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Abstrak :
Kurangnya kepatuhan terhadap pengobatan menjadi faktor risiko munculnya jenis HIV yang resisten terhadap obat, yang dapat ditularkan kepada orang lain. Kepatuhan terhadap pengobatan yang buruk tidak hanya membahayakan kesehatan individu tetapi juga meningkatkan penularan. Penelitian ini bertujuan untuk mengamati faktor-faktor yang berhubungan dengan terjadinya ketidakpatuhan minum obat ARV pada ODHIV yang mendapatkan terapi ARV di Rumah Sakit Umum Daerah Kabupaten Tangerang. Jenis penelitian ini menggunakan penelitian observasional dengan rancangan cross sectional. Penelitian dilakukan di poli HIV Rumah Sakit Umum Daerah Kabupaten Tangerang dan waktu penelitian dilakukan pada bulan November 2023 menggunakan data sekunder. Populasi penelitian berjumlah 1.337 ODHIV yang aktif menjalani pengobatan antiretroviral di Rumah Sakit Umum Daerah Kabupaten Tangerang dengan menggunakan total sampling sesuai dengan kriteria inklusi dan ekslusi sehingga sampel penelitian berjumlah 1.286 ODHIV. Hasil analisis univariat menunjukan bahwa usia ≥ 35 tahun (56,45), laki-laki (61,20%), pendidikan rendah (87,10%), belum kawin atau cerai (51,92%), domisili dalam kabupaten Tangerang (55,88%), mendapatkan konseling kepatuhan (63,73%), memiliki jaminan kesehatan (51,92%), ≥5km akses layanan kesehatan (54,07%), IO non TB (40,90%), stadium lanjut (63,69%), viral load ≥40 mL (46,73%), tidak ada efek samping obat (53,34%), lamanya pengobatan >5 tahun (72,01%), masuk kedalam populasi kunci (88,01%) dan tidak mendapat dukungan (61,12%). Hasil analisis kai kuadrat secara statistik ada hubungan antara umur, jenis kelamin, status pendidikan, status perkawinan, domisili, pelayanan konseling kepatuhan, stadium klinis WHO, viral load, lamanya pengobatan ARV, kelompok populasi kunci dan dukungan teman sebaya (P-Value<0,05) dengan ketidakpatuhan minum obat ARV. Hasil analisis cox regression dengan faktor yang secara statistik berhubungan terhadap ketidakpatuhan minum obat antiretroviral pada ODHIV adalah umur (P-Value=0,01) nilai PR 1,20 dengan 95% CI (1,05-1,38), status perkawinan (P-Value=0,02) nilai PR 1,18 dengan 95% CI (1,03-1,36), domisili (P-Value=0,01) nilai PR 1,19 dengan 95% CI (1,04-1,36), viral load (P-Value=0,001) nilai PR 1,27 dengan 95% CI (1,10-1,43), lamanya pengobatan ARV (P-Value=0,005) nilai PR 1,25 dengan 95% CI (1,07-1,47), kelompok populasi kunci (P-Value=0,02) nilai PR 1,27 dengan 95% CI (1,04-1,56), dukungan teman sebaya (P-Value=0,04) nilai PR 1,15 dengan 95% CI (1,00-1,32). Faktor umur, status perkawinan, domisili, viral load, lamanya pengobatan, kelompok populasi kunci dan dukungan teman sebaya  memiliki pengaruh terhadap ketidakpatuhan minum obat antiretroviral (ARV) pada ODHIV di Rumah Sakit Umum Daerah Kabupaten Tangerang. ......Lack of treatment adherence becomes a risk factor for the emergence of drug-resistant strains of HIV, which can be transmitted to others. Poor adherence to treatment harms the individual’s health and increases the risk of transmission. This study aims to observe the factors associated with the occurrence of non-adherence to taking ARV drugs in PLHIV who receive ARV therapy at the Regional General Hospital of Tangerang Regency. This type of study uses observational research with a cross-sectional design. The study was conducted at the HIV Specialist of the Regional Govern Hospital of Tangerang Regency and the time of the study was carried out in November 2023 using secondary data. The study population amounted to 1,337 PLHIV who were actively undergoing antiretroviral treatment at the Regional General Hospital of Tangerang Regency using total sampling by inclusion and exclusion criteria so that the study sample amounted to 1,286 PLHIV. The results of the univariate analysis showed that the age of ≥ 35 years (56.45), male (61.20%), low education (87.10%), unmarried or divorced (51.92%), domiciled in Tangerang district (55.88%), received compliance counselling (63.73%), had health insurance (51.92%), ≥5km of health service access area (54.07%), non-TB IO (40.90%), advanced stage (63.69%), viral load ≥40 mL (46.73%), no drug side effects (53.34%), duration of treatment ≥5 years (72.01%), entered into key populations (88.01%) and received no support (61.12%). The results of the kai squared analysis statistically showed there was an association between age, sex, educational status, marital status, domicile, adherence to counselling services, WHO clinical stage, viral load, duration of ARV treatment, key population groups and peer support (P-Value<0.05) with non-adherence to taking ARV drugs. The results of Cox Regression analysis with factors statistically related to non-adherence to taking antiretroviral drugs in ODHIV were age (P-Value = 0.01), PR value 1.20 with 95% CI (1.05-1.38), marital status (P-Value = 0.02), PR value 1.18 with 95% CI (1.03-1.36), domicile (P-Value = 0.01), PR value 1.19 with 95% CI (1.04-1.36), viral load (P-Value = 0.001), PR value 1.27 with 95% CI (1.10-1.43),  duration of ARV treatment (P-Value = 0.005), PR value 1.25 with 95% CI (1.07-1.47), key population group (P-Value = 0.02), PR value 1.27 with 95% CI (1.04-1.56), peer support (P-Value = 0.04), PR value 1.15 with 95% CI (1.00-1.32). Factors such as age, marital status, domicile, viral load, duration of treatment, key population groups and peer support have an influence on non-adherence to taking antiretroviral drugs (ARV) in PLHIV at the Regional General Hospital of Tangerang Regency.

