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"Penelitian ini bertujuan untuk mengetahui pengaruh lokasi anatomi TB terhadap kesintasan (ketahanan hidup) 2 tahun pasien ko-infeksi TB-HIV setelah diagnosis.Penelitian ini menggunakan desain kohort restrospektifdinamik menggunakan 177 rekam medik pasien ko-infeksi TB-HIV di RSPI Prof. Dr Sulianti Saroso Jakarta yang terdaftar tahun 2010-2013, diambil secara simple random samplingKasintasan pasien ko-infeksi TB-HIV 2 tahun setelah diagnosa dengan lokasi anatomi TB di ekstraparu sebesar 86%, lebih rendah dibandingkan dengan lokasi anatomi TB di paru sebesar 98%. Lokasi anatomi TB di ekstraparu mempengaruhi kecepatan kematian pasien ko-infeksi TB-HIV (adjusted HR 1,48, 95% CI : 0,55-4,02), setelah dikontrol oleh faktor risiko penularan dan kadar CD4 awal. Infeksi HIV mengakibatkan kerusakan sistem imunitas tubuh yang luas sehingga infeksi dan penyebaran kuman TB juga akan meluas seperti ke kelenjar getah bening, pleura dan organ lainnya. TB ekstra paru memiliki beban bakteri TB yang lebih tinggi dan menunjukkan progresifitas perjalanan penyakit semakin parah yang mengakibatkan probabilitas ketahanan hidup (kesintasan) penderitanya semakin menurun.Perlu dilakukan screening lebih intensif terhadap pasien ko-infeksi TB-HIV untuk menemukan kemungkinan TB di ekstra paru sedini mungkinagar dapat diberikan penatalaksanaan yang tepat dalam rangka meningkatkan kualitas hidup penderitanya.

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The objective of this study was to determine the influence of anatomical site to the survival of TB-HIV co-infection patient in 2 years after diagnosed. The design of this study was dynamic retrospective cohort with 177 medical records of TB-HIV co-infection patients in the Center of infection hospital Prof. Dr. SuliantiSaroso, Jakarta, from 2010 to 2013, taken by simple random sampling technique. The survival of TB-HIV co-infection for 2 years after it was diagnosed in patients with anatomical site of TB in the extrapulmonary was 86% and it was lower compared to patient with the anatomical site in the pulmonary which was 98%. Anatomical site of TB in the extrapulmonary were found to be an influencing factor to the rate of death in TB-HIV co-infection patients (adjusted HR 1,48, 95% CI : 0,55-4,02) after controlling with contagion factors and the level of CD4. HIV infection cause the widespreading damage in the immunity system therefor the infection of TB microbe also spreading to other organ such as lymph nodes and pleura. Extrapulmonary TB has much more TB microbe that worsen the progressivity of the disease and decrease the probability of the patient’s survival. Intensive screening are needed for TB/HIV co-infection patients to diagnosed the possibility of TB infection in the extrapulmonary as early as possible to increase the quality of life of its patients by finding the proper treatment."

"Telah dilakukan suatu penelitian eksperimental untuk menilai peran sel T regulator pada pasien dengan ko-infeksi HIV-TB. Terhadap 18 subyek HIV positif dilakukan penilaian IGRA, isolasi dan kultur PBMC dengan stimulasi antigen MTB, serta sorting dan deplesi Treg CD4 CD25highCD127low dengan metode FACS. Produksi sitokin IFN- dan IL-10 dinilai secara kuantitatif dengan multiplex Luminex 200. Diperoleh sebanyak 10 55,6 subyek TB negatif, 6 33,3 subyek TB laten, dan 2 11,1 subyekTB aktif. Persentase Treg dari CD4 pada subyek HIV dengan status TB menunjukkan kenaikan signifikan dibanding nilai referensi batas atas persentase Treg dalam CD4 subyek normal 11,006 2,840 ; p=0,008 . Rerata persentase Treg dari sel PBMC total antara kelompok TB aktif dan TB negatif menunjukkan perbedaan yang signifikan 1,3 vs 0,8 ; p=0,036 . Tidak terdapat perbedaan rasio sitokin proinflamasi INF- terhadap sitokin anti inflamasi IL-10 pada kelompok dengan ko infeksi HIV- TB aktif dan laten sebelum dan sesudah deplesi Treg.

