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Abstrak :
ABSTRAK
Latar belakang. Infeksi Cytomegalovirus (CMV) kongenital merupakan faktor non genetik yang paling sering menjadi penyebab terjadinya ketulian sensorineural pada bayi dan anak. Infeksi CMV dapat memberikan tanda dan gejala namun dapat juga tidak memberikan gejala pada yang terinfeksi. Ketulian akibat infeksi CMV kongenital tidak memiliki konfigurasi patognomik sehingga penelitian terhadap infeksi CMV kongenital pada pendengaran masih sangat diperlukan. Pengetahuan tentang ketulian akibat infeksi CMV kongenital di negara-negara luar yang semakin berkembang membuat peneliti ingin mengetahui bagaimana gambaran gangguan pendengaran anak dengan infeksi CMV kongenital di Indonesia, khususnya RS Cipto Mangunkusumo. Tujuan. Mengetahui gambaran gangguan pendengaran pada anak usia 0-5 tahun yang mengalami infeksi CMV kongenital berdasarkan pemeriksaan DPOAE dan BERA click. Metode. Penelitian cross sectional ini dilakukan di RSUPN Cipto Mangunkusumo pada bulan November 2015-Mei 2016 pada 27 subjek anak usia 0-5 tahun yang telah didiagnosa terinfeksi CMV kongenital. Hasil. Gambaran gangguan fungsi pendengaran pada subjek anak usia 0-5 tahun dengan infeksi CMV kongenital berdasarkan pemeriksaan DPOAE dan BERA click pada unit telinga adalah tuli sensorineural sebanyak 58,0%. Didapatkan hubungan yang bermakna secara statistik (p = 0,002) antara keterlambatan tumbuh kembang dengan terjadinya tuli sensorineural. Keterlambatan tumbuh kembang memiliki risiko 6,57 (CI 95%; 1,88 – 22,87) kali lebih besar dibandingkan pasien dengan tumbuh kembang normal untuk mengalami gangguan pendengaran sensorineural.

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ABSTRACT
Background. Congenital cytomegalovirus (CMV) infection is a non genetical factor that is most commonly found asthe etiology of sensorineural hearing loss in infants and children. CMV does not always cause signs and symptoms.Hearing loss caused by CMV infection does not have a patognomonic configuration hence further research is needed. The development on the knowledge on hearing loss caused by congenital CMV infection in foreign countriesis the reason the author decide to investigate on the profile of hearing impairment in children with congenital CMV infection in Indonesia, especially in Cipto Mangunkusumo Hospital. Purpose. To know the profile of hearing impairment in children age 0-5 years old with congenital CMV infection based on DPOAE and BERA click. Methods.This cross-sectional study was conducted in Cipto Mangunkusum Hospital since November 2015-May 2016 in 27 subjects, children age 0-5 years old with congenital CMV infection. Results.Hearing impairment in subjects children age 0-5 years old with congenital CMV inefection, based on DPOAE and BERA click on ear unitsis 58,0% with sensorineural hearing loss. There is a significant relationship (p=0,002) between developmental delay and the incidence of sensorineural hearing loss. Developmental delay has a 6,57 times (CI 95%; 1,88 – 22,87) higher the risk for subjects to experience sensorineural hearing loss compared to normal development.;

Abstrak :
Cytomegalovirus (CMV) is a double-stranded DNA virus and a member of the Herpesviridae family. Cytomegalo- virus infection is one of the important causes of mortality and morbidity in immunocompromised patients. This is a case report of 72 year-old immunocompromised male patient with worsening cough needing an intubation despite previous adequate antibiotic administration. Further examination showed positive CMV infection. The patient showed improvement after administration of ganciclovir.