Abstrak :
Terapi antiretroviral mampu menekan replikasi HIV, mencegah morbilitas dan mortalitas. Kepatuhan pengobatan dibutuhkan untuk mencapai kesuksesan terapi, mencegah resistensi obat antiretroviral dan risiko penularan HIV ditengah masyarakat. Penelitian ini bertujuan untuk mengetahui factor-faktor yang mempengaruhi kepatuhan pengobatan obat antiretroviral pasien HIV/AIDS di empat rumah sakit di DKI Jakarta tahun 2018-2019. Penelitian ini merupakan penelitian observasional dengan rancangan cross sectional dari data baseline penelitian INA-PROACTIVE (data sekunder). dimana sebanyak 666 ODHA dipilih sebagai sampel. Kepatuhan pengobatan diukur berdasarkan self report. Data dianalisa dengan menggunakan cox proportional hazard regression dengan perangkat lunak STATA12. Hasil penelitian menunjukkan proporsi kepatuhan <95% sebesar 17,9%. Analisis faktor determinan kepatuhan berobat pada penelitian ini menggunakan analisis multivariat cox regresi dan besar pengaruh dinyatakan dalam prevalensi rasio (PR) dengan confident interval (CI) 95%. Penelitian ini menunjukkan faktor sosio-demografi yang berhubungan dengan ketidakpatuhan pengobatan pada ODHA yang mendapat terapi ARV adalah variabel jenis kelamin, usia, status pernikahan dan rute transmisi HIV. Faktor klinis yang mempunyai hubungan dengan kepatuhan minum obat ARV adalah variabel adanya riwayat infeksi oportunistik sifilis dan nilai CD4. Faktor pengobatan yang mempunyai hubungan dengan kepatuhan minum obat ARV adalah variabel jenis paduan ARV dan lama pengobatan ARV. Semua variabel tersebut tidak berpengaruh signifkan secara statistik dengan nilai p value > 0,05. ......Antiretroviral therapy suppresses HIV replication, prevent mobility and mortality. Treatment adherence is needed to achieve therapeutic success, prevent antiretroviral drug resistance and the risk of HIV transmission in the community. This study aims to determine the factors that associated with the adherent of antiretroviral drug treatment of HIV / AIDS patients in four hospitals in Jakarta in 2018-2019. This study was an observational study with a cross sectional design from the baseline data of INA-PROACTIVE study (secondary data) from 666 people living with HIV. Treatment compliance was measured by self-report. Data were analyzed using cox proportional hazard regression with STATA12 software. The results showed the proportion of non-adherent by 17.9%, Analysis of determinant factors for compliance with treatment in this study using multivariate cox regression analysis and the magnitude of the effect was expressed in the prevalence ratio (PR) with 95% confidence interval (CI). Our study showed a proportion of ARV treatment adherence ≥ 95% showed 82.1%. This study showed that the socio-demographic factors associated with ARV treatment adherence among people living with HIV who received ARV therapy were gender, age, marital status and HIV transmission route. Clinical factors that have a relationship with adherence of ARV were the variable history of opportunistic infection syphilis and CD4 value. Treatment factors that have a relationship with adherence of ARV were the variable type of ARV regiment and duration of ARV treatment. All these variables were not statistially significant effect with p value > 0.05.