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An experimental study has been conducted to assess the role of T regulatory cells in patients with HIV TB co infection. 18 HIV positive subjects undergo IGRA assessment, PBMC isolation and culture with ESAT 6 CFP 10 mycobacterial antigen stimulation, and Treg CD4 CD25highCD127low sorting and depletion by FACS method. The production of cytokines IFN and IL 10 were quantitatively assessed with Luminex 200 multiplex assay. Respectively, 10 55.6 were negative TB subjects, 6 33.3 were latent TB subjects, and 2 11.1 subjects were TB active. The percentage of Treg from CD4 cells in HIV subjects with TB status showed a significant increase over the reference value in normal subjects 11.006 2.840 p 0.008 . The mean percentage of Treg from total PBMC cells between active and negative TB groups showed a significant difference 1.3 vs. 0.8 p 0.036 . There was no difference in the ratio of proinflammatory cytokines INF to the anti inflammatory cytokine IL 10 in the group with active and latent HIV TB infection coinfection before and after Treg depletion. "

"HIV telah menjadi epidemi selama lebih dari tiga dekade dunia dan menjadi agenda kesehatan global yang terus dibahas. Status epidemi HIV di Tanah Papua menunjukkan perkembangan yang berbeda dengan wilayah lain di Indonesia dan telah memasuki kategori tergeneralisasi. Penelitian ini bertujuan mengetahui besar masalah HIV dan hubungan faktor sosiodemografi, ko-infeksi, perilaku, lingkungan dan pelayanan kesehatan dengan kejadian HIV di Tanah Papua pada tahun 2013. Penelitian ini merupakan penelitian kuantitatif dengan desain studi cross sectional dengan menggunakan data sekunder Survei Terpadu Biologis dan Perilaku Tanah Papua Tahun 2013. Sampel berjumlah 5.334 responden, berusia 15-49 tahun yang bersedia dan berhasil dilakukan rapid test untuk mengetahui status HIV. Hasil penelitian ini adalah ditemukannya faktor sosiodemografi yang berhubungan dengan kejadian HIV di Tanah Papua, yaitu usia, tingkat pendidikan dan suku asal; faktor ko-infeksi, yaitu status sifilis; faktor perilaku, yaitu pengetahuan, usia pertama berhubungan seks, status poligami, sirkumsisi, seks di luar nikah, seks saat menstruasi, konsumsi alkohol sebelum berhubungan seks, penggungaan narkoba suntik dan kebiasaan menyayat tubuh; faktor lingkungan, yaitu strata geografis; faktor pelayanan kesehatan, yaitu ketersediaan kondom, akses dan biaya pemeriksaan pelayanan VCT. Uji statistik multivariat menunjukkan faktor yang paling berhubungan dengan HIV pada responden laki-laki yaitu sirkumsisi, sedangka pada keseluruhan responden yaitu biaya pemeriksaan pelayanan VCT. Penelitian ini menemukan bahwa peluang lebih tinggi untuk status HIV positif ditemukan pada responden berada pada usia 15-24 tahun, pendidikan tinggi, suku asal papua, status sifilis positif, pengetahua rendah, pertama kali berhubungan seks pada usia 15-24 tahun, tidak berpoligami, tidak sirkumsisi, pernah seks di luar nikah dan saat menstruasi, jarang konsumsi alkohol sebelum seks, menggunakan narkoba suntik, tidak melakukan kebiasaan menyayat tubuh, akses kondom sulit, akses ke pelayanan VCT mudah, serta biaya pemeriksaan VCT tidak terjangkau.