Abstrak :
Background Prodromal factors of Guillain-Barre syndrome (GBS) are often associated with previous viral infection (60%). The ailment supported by the acquired immunomediated disorder concept. Viral hepatitis is very rarely found in GBS, preceded by cytomegalovirus (15-18%), Campylobacter jejuni (28%), and Epstein-Barr virus (5%). There is no specific etiology of GBS because those viruses usually appear sporadically (subclinically). All hepatitis virus infection can cause neurological complications, including GBS. Case Report We report two cases of hepatitis A virus infection (HAV) in GBS patients in Dr. Sardjito General Hospital during 5 years of observation (1996-2000) from 92 GBS patients. The diagnosis of HAV was based on more than 2 times increment of transaminase enzyme, positive IgM anti HAV, negative HbsAg, and negative IgM ami HCV. The diagnosis of GBS was based on clinical symptoms of acute generalized paralysis, cerebrospinal fluid examination, and electromyelography. In both cases, sub-clinical and sporadic symptoms appeared several days before paralysis, which makes it more likely that the prodromal period of GBS occurred at the same time of HAV incubation period. Discussion The incidence of HAV in GBS patients during 5 years of observation was 2%. This corresponds with the case reported by Verona et al, 1996 and Pelletier et al, 1985, i.e. the presence of peripheral neuropathy (n. facialis and n. occulomotorius). Possible alternative pathways for hepatitis virus complicating as GBS are perivascular and endometrial peripheral nerve infiltration by mononuclear cells, T cell sensitization, stimulation of IL-2 growth factor surface receptor, and B cell stimulation. All of the conditions mentioned above causes necrotizing arteritis, vascular occlusion, and at the end, segmental demyelinization. Hepatitis virus may replicate in the central nervous system or peripheral nervous system, subsequently developing into multiple neuropathy disorder and poly arteritis. Conclusion The diagnoses of HAV and GBS in both cases were established. HAV is one of several viruses that may trigger GBS. In both cases, HAV infection was sub-clinical and sporadic. Symptoms of hepatitis infection subsided along with improvements in the patient's neurological status. Acute viral hepatitis has a wide clinical spectrum and laboratory manifestation that is in accordance with the severity, varying from unclear symptom (anicteric) to jaundice. Acute hepatitis A, B, C infections have the same symptoms in general. However, hepatitis B and C tend to be more severe. The mildest symptoms are transaminase enzyme level increment, no jaundice, gastrointestinal symptoms, flu-like symptoms, and sometimes it can not be diagnosed. The more severe symptoms are jaundice with obvious generalized symptoms.' The incidence of hepatitis A is difficult to be determined accurately because of its characters, i.e. sporadic, endemic, and has a high rate of asymptomatic infection.23-4

Abstrak :
Cytomegalovirus (CMV) merupakan suatu virus DNA rantai ganda, yang termasuk dalam famili Herpesviridae. Infeksi CMV merupakan salah satu penyebab penting mortalitas dan morbiditas pada pasien-pasien imunokompromais. Tulisan ini melaporkan kasus seorang pasien pria imunokompromais berusia 72 tahun dengan batuk yang semakin memburuk hingga perlu dilakukan intubasi, meskipun sebelumnya telah diberikan terapi antibiotik yang adekuat. Pemeriksaan lebih lanjut menunjukkan adanya positif infeksi CMV. Pasien menunjukkan adanya perbaikan setelah pemberian ganciclovir.

