City Health Office in 2022. The research method was carried out using an approach Descriptive qualitative using the Rapid Assessment Procedure (RAP) design, using in-depth interviews with 14 (fourteen) informants and document review to see quickly and provide input for improvements to the implementation of performance-based budgeting in basic services for groups at risk of HIV infection at the Binjai City Health Office 2022. The budget calculation results are based on the 2022 performance target of Rp. 648,295,342 with a budget allocation of Rp.188,202,607. Meanwhile, this gap is influenced by structural factors including understanding and competence of human resources, policy support, lack of availability of accurate data and information using health information systems. In the process component, lack of public participation, priority scale in planning and budgeting, communication and coordination, budget synchronization and fragmentation, budget absorption that is not optimal, monitoring and evaluation effectiveness has not been used as a basis for improving next year's budget policy. Regional commitment is still weak for basic HIV service programs. This study concludes that there is a budget mismatch to achieve the performance set with the budget allocation available for basic services for groups at risk of HIV infection at the Binjai Municipality Public Health Office in 2022. Capacity building and involvement of all organizational components is needed in preparing performance-based budgeting, providing data and information integrated, using information systems such as Siskobikes in the budget process, increasing commitment and budgetary support from the central and regional governments so that budget allocations can meet the needs to achieve basic service performance for groups at risk of HIV infection."
Depok: Fakultas Kesehatan Masyarakat Universitas Indonesia, 2023
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UI - Tesis Membership  Universitas Indonesia Library
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Tambunan, Riski Amanda
Infeksi galur sel T CD4 dengan virus HIV-1 CRF01_AE untuk mendapatkan klona galur sel T pengekspresi HIV-1 = Infection of CD4 T cell line with HIV-1 CRF01_AE virus to achieve T cell line expressing HIV-1 clone
"Kejadian AIDS (Acquired Immunodeficiency Syndrome) yang disebabkan Human Immunodeficiency Virus tipe 1 (HIV-1) terus meningkat setiap tahunnya. Pencegahan penularan virus HIV-1 masih sulit karena belum ada vaksin yang telah ditemukan untuk mencegah penularan atau transmisi virus ini. Selain itu, faktor lainnya adalah jarangnya diagnostik yang tersedia untuk awal infeksi, serta variasi genetik virus HIV-1 yang meningkat dengan cepat. Penelitian bertujuan untuk mengembangkan virus dengan menggunakan klona galur sel T CD4 yaitu CEM-GFP dengan virus HIV-1 CRF01_AE untuk mendapatkan virus dengan sifat genetik yang relatif homogen dan sifat virus yang sama. Ekspresi virus dalam sel target dimonitor melalui induksi green fluorescent protein yang akan diekspresikan oleh CEM-GFP ketika sel ini terinfeksi oleh virus HIV-1. Infeksi dilakukan dengan dua metode yaitu direct cell to cell transmission dan cell-free virus infection, hasil infeksi kedua metode ini dibandingkan fluoresensinya dengan mikroskop fluoresensi dan pengukuran ekspresi GFP dengan sitometer.
Setelah 7 hari kultur, pengamatan dengan mikroskop fluoresensi menunjukkan bahwa sel terinfeksi dengan metode direct cell to cell transmission lebih banyak dibandingkan dengan cell-free virus infection. Pengukuran ekspresi GFP dengan sitometer pun menunjukkan hal serupa dimana ekspresi GFP sel terinfeksi dengan metode direct cell to cell transmission lebih banyak dibanding dengan cell-free virus infection. Untuk melihat apakah virus berhasil dikeluarkan dari sel terinfeksi dilakukan dengan metode Polymerase Chain Reaction. Hasil menunjukkan bahwa virus telah berhasil terdeteksi pada supernatan kultur sel CEM-GFP terinfeksi virus HIV-1.
The incidents of AIDS (Acquired Immunodeficiency Syndrome) that caused by Human Immunodeficiency Virus type 1 (HIV-1) are increasing every year. The prevention of HIV transmission is still difficult to be done because HIV vaccine has not been found yet. Besides, another factor in HIV therapy is the rare early diagnostic available and the genetic variation of HIV-1 virus that increased rapidly. This study was aimed for propagating virus by using CEM-GFP clones, the derivative of CD4 T cells infected with CRF01_AE for obtaining virus with relatively homogen genetic variation and possessing the same characteristic. The virus expression in the target cell was observed by the induction of green fluorescent protein expressed by CEM-GFP when this cell was infected by HIV-Virus. The infection was held by two methods, cell-to-cell transmission and cellfree virus infection, the fluorescent of infected cell of this two methods was compared with fluorescent microscope and GFP expression assay with cytometer.
Within 7 days of culture, observation with fluorescent microscope showed that the infected cells of direct cell-to-cell transmission method was higher than the cellfree virus infection. GFP expression assay also showed the same result. The GFP expression of infected cells with direct cell-to-cell transmission was higher than cell-free virus infection. To investigate whether the virus was released from the infected cells, Polymerase Chain Reaction, were applied in this study. The result showed that the cell-free virus can be detected in culture supernatant of CEMGFP cells infected with HIV-1."
Depok: Fakultas Farmasi Universitas Indonesia, 2013
S47681
UI - Skripsi Membership  Universitas Indonesia Library
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Ni Nengah Dwi Fatmawati
Reserve transcription polymerase chain reaction (RT-PCR) sebagai uji alternative untuk deteksi infeksi Human Immunodeficiency Virus type-I (HIV-1)
"Human Immunodeficiency Virus type-I (HIV-1) merupakan penyebab sindroma penurunan sistem imun tubuh yang disebut dengan Acquired Immunodeficiency Syndrome (AIDS). Infeksi HIV-I di dunia dan Indonesia cenderung meningkat. Pemeriksaan yang cepat dan spesifik diperlukan untuk mencegah penyebaran infeksi HIV-I. Berbagai teknik telah dikembangkan untuk deteksi infeksi HIV-I. Pada penelitian ini dikembangkan pemeriksaan RT-PCR HIV-1 Mikrobiologi FKUI (in-house RT-PCR) untuk mendapatkan uji alternatif deteksi HIV-1. Sebanyak 46 plasma dan serum kelompok berperilaku risiko tinggi yang berkunjung ke klinik VCT . RSUP Sanglah Denpasar, telah diperiksa dalam penelitian ini. Serum diperiksa dengan 3 kit rapid test yang berbeda yaitu DetermineTM HIV-1/2 (Abbott), ImmunoCombR HIV 1 & 2 BiSpot (Organics), dan SerodieR HIV-1/2 (Fujirebio Inc.). Plasma diuji dengan pemeriksaan RTPCR generasi I menggunakan primer spesifik terhadap daerah gag dan RT-PCR generasi 2 menggunakan primer spesifik terhadap daerah protease dari genom HIV-1. Hasil rapid test menunjukkan dari 46 sampel, sebanyak 26 serum (56,5%) reaktif dan 20 serum (43,5%) non-reaktif. Tingkat sensitivitas, spesifisitas, nilai duga positif, dan nilai duga negatif RT-PCR generasi 1 secara berturut-turut adalah 80,8%, 95%, 95,5%, dan 79,2%, sedangkan rasio kemungkinan positif dan negatif adalah 16,2, dan 0,2. Pemeriksaan RTPCR generasi 2 menunjukkan tingkat sensitivitas 65,4%, spesifisitas 90%, nilai duga positif 89,5%, nilai duga negatif 66,7%, rasio kemungkinan positif 6,5, dan rasio kemungkinan negatif 0,4. Teknik RT-PCR yang menggunakan primer tersebut dapat mendeteksi HIV pada semua stadium klinis WHO pada kelompok ini. Sensitivitas dan spesifisitas RT-PCR generasi 1 lebih baik daripada RT-PCR generasi 2, tetapi, masih lebih rendah daripada baku emas, Secara keseluruhan, RT-PCR pada penelitian ini belum dapat direkomendasikan sebagai uji altematif baik uji skrining maupun uji konfirmasi dalam mendeteksi infeksi HIV-1.
Human Immunodeficiency Virus type 1 (HIV-1) can cause decrease of immune response which is called Acquired Immunodeficiency Syndrome (AIDS). HIV-l infection in the world and Indonesia tends to increase. Many techniques were developed to detect HIV-1 infection. A specific and rapid diagnosis is needed to prevent transmission of HIV-1 infection. In this study, we performed RT-PCR HIV-1 Microbiology FKUI (in-house RT-PCR) as an alternative test to detect HIV-1. Forty six plasmas and serums from high risk behavior group who visited VCT Clinic Sanglah General Hospital, Denpasar were used in this study. Serums were tested with 3 different rapid test kits i.e. Determine ° IIIV-112 (Abbott), immunoComb HIV I & 2 BiSpot (Orgenics), and Serodia ' HIV-112 (Fujirebio Inc.). Plasmas were tested with I generation RT-PCR which used specific primers to gag region in HIV-1 genome and specific primers to protease region in IIIV-1 genome for 2nd generation RT-PCR. Results of rapid test demonstrated 26 serums (56.5%) were reactive and 20 serums (43.5%) were non-reactive. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 1st generation RT-PCR was 80.8%, 95%, 95.5%, 79.2%, whereas positive likelihood ratio (LR +) and negative likelihood ratio (LR -) was 16.2, and 0.2, respectively. The 2"d generation RT-PCR showed sensitivity, specificity, PPV, NPV, LR (+), and LR (-) was 65.4%, 90%, 89.5%, 66.7%, 6.5, and 0.4, respectively. These in-house RT-PCR could detect HIV-1 in all WHO clinical staging in this group. This study showed that lsi generation RT-PCR gives better results than 2"d generation RT-PCR. But still inferior than rapid test to detect HIV-1 infection. Overall, RT-PCR in this study has not been recommended yet as an alternative test to detect HIV-I infection."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2006
T21154
UI - Tesis Membership  Universitas Indonesia Library
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