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HIV has become an epidemic for more than three decades and remained global health issue. The status of the HIV epidemic in Papua shows a different developments compared to other regions in Indonesia and has been classified as having generalized category. This research aims to determine the problem of HIV and the association between sociodemographic, co-infections, behavioral, environmental and health services factors with HIV infection in Tanah Papua in the year 2013. This research is a quantitative study, with a cross-sectional design and use secondary data from the Survei Terpadu Biologis dan Perilaku in Tanah Papua in 2013. The number of sample is 5334 respondents aged from 15-49 years old who are willing to and successfully conduct a rapid test to determine the HIV status. The results of this research is to find sociodemographic factors that associated with HIV infection in Papua, which are age, education and ethnic; co-infection factors, which is the status of syphilis; behavioral factors, which are knowledge, age of first sex, status of polygamy, circumcision, extramarital sex, sex during menstruation, drunk alcohol before having sex, injecting drug use, and traditional healing with scrathcing body; environmental factors, which is geographical strata; health care factors, which are availability of condoms, access to VCT and costs of VCT test. Multivariate statistical test indicates that the most associated factor with HIV infection among male respondents is circumcision, however among overall respondents the most associated factor is the costs of VCT test.. This research found the risk of HIV infection is higher for respondents around the age of 15-24 years old, higher educational level, origin of Papua, positive in syphilis status, lower knowledge level, first had sex at around the age of 15-24 years old, had one sex partner, lack of circumcision, had extramarital sex, had sex during menstruation, infrequent drunk alcohol before sex, injecting drug use, not making a habit of healing with scrathcing body, have a difficult access to condom, accessable to VCT, and high costs of VCT test."

"ABSTRAKProgram penanggulangan TB nasional menggunakan strategi DOTS (DirectlyObserved Treatment Shortcourse) telah dilaksanakan sejak tahun 1995. Secaranasional strategi DOTS telah memberikan perubahan meskipun belum secarakomprehensif. Kondisi diatas diperparah dengan munculnya masalah baru,diantaranya adalah kejadian TB-HIV. Tipe penderita dan ko-infeksi TB-HIVmenjadi faktor risiko terjadinya putus berobat OAT pada penderita TB Paru BTAPositif. Tujuan penelitian ini untuk mengetahui hubungan tipe penderita dan koinfeksiTB-HIV dengan kejadian putus berobat penderita TB Paru BTA positif diKota Jakarta Timur.Desain penelitian kasus kontrol, dilakukan pengamatan pada penderita TB ParuBTA positif di Kota Jakarta Timur. Analisis multivariat dengan regresi logistic.Hasil penelitian didapatkan hubungan yang signifikan antara ko-infeksi TB-HIVdengan kejadian putus berobat pada penderita TB Paru BTA positif di KotaJakarta Timur dengan aOR 19,27 setelah dikontrol jenis kelamin dan status PMO(p value=0,006; 95% CI: 2,36-157,21). Keberadaan infeksi HIV secara bersamaandengan infeksi TB semakin mengancam kelangsungan hidup sehingga diperlukanterapi yang adekuat untuk mengendalikan virus dan membunuh kumanmycobacterium tuberculosis. Skrining HIV pada penderita TB harus dilakukansecara intensif untuk tata laksana pengobatan yang adekuat melalui programkolaborasi TB-HIV sehingga penderita bisa sembuh dari infeksi TB.

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ABSTRACTA national TB control program using the DOTS strategy (Directly ObservedTreatment Shortcourse) has been implemented since 1995. Nationally, the DOTSstrategy has provided changes although not yet comprehensively. The aboveconditions are exacerbated by the emergence of new problem, such as theincidence of TB-HIV. Type of patient and TB-HIV co-infection is a risk factor todefault of anti tuberculosis drugs on positive smear pulmonary tuberculosispatient. The purpose research is to know relation between patient type and TBHIVco-infection default of treatment for positive smear pulmonary tuberculosis patients in East Jakarta.The design of case control research, conducted observation on the patient of smearpositive pulmonary tuberculosis in East Jakarta. Multivariate analysis with logisticregression.The result of anti tuberculosis drugs of the research showed significant correlationbetween TB-HIV co-infection with default with smear positive pulmonarytuberculosis patient with aOR 19,27 after controlled sex and drug administersuperviser statue (p value = 0,006; 95% CI: 2,36-157.21). The presence of HIVinfection simultaneously with TB infection is increasingly threatening survival sothat adequate therapy is needed to control the virus and kill the bacteriamycobacterium tuberculosis. HIV screening of tuberculosis patients should beintensified for an adequate treatment regimen through a TB-HIV collaborationprogram so that people can recover from TB infection."