Abstrak :
Latar Belakang. Walaupun pasien HIV mendapat terapi antiretroviral yang efektif, penurunan fungsi fisik sering ditemukan lebih awal dan menimbulkan masalah baru berupa penuaan dan frailty. Tujuan. Mengetahui proporsi dan faktor-faktor yang berhubungan dengan prefrail dan frail pada pasien HIV dalam terapi antiretroviral. Metode. Desain studi potong lintang pada pasien HIV usia ≥30 tahun dalam terapi ARV minimal 6 bulan. Pasien yang memenuhi inklusi dilakukan pencatatan demografis, penyakit komorbid, faktor terkait HIV seperti lama terdiagnosis, lama ARV, dan CD4, pengukuran antropometri seperti indeks massa tubuh, penilaian depresi dengan Indo BDI-II, dan penilaian frailty dengan kriteria Fried. Pasien dengan riwayat infeksi otak, kanker, dan oportunistik aktif dieksklusi. Analisis bivariat dan multivariat dilakukan pada faktor-faktor tersebut. Hasil. Terdapat 164 pasien yang dianalisis. Proporsi prefrail sebanyak 51,2% (84 pasien) dan frail 3,7% (6 pasien), dengan komponen dominan pada kelemahan genggam. Pasien laki-laki sebanyak 72% dengan median usia (IQR) 40,5 (36-47) tahun, dan median CD4 nadir (IQR) 53 (21–147) sel/mm3, median CD4 awal (IQR) 77 (32 – 206) sel/mm3. Hepatitis C menjadi faktor komorbid terbanyak. Depresi berhubungan dengan prefrail dan frail dengan OR 2,14 (IK95%: 1,034–4,439) dan p = 0,036. Tidak terdapat hubungan faktor usia ≥50 tahun, ≥2 penyakit komorbid, lama terdiagnosis HIV ≥5 tahun, lama ARV ≥5 tahun, CD4 <200 sel/mm3, indeks massa tubuh ≥25 kg/m2, dan pendapatan rendah dengan prefrail dan frail. Kesimpulan. Terdapat proporsi prefrail sebanyak 51,2% dan frail 3,7%. Depresi merupakan salah satu faktor yang terbukti berhubungan terhadap prefrail dan frail pada pasien HIV dalam terapi ARV. ......Background. Although HIV patients receive effective antiretroviral therapy, decrease in physical function is often found earlier and creates new problems in the form of aging and frailty Aim. to determine the proportion and factors associated with prefrail and frail in HIV patients on antiretroviral therapy. Method. A cross-sectional study design in HIV patients aged ≥30 years who were on ARV therapy for at least 6 months. Patients who fulfilled the inclusion were recorded demographically, comorbid diseases, HIV-related factors such as length of diagnosis, duration of ARV, CD4, anthropometric measurements such as body mass index, depression assessment with Indo BDI-II, and frailty assessment with Fried criteria. Patients with a history of brain infection, cancer, and active opportunists were excluded. Bivariate and multivariate analysis was carried out on these factors. Results. There were 164 patients analyzed. The proportions of prefrail and frail were 51.2% and 3.7% respectively, with the dominant component in muscle weakness. Male patients were 72% with median age (IQR) 40.5 (36-47) years, median baseline CD4 (IQR) 77 (32 - 206) cell/mm3, and median nadir CD4 (IQR) 53 (21–147) cells/mm3. Hepatitis C is the most comorbid factor. Depression is related to prefrail and frail with OR 2.14 (95%CI: 1,034-4,439) and p = 0,036. There was no correlation between factors such as age ≥50 years, ≥2 comorbid diseases, length of diagnosis of HIV ≥5 years, duration of ARV ≥5 years, CD4 cell count <200 cells/mm3, body mass index ≥25 kg/m2, and low income with prefrail and frail. Conclusion. The proportions of prefrail and frail are 51.2% and 3.7% respectively. Depression is one of the factors that is proven to be related to prefrail and frail in HIV patients in ARV therapy.

Abstrak :
ABSTRAK
Latar belakang: Infeksi HIV masih banyak ditemukan di Indonesia saat ini. Terapi antiretroviral telah merubah morbiditas dan mortalitas pasien terinfeksi HIV, dan juga merubah manifestasi oral HIV/AIDS, termasuk kandidiasis orofaring KOF . Dalam penelitian ini dieksplorasi peran faktor genetik dan respons imun pasien terinfeksi HIV dengan dan tanpa KOF, sebelum dan sesudah terapi ARV.Metode: Subyek penelitian sebesar 82 pasien terinfeksi HIV, ARV-na ve dengan jumlah sel T CD4

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ABSTRACT
Background HIV infection remains common in Indonesia nowadays. Antiretroviral therapy ART has altered morbidity and mortality of HIV infected people, and also altered oral manifestation of HIV AIDS, including oropharyngeal candidiasis OPC . Here we explore the role of host genetic factors and immune responses in HIV infected patients beginning ART.Methods This study included 82 ARV na ve HIV infected patients with

Abstrak :
Liver disease has been identified as a leading cause of death in HIV-infected patients since the introduction of highly active antiretroviral therapy (HAART) in 1996. The HIV treatment community has been caught largely unaware of this emerging dilemma. Many HIV care providers are ill-equipped to understand and interpret liver injury patterns, or to provide comprehensive care and management for viral coinfections which they are not familiar with. HIV and liver disease provides a comprehensive update of the field covering the epidemiology, pathogenesis, management and treatment of liver disease in patients with HIV infection. The volume will help HIV care providers understand and interpret liver injury patterns, and/or provide comprehensive care and management for viral coinfections. Gastroenterologists and hepatologists will gain an understanding of complex drug regimens that are used to treat HIV and which may impact HCV and HBV treatment. Written by expert clinicians and researchers across multiple disciplines, HIV and Liver Disease will be of great value to gastroenterologists, hepatologists, infectious disease practitioners, as well as other health care providers who provide care or participate in research in the field of HIV.