Abstrak :
Latar Belakang: Infeksi sitomegalovirus (CMV) telah menjadi masalah besar secara global dengan prevalens yang tinggi. Demam neutropenia merupakan kegawatdaruratan anak di bidang onkologi karena dapat meningkatkan morbiditas dan mortalitas, salah satu penyebabnya yaitu infeksi CMV. Mengingat tingginya seroprevalens CMV di Indonesia yang dapat meningkatkan angka kematian pasien keganasan, maka penting untuk memahami profil klinis, laboratoris, dan tata laksana infeksi CMV pada demam neutropenia. Tujuan: Untuk mengetahui prevalens, karakteristik klinis, laboratoris dan tata laksana infeksi CMV pada pasien anak dengan demam neutropenia karena keganasan. Metode: Penelitian ini merupakan uji observasional secara prospektif. Subyek yang diteliti adalah seluruh pasien demam neutropenia usia 1 bulan-18 tahun yang dirawat di bangsal anak Rumah Sakit Cipto Mangunkusumo, Jakarta pada bulan Januari sampai dengan Mei 2024. Hasil: Terdapat 89 episode demam neutropenia yang memenuhi kriteria inklusi dan eksklusi, yang terjadi pada 71 pasien anak dengan median usia 6 tahun (5 bulan-16 tahun), lelaki 56,3%, dan tumor padat 53,5%. Kultur steril terbanyak yaitu darah (78,3%) dan urin (65,2%), dengan kultur positif terbanyak yaitu feses (100%), darah (21,7%), urin (34,8%), dan sputum (100%). Dari kultur yang positif, proporsi kuman terbanyak adalah Klebsiella pneumoniae (29%) dengan sensitivitas antibiotik tertinggi yaitu lini 1 gentamisin (50%), lini 2 sefoperazon sulbaktam (55,5%), dan lini 3 imipenem (72,2%). Terdapat 2 subyek dengan infeksi CMV berdasarkan PCR CMV dan peningkatan IgG 4 kali lipat dalam 4 minggu. Karekteristik klinis yang ditemukan yaitu demam neutropenia episode kedua, durasi demam 1,5 hari, suhu puncak demam 39,45oC, diare, muntah, pucat, dan perdarahan. Kedua subyek dengan status gizi baik. Karakteristik laboratoris yang ditemukan yaitu pansitopenia, peningkatan CRP, dan kultur yang negatif. Karakteristik tata laksana yang ditemukan yaitu pemberian antibiotik empiris, antijamur, dan antivirus valgansiklovir selama 14 hari. Kesimpulan: Prevalens infeksi CMV pada anak dengan demam neutropenia karena keganasan di RSCM sebesar 2,2%, dengan karakteristik klinis demam neutropenia episode kedua, durasi demam 1,5 hari, suhu puncak 39,45oC, gejala diare, muntah, pucat, dan perdarahan. Tidak terdapat karakteristik laboratoris dan tata laksana, tetapi ditemukan pansitopenia, peningkatan CRP, kultur negatif, dan pemberian valgansiklovir selama 14 hari. Hasil tambahan berupa proporsi kuman tertinggi pada pasien demam neutropenia yaitu Klebsiella pneumoniae dengan sensitivitas antibiotik tertinggi yaitu sefoperazon sulbaktam. ......Background: Cytomegalovirus (CMV) infection has become a major problem globally with high prevalence. Neutropenic fever is a pediatric oncology emergency, increasing morbidity and mortality. CMV infection should be considered as a cause of neutropenic fever. Given the high CMV seroprevalence in Indonesia, which can increase cancer patient mortality, it is crucial to understand the clinical profile, laboratory findings, and management of CMV infection in neutropenic fever. Objective: To determine the prevalence, clinical, laboratory, and management characteristics of cytomegalovirus infection in pediatric patients with neutropenic fever due to malignancy. Methods: This research was an observational study prospectively. The subjects were all neutropenic fever patients aged 1 month-18 years who were hospitalized in the Cipto Mangunkusumo Hospital (CMH) pediatric wards from January to Mei 2024. Results: There were 89 episodes of neutropenic fever that met the inclusion and exclusion criteria, found in 71 pediatric patients, with median age was 6 years old (5 months-16 years old), male 56.3%, and solid tumor 53.5%. Sterile results were found in blood (78.3%) and urine (65.2%) cultures. Positive cultures were found in feces (100%), blood (21.7%), urine (34.8%), and sputum (100%). Klebsiella pneumoniae (29%) was the highest proportion of positive cultures with the highest sensitivity antibiotic in the first line was gentamicin (50%), second line cefoperazone sulbactam (55.5%), and third line imipenem (72.2%). Two subjects were CMV infection based on PCR CMV and IgG increasing 4 times in 4 weeks. Clinical characteristics were second episode of neutropenic fever, duration of fever 1.5 days, peak temperature 39.45oC, diarrhea, vomiting, pale, bleeding, and both had good nutritional status. Laboratory characteristics showed pancytopenia, increasing CRP, and negative culture. Management characteristics included empirical antibiotic, antifungal, and antiviral valganciclovir for 14 days. Conclusion: The prevalence of CMV infection in neutropenic fever at CMH was 2.2%. Clinical characteristics were second episode of neutropenic fever, duration of fever 1.5 days, peak temperature 39.45oC, diarrhea, vomiting, pale, and bleeding. There is no laboratory and management characteristics, but found pancytopenia, increased CRP, negative culture, and administering valganciclovir for 14 days. The additional result was Klebsiella pneumoniae as the highest microbe with the highest antibiotic sensitivity was cefoperazone sulbactam.