"AbstrakDespite asthma being the most common chronic childhood ailment, there is still much to learn about the disease. Early childhood infections with well-known or emerging viruses can lay the pathophysiologic framework for asthma development and exacerbation later in life, which may be due partly to alteration of the airway microbiome. Once asthma is established, acute exacerbations are usually associated with infections with respiratory viruses, such as rhinoviruses (RVs). Once again, there are bidirectional interactions between viruses and airway bacteria that appear to influence the severity of illness and the likelihood of exacerbation. Studies employing recent advances in viral and bacterial identification analytic techniques will clarify these new concepts and may provide the basis for new treatments or prevention or respiratory infection-associated exacerbation. This paper is a review of the associations among respiratory viruses, bacteria, inflammatory mechanisms, and asthma exacerbation."

"Background: Narcotics and psychoactive substances abuse, particularly by intravenous route, currently is a major health problem affecting young Indonesian people. Consequently, there is an increasing incidence of blood-borne viral diseases, including hepatitis C virus (HCV) and human immunodeficiency virus (HIV) infections. This study was aimed to investigate the prevalence of HCV and HIV co-infection among narcotics abusers in Pondok Indah Hospital, Jakarta.Method: This was a cross-sectional study in Pondok Indah Hospital, Jakarta using patients' medical records. Data from patients with the diagnosis of mental and behavioral disorders due to various psychoactive substances and HIV-related diseases were retrieved to obtain demographic characteristics, history of drug abuse and sewlogical testing. Patients were excluded if there were another organic mental disorders found or a history of blood transfusion prior to infection.Results: There were 157 cases of drug abuse collected between January 2000 and May 2005, 85.4% were men and their median age was 24 years old. The peak age group was 21-25 years old. Injection drug users (IDUs) were found in 72% of cases. Anti-HCV total antibody was found in 45.2% cases, including 2 non-IDUs, while anti-HIV antibody and combined anti-HCV/anti HIV antibodies were found in 13.4% and 7.6% cases, respectively. Anti-HCV positive patient are significantly younger than anti-HCV negative patients (27.9 ± 8.2 vs. 23.7 ± 4.4 years, p < 0.001), while the duration of use was not significantly correlated with HCV infection. Neither age nor duration of use was statistically significant with the presence of anti-HIV antibody. However, there is a significant correlation between the duration of drug abuse with HCV and HIV co-infection (6.0 ± 3.0 vs. 4.1 ± 2.8 years, p = 0.027).Conclusion: The prevalence of HCV and HIV co-infection among narcotics abusers in Pondok Indah Hospital was 7.6%. The emerging cases of hepatitis C and HIV infections during the last several years was significantly related to the increasing numbers of narcotics abusers."

"Infeksi parasit masih merupakan masalah di dunia, terutama di daerah endemis. Adanya pandemi menyebabkan kemungkinan terjadinya misdiagnosed ataupun late diagnosed dari infeksi parasit karena gejala klinis yang mirip. Penelitian ini bertujuan untuk mengetahui penegakan diagnosis dan tatalaksana infeksi parasit pada pasien dengan koinfeksi COVID-19. Metode yang dilakukan adalah dengan tinjauan pustaka sistematis pada berbagai laporan kasus yang dipublikasikan. Penelusuran artikel dilakukan sesuai dengan alur pada diagram Prisma secara online melalui PubMed, Google Scholar, Hindawi, Cochrane library, Science direct, DOAJ, Public Library of Science (PLoS). Kata kunci yang digunakan yaitu parasite infection, COVID-19, parasite coinfection covid, intestinal parasite, helminthiasis, protozoa infection, ascariasis, trichuriasis, hookworm, strongyloidiasis, filariasis, schistosomiasis, amebiasis, giardiasis, malaria, typanosomiasis, leishmaniasis. dengan menggunakan quoatation mark “ “ dan Boolean operator “OR” “AND”. Hasil penelusuran didapatkan 700 artikel kemudian dilakukan penapisan dan telaah sehingga didapatkan 14 artikel yang sesuai untuk dianalisis. Dari 14 artikel tersebut didapatkan 17 kasus infeksi parasit, yaitu 2 kasus strongyloidiasis, 1 kasus filariasis, 11 kasus malaria, 2 kasus chagas disease, dan 1 kasus visceral leismahniasis. Penegakan diagnosis infeksi parasit pada pasien koinfeksi COVID-19 58,8% terlambat dilakukan. Tatalaksana infeksi parasit sudah sesuai dengan diagnosis, tetapi perlu diperhatikan adanya interaksi obat. Pemeriksaan diagnostik untuk infeksi parasit pada koinfeksi COVID-19 hendaknya dilakukan secara dini agar penyakit dapat teratasi dengan baik.

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A parasitic infection has always been a global issue, especially in an endemic area. The occurrence of pandemic increases the possibility of either misdiagnosed or late-diagnosed of parasitic infection due to the similarity of clinical manifestation. This study was aimed at determining the diagnosis and management of parasitic infection in COVID-19 co- infection patients. The method used in this study was a systematic literature review of various published case reports. Article searches were executed based on the flow on the Prism diagram online through PubMed, Google Scholar, Hindawi, Cochrane library, Science direct, DOAJ, Public Library of Science (PLoS). The keywords used were parasite infection, COVID-19, parasite co-infection covid, intestinal parasite, helminthiasis, protozoa infection, ascariasis, trichuriasis, hookworm, strongyloidiasis, filariasis, schistosomiasis, amebiasis, giardiasis, malaria, trypanosomiasis, leishmaniasis, applying the quotation mark “ ” and the Boolean operator “OR” “AND”. The search results gathered 700 articles which were filtered and analyzed that narrowed to 14 journals suitable for the analysis. Out of these 14 journals, 17 cases of parasitic infection were found, namely 2 cases of strongyloidiasis, 1 case of filariasis, 11 cases of malaria, 2 cases of Chagas disease, and 1 case of visceral leishmaniasis. About 58.8% of patients coinfected with COVID-19 were diagnosed late. The management of parasitic infection has been done in accordance with the diagnosis, but drug interaction must be considered. Early diagnostic examination for patients coinfected with COVID-19 is highly suggested to ensure that the disease is treated well."

"IntroduksiHuman Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS), sejak dikenalnya sindrom penyakit ini lebih dari 2 (dua) dekade, terus menerus menyebar diseluruh dunia tanpa ada tanda-tanda pengurangan. Tuberkulosis (TB) merupakan penyebab utama kesakitan dan kematian pada orang dengan HIV/AIDS sekitar 40%-50%. Tujuan penelitian yaitu mengetahui kesintasan tiga tahun pasien HIV/AIDS dan pengaruh ko-infeksi TB terhadap kesintasan 3 tahun pasien HIV yang mendapat terapi ARV.MetodePenelitian ini adalah dengan pendekatan cohort retrospective di RSPI prof.dr. Sulianti Saroso Tahun 2009-2011.HasilProbabilitas kesintasan kumulatif pasien HIV/AIDS yang mendapat ART pada tahun pertama adalah 84,2%, 2 tahun adalah 81,4%, dan 3 tahun adalah 79,26%. Hasil analisis multivariate dengan uji regresi Cox Time Dependent Covariate menemukan koinfeksi TB mempengaruhi kecepatan kematian pasien HIV/AIDS (adjusted HR 1,60; 95% CI: 0,96-2,67) setelah dikontrol oleh faktor risiko penularan dan hitung CD4 sebelum terapi ARV. IDU memiliki pengaruh terhadap kesintasan tiga tahun pasien HIV/AIDS (aHR 1,71; 95% CI: 1,04-2,95). Apabila pajanan Koinfeksi TB dapat dieliminasi, maka sebesar 40% kematian pasien HIV/AIDS dapat dicegah di Rumah Sakit Prof. