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Abstrak :
HIV merupakan penyakit yang sering terjadi bersamaan dengan penyakit lain. Keberadaan penyakit penyerta memerlukan terapi bersama dengan obat ARV. Hal ini memungkinkan terjadinya interaksi antar obat yang berpotensi menyebabkan penurunan atau peningkatan kadar obat dalam darah, yang bisa menimbulkan kegagalan terapi atau efek samping berupa toksisitas. Penelitian ini bertujuan melihat potensi interaksi yang penting secara klinis dari terapi ARV dengan obat komorbidnya. Penelitian ini adalah penelitian non eksperimental, pengambilan data dilakukan secara potong lintang pada pasien HIV dengan komorbid yang dirawat di rumah sakit Cipto Mangunkusumo dalam periode Januari 2016 sampai dengan Juli 2017. Data diambil dari electronic health record dan pusat rekam medis RSCM. Dari 224 pasien HIV yang masuk kedalam kriteria inklusi, terdapat 121 pasien yang memenuhi persyaratan dan diambil menjadi subjek penelitian. Potensi interaksi yang penting secara klinis didefinisikan sama dengan potensi interaksi mayor memerlukan modifikasi dosis, jangan diberikan bersamaan, kontraindikasi atau hindari . Hasil penelitian menunjukkan dari 121 pasien, potensi interaksi mayor terjadi pada 18 pasien 14,99 dengan potensi interaksi yang menurunkan kadar ARV pada 14 pasien 11,57 . Kejadian potensi interaksi mayor yang paling banyak terjadi yaitu antara nevirapin dan rifampisin 3,53 . Komorbid terbanyak adalah Tuberkulosis Paru 12,92 . Diperlukan penelitian prospektif pengukuran kadar obat dan efek terapi akibat interaksi obat ARV dengan obat komorbidnya. ......HIV is a disease commonly presents with other comorbidities which need concomitant treatments with ARV. Drug-drug interaction is an unavoidable consequence which may potentially lead to an increase or a decrease of affected drug and ultimately resulted in therapeutic failure or otherwise, toxicity.This study was aimed to look at the potential of clinically significant drug-drug interactions between ARV and other treatments. This was a non experimental cross sectional study conducted on HIV patients with comorbids treated at the Cipto Mangunkusumo hospital from January 2016 to Juli 2017. Data were taken from the electronic health record and Cipto Mangunkusumo hospital medical record. From 224 HIV patients who meet the criteria of inclusion, there are 121 patients that rsquo;s fulfilled the conditions and was taken to be the subjects of research. The potential of clinically significant drug-drug interactions are definitioned as potential for major interaction requiring dose modification, do not coadminister, contraindicated or avoid . The results showed that potential for mayor interactions occurred in 18 out of 121 patients 14.99 . Potential decrease of blood ARV level was found in 14 patients 11.57 . The occurance of potential for major interaction mostly happened between nevirapin and rifampisin 3,35 . The most comorbid is pneumonia tuberculosis 12.92 . Prospective study is required to measure drugs level and the effect of therapy consequence ARV drugs interaction with comorbid drugs

Abstrak :
Permasalahan Narkoba dan Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) menjadi epidemi ganda yang menuntut ditangani oleh pemerintah, yaitu Badan Narkotika Nasional (BNN) dan Komisi Penanggulangan AIDS (KPA). Munculnya paradigma yang berbeda antara Pemerintah dan Yayasan Pelita Ilmu Kampung Bali (YPI Kambal) menyebabkan masalah Narkoba dan HIV/AIDS itu tidak tertangani dengan baik. Penelitian ini mengajukan Rumusan Permasalahan : (1) Apa perbedaan paradigma implementasi pencegahan Narkoba dan HIV/AIDS yang dilakukan pemerintah dan YPI Kambal?; (2) Mengapa YPI Kambal tetap dapat eksis walaupun berbeda paradigma implementasi pencegahan Narkoba dan HIV/AIDS dengan kebijakan pemerintah?; dan (3) Apa langkah-langkah yang dilakukan Pemerintah dalam mengkoordinasikan implementasi kebijakan pencegahan Narkoba dan HIV/AIDS dengan YPI Kambal? Penelitian ini menggunakan prosedur deskriptif analitis atau eksplanatoris yang dilakukan selama hampir empat bulan. Teori yang membimbing penulis adalah teori Paradigma, teori Implementasi, konsep Lembaga Swadaya Masyarakat, Pencegahan Narkoba dan HIV/AIDS, Narkoba, Heroin/Putaw, HIV/AIDS. Dari hasil penelitian ini diketahui : (1) Pemerintah menggunakan pendekatan hukum dan kesehatan, dengan Model Mekanisme Paksa, didukung dana APBN dan APBD dan bersikap hati-hati menerapkan program Pertukaran Jarum Suntik Steril (PJSS). Sedang YPI Kambal menggunakan Pendekatan Sosial Kemasyarakatan, dengan model Mekanisme Pasar, dana swadaya dan donasi negara donor dan tidak masalah menerapkan PJSS. (2) Faktor-faktor yang menyebabkan YPI Kambal tetap dapat eksis, yaitu : (a) membuka diri, (b) dalam berorganisasi membuka diri dengan manajemen terbuka kepada anggotanya. (c) Perkembangan anggota yang meningkat; (d) Perkembangan wilayah binaan yang semakin meluas. (e) Adanya lembaga atau instansi yang mengadopsi konsep YPI Kambal. (3) Langkah-langkah yang dilakukan Pemerintah dalam mengkoordinasikan implementasi kebijakan pencegahan Narkoba dan HIV/AIDS dengan YPI kambal, antara lain : (a) Dengan melakukan Kunjungan ke Kampung Bali; (b) Mengundang Partisipasi YPI Kambal dalam Kegiatan Pemerintah; (c) Memberikan bantuan berupa obat-obatan, ambulan dan petugas Medis; (d) Melakukan Implementasi Pencegahan Narkoba dan HIV/AIDS secara bersama.

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Problems of Drug abuse and of Human Immunodeficiency Virus/Immunodeficiency Syndrome acquired (HIV/AIDS) become double epidemic which claim to be handled by government are National Narcotic Board (BNN) and Commission of Struggle AIDS (KPA) different Appearance Paradigm between Government and Institution of Yayasan Pelita Ilmu Kampung Bali (YPI Kambal) causing the problem of Drugs and HIV/AIDS do not handle better. This research raise formula problems : (1) What difference of preventive implementation paradigm the problem of Drugs and HIV/ AIDS between government and YPI Kambal?; (2) Why YPI Kambal remain to earn exist although differ preventive implementation paradigm of Drugs and HIV/ AIDS with policy of government?; and (3) What done stages and steps is Government in coordinated preventive policy implementation of Drugs and HIV/AIDS with YPI Kambal? This research use analytical descriptive procedure or conducted explanatory during almost four months. Theory guiding writer [is] Paradigm theory, Implementation theory, theory Model Implementation, preventive of Drugs and HIV/ AIDS. From this research result is known : (1) Government use the approach punish and health, with the Mechanism Model Force, supported by fund of State budget and District budget and behave to beware of to apply the Needle Exchange Program (NEP). Medium of YPI Kambal use the Community Base, with the model of Market Mechanism, self-supporting fund and donation of donor state and problem not apply the NEP. ( 2) Factors causing YPI Kambal remain to earn the eksis, that is : (a) expose oneself, (b) in have organization to expose oneself with the management opened to its member; (c) member Growth mounting; (d) regional Growth of area program which progressively extend; (e) the Existence of institute or institution adopting concept of YPI Kambal. (3) Stages; Steps conducted by Government in coordinated the implementation of policy of prevention of Drugs and HIV/AIDS by YPI Kambal, for example : ( a) Visiting to Kampung Bali; ( b) Invite The Participation of YPI Kambal in Governmental Activity; (c) Give the aid in the form of medicine, Medical worker and; ( d) Conduct The Preventive Implementation of Drugs and HIV/AIDS together.

Abstrak :
This is the first report of HIV drug resistance in RSUPN Dr. Cipto Mangunkusumo. We tested We reviewed eleven new cases of HIV patients who had virologic failure after 6 months first-line antiretroviral therapy. With the sequencing method, analysis of gene mutations encoded HIV drug resistance. Genotypic resistance results and HIV-1 subtype were interpreted by Stanford DR database. Of ten plasma samples that were successfully amplified and sequenced, all samples were resistant to at least one antiretroviral drug. Genotypic resistance towards the antiretroviral drugs being used was observed in lamivudine (90%), tenofovir (83%), nevirapine (100%) dan efavirenz (100%). It is interesting that no zidovudine resistance were found, including in four patients receiving zidovudine in their HAART. The common NRTI mutations were M184VI and K65R, while NNRTI mutations were Y181CFGVY, K103N, A98AG, E138GQ and G190AGS. No mayor PI mutations were found. Based on these findings, we supports the need for appropriate virology monitoring and HIV drug resistance survey in clinical practice and access to drug options in case of virology failure.