Abstrak :
Pengalaman Ibu dalam Memberikan Stimulasi Tumbuh Kembang pada Anak yang Pernah Terinfeksi Cytomegalovirus Anak yang pernah terinfeksi Cytomegalovirus CMV dapat mengalami keterlambatan tumbuh kembang dan disabilitas. Penelitian ini bertujuan memperoleh gambaran pengalaman ibu dalam memberikan stimulasi tumbuh kembang pada anak yang pernah terinfeksi CMV. Metode penelitian adalah kualitatif dengan pendekatan fenomenologi melalui wawancara semi terstruktur pada tujuh ibu. Penelitian ini mengidentifikasi enam tema: anak saya istimewa, konflik tiada henti, perasaan tidak menentu, berjuang agar anak normal, tidak merasa sendirian, dan optimis perkembangan anak normal. Hasil penelitian ini terhadap pelayanan keperawatan adalah perawat dapat menginisiasi pembentukan peer group bagi ibu-ibu yang memiliki anak yang pernah terinfeksi CMV.

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Mothers rsquo Experience in Growth and Development Stimulation in Cytomegalovirus Infected Children A child that ever infected CMV may experience delayed growth and development, as well as disability. The purpose of this research was to obtain description the mothers rsquo experience in growth and development stimulation to a child that ever infected CMV. The research methodology was qualitative using phenomenology approach with semi structured interview to seven mothers. This research identified six themes my child is special, never ending conflict, uncertain feeling, struggling for normal child, not feeling alone and optimism the child development is normal. The result of this study on nursing care is nurses can initiate the formation of peer group for mothers who have children who have been infected with CMV.

Abstrak :
Sampai saat ini di Indonesia belum diketahui prevalensi seropositif CMV pada darah donor sehingga belum dilakukan uji saring terhadap antibodi CMV dan analisis DNA CMV pada PRC leukodepleted secara rutin untuk kemanan darah donor. Tujuan penelitian ini adalah mendapatkan informasi efektifitas teknik leukodeplesi PRC terhadap deteksi DNA CMV, mendapatkan informasi mengenai prevalensi PRC dengan antibodi IgG CMV positif dan mendapatkan informasi mengenai prevalensi DNA CMV positif pada PRC non-leukodepleted serta PRC leukodepleted di UTD PMI Provinsi DKI Jakarta. Metode yang digunakan desain potong lintang cross sectional dengan jumlah sampel 113 darah donor yang telah memenuhi kriteria inklusi. Uji saring antibodi IgG CMV menggunakan metode indirect chemiluminescence immunoassay ChLIA dengan alat Liason XL 10050 Chemiluminescence Analyzer dan analisis DNA CMV menggunakan metode qPCR untuk deteksi UL54 CMV dengan alat Roche Light Cycler 480 II. Hasil penelitian menunjukkan prevalensi IgG CMV positif sebanyak 111 sampel 98,23 dan IgG CMV negatif sebanyak 2 sampel 1,77 . Prevalensi DNA CMV positif pada PRC non- leukodepleted adalah 1 sampel 0,88 dan PRC leukodepleted adalah 0 sampel 0. Kesimpulan penelitian ini, PRC leukodepleted efektif dalam meningkatkan keamanan darah donor terhadap infeksi CMV.Kata kunci: Cytomegalovirus, PRC Leukodepleted, IgG CMV, qPCR UL54 CMV.

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To date, the seropositive prevalence of CMV in blood donor is still remaining unknown. Therefore, no screening test for CMV antibody and CMV DNA analysis on leukodepleted PRC that is routinely performed in Indonesia for the safety of the blood donor. The purpose of this study was to obtain information on the effectiveness of PRC leukodepleted techniques on CMV DNA detection, to obtain information on the prevalence of PRC with positive CMV IgG antibodies and to obtain information on the prevalence of positive CMV DNA in non leukodepleted PRC and leukodepleted PRC at UTD PMI DKI Jakarta. Cross sectional design with total sample of 113 donor blood that has fulfilled the inclusion criteria was used as methodology. Indirect chemiluminescence immunoassay ChLIA method with Liason XL 10050 Chemiluminescence Analyzer was used for IgG CMV antibody screening test and qPCR technique with UL54 CMV by Roche light cycler 480 II was used for CMV DNA analysis. The results showed that 111 samples 98.23 were positive to IgG CMV and 2 samples 1.77 was negative to CMV IgG. The prevalence of positive CMV DNA in PRC before leukodepleted was 1 sample 0.88 and PRC after leukodepleted was 0 sample 0. The conclusion of this study is leukodepleted PRC effective to reduce the spread of CMV infection through blood transfusions.Key words Cytomegalovirus, PRC Leukodepleted, IgG CMV, qPCR UL54 CMV.

Abstrak :
ABSTRAK
Latar belakang : Cytomegalovirus (CMV) merupakan salah satu infeksi oportunistik pada pasien dengan sindrom immunodefisiensi (AIDS). Gejala klinis dan CT scan tidak dapat menegakkan diagnosa definitif ensefalitis CMV. Oleh karena itu diperlukan uji alternatif untuk menegakkan diagnosis infeksi CMV pada pasien HIV dengan infeksi otak. Salah satu uji yang sensitif dan spesifik adalah Real Time Polymerase Chain Reaction (rPCR). Tujuan : Mendapatkan uji deteksi molekular CMV pada pasien HIV dengan tersangka infeksi otak. Metode : Penelitian dilakukan dalam 3 tahap. Tahap 1 adalah optimasi konsentrasi primer, probe, suhu annealing, volume elusi ekstraksi DNA, dan volume cetakan. Tahap 2 adalah uji spesifisitas (reaksi silang) dan uji sensitivitas (ambang batas deteksi DNA) rPCR dan tahap 3 adalah penerapan uji rPCR yang sudah dioptimasi terhadap sampel plasma, urin, dan LCS. Hasil : Kondisi optimal uji rPCR telah diperoleh dengan konsentrasi primer dan probe 0,1 μM, dengan kondisi suhu reaksi rPCR: aktivasi enzim pada 950C selama 3 menit; 45 siklus pada 950C selama 15 detik (denaturasi) dan 560C selama 1 menit (annealing dan ekstensi). Volume elusi ekstraksi DNA yang optimal untuk ketiga jenis sampel (LCS, plasma dan urin) adalah 40 μL, dan volume cetakan rPCR untuk LCS, plasma, dan urin, masing-masing adalah 5, 4, dan 3 μL. Uji rPCR mampu mendeteksi DNA pada 50.000 jumlah kopi/mL dan tidak bereaksi silang dengan Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus saprophyticus, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Mycobacterium tuberculosis, Candida spp, Toxoplasma gondii, EBV,HSV,dan VZV. Penerapan uji rPCR pada sampel klinis memberikan hasil negatif pada semua sampel LCS, 72,22% positif pada sampel plasma, dan 72,22% positif pada sampel urin. Kesimpulan: Telah dilakukan optimasi uji rPCR dengan minimal deteksi DNA CMV 50.000 jumlah kopi/mL dan tidak bereaksi silang dengan mikroorganisme yang berpotensi menyebabkan positif palsu (false positive).ABSTRACT
Background: Cytomegalovirus (CMV) is one of opportunistic infections in patients with Aquired Immunodeficiency Syndrome (AIDS). Clinical manifestations are not typical, and CT scans can not define encephalitis CMV specifically. Therefore, it is important to apply an alternative assay for sensitive and specific detection of CMV infection in HIV patients with suspected central nervous system (CNS) infections. One of the assays is real time polymerase chain reaction (rPCR). Objective: To obtain a molecular assay for detection of CMV in HIV patients with suspect CNS infections. Methods: This study was conducted in three phases. The first is optimization of concentrations of primers, probe, annealing temperature, final elution of DNA extraction, and volume of PCR template. The second is determinations of sensitivity (minimal detection of DNA) and specificity (cross-reaction) of the optimized rPCR, and the third is application of the rPCR for clinical samples of plasma, urine, and liquor cerebrospinal (LCS). Results: The rPCR reaction showed optimal concentrations of primers and probe at 0.1 μM, with thermal cycler: 950C for 3 min (enzyme activation), followed by 45 cycles of 950C for 15 sec (denaturation) and 560C for 1 min (annealing and extension). Final elution of DNA extraction was 40 μL and volume of PCR templates for urine, plasma, and LCS was 3, 4, and 5 μL, respectively. The rPCR had minimal detection of DNA at 50,000 copies/mL and was not cross-reacted with Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus saprophyticus, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Mycobacterium tuberculosis, Candida spp, Toxoplasma gondii, Epstein-Bar Virus (EBV), Herpes Simplex Virus (HSV) and Varicella Zoster Virus (VZV). Application of rPCR for clinical samples showed that the rPCR yielded 72.22% positive for plasma or urine, and negative for all LCS samples. Conclusion: The rPCR has been optimized in this study with minimal DNA detection at 50,000 copies/mL and was not cross-reacted with other microorganisms that are potential to cause false positive results.;Background: Cytomegalovirus (CMV) is one of opportunistic infections in patients with Aquired Immunodeficiency Syndrome (AIDS). Clinical manifestations are not typical, and CT scans can not define encephalitis CMV specifically. Therefore, it is important to apply an alternative assay for sensitive and specific detection of CMV infection in HIV patients with suspected central nervous system (CNS) infections. One of the assays is real time polymerase chain reaction (rPCR). Objective: To obtain a molecular assay for detection of CMV in HIV patients with suspect CNS infections. Methods: This study was conducted in three phases. The first is optimization of concentrations of primers, probe, annealing temperature, final elution of DNA extraction, and volume of PCR template. The second is determinations of sensitivity (minimal detection of DNA) and specificity (cross-reaction) of the optimized rPCR, and the third is application of the rPCR for clinical samples of plasma, urine, and liquor cerebrospinal (LCS). Results: The rPCR reaction showed optimal concentrations of primers and probe at 0.1 μM, with thermal cycler: 950C for 3 min (enzyme activation), followed by 45 cycles of 950C for 15 sec (denaturation) and 560C for 1 min (annealing and extension). Final elution of DNA extraction was 40 μL and volume of PCR templates for urine, plasma, and LCS was 3, 4, and 5 μL, respectively. The rPCR had minimal detection of DNA at 50,000 copies/mL and was not cross-reacted with Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus saprophyticus, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Mycobacterium tuberculosis, Candida spp, Toxoplasma gondii, Epstein-Bar Virus (EBV), Herpes Simplex Virus (HSV) and Varicella Zoster Virus (VZV). Application of rPCR for clinical samples showed that the rPCR yielded 72.22% positive for plasma or urine, and negative for all LCS samples. Conclusion: The rPCR has been optimized in this study with minimal DNA detection at 50,000 copies/mL and was not cross-reacted with other microorganisms that are potential to cause false positive results.;Background: Cytomegalovirus (CMV) is one of opportunistic infections in patients with Aquired Immunodeficiency Syndrome (AIDS). Clinical manifestations are not typical, and CT scans can not define encephalitis CMV specifically. Therefore, it is important to apply an alternative assay for sensitive and specific detection of CMV infection in HIV patients with suspected central nervous system (CNS) infections. One of the assays is real time polymerase chain reaction (rPCR). Objective: To obtain a molecular assay for detection of CMV in HIV patients with suspect CNS infections. Methods: This study was conducted in three phases. The first is optimization of concentrations of primers, probe, annealing temperature, final elution of DNA extraction, and volume of PCR template. The second is determinations of sensitivity (minimal detection of DNA) and specificity (cross-reaction) of the optimized rPCR, and the third is application of the rPCR for clinical samples of plasma, urine, and liquor cerebrospinal (LCS). Results: The rPCR reaction showed optimal concentrations of primers and probe at 0.1 μM, with thermal cycler: 950C for 3 min (enzyme activation), followed by 45 cycles of 950C for 15 sec (denaturation) and 560C for 1 min (annealing and extension). Final elution of DNA extraction was 40 μL and volume of PCR templates for urine, plasma, and LCS was 3, 4, and 5 μL, respectively. The rPCR had minimal detection of DNA at 50,000 copies/mL and was not cross-reacted with Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus saprophyticus, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Mycobacterium tuberculosis, Candida spp, Toxoplasma gondii, Epstein-Bar Virus (EBV), Herpes Simplex Virus (HSV) and Varicella Zoster Virus (VZV). Application of rPCR for clinical samples showed that the rPCR yielded 72.22% positive for plasma or urine, and negative for all LCS samples. Conclusion: The rPCR has been optimized in this study with minimal DNA detection at 50,000 copies/mL and was not cross-reacted with other microorganisms that are potential to cause false positive results.;Background: Cytomegalovirus (CMV) is one of opportunistic infections in patients with Aquired Immunodeficiency Syndrome (AIDS). Clinical manifestations are not typical, and CT scans can not define encephalitis CMV specifically. Therefore, it is important to apply an alternative assay for sensitive and specific detection of CMV infection in HIV patients with suspected central nervous system (CNS) infections. One of the assays is real time polymerase chain reaction (rPCR). Objective: To obtain a molecular assay for detection of CMV in HIV patients with suspect CNS infections. Methods: This study was conducted in three phases. The first is optimization of concentrations of primers, probe, annealing temperature, final elution of DNA extraction, and volume of PCR template. The second is determinations of sensitivity (minimal detection of DNA) and specificity (cross-reaction) of the optimized rPCR, and the third is application of the rPCR for clinical samples of plasma, urine, and liquor cerebrospinal (LCS). Results: The rPCR reaction showed optimal concentrations of primers and probe at 0.1 μM, with thermal cycler: 950C for 3 min (enzyme activation), followed by 45 cycles of 950C for 15 sec (denaturation) and 560C for 1 min (annealing and extension). Final elution of DNA extraction was 40 μL and volume of PCR templates for urine, plasma, and LCS was 3, 4, and 5 μL, respectively. The rPCR had minimal detection of DNA at 50,000 copies/mL and was not cross-reacted with Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus saprophyticus, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Mycobacterium tuberculosis, Candida spp, Toxoplasma gondii, Epstein-Bar Virus (EBV), Herpes Simplex Virus (HSV) and Varicella Zoster Virus (VZV). Application of rPCR for clinical samples showed that the rPCR yielded 72.22% positive for plasma or urine, and negative for all LCS samples. Conclusion: The rPCR has been optimized in this study with minimal DNA detection at 50,000 copies/mL and was not cross-reacted with other microorganisms that are potential to cause false positive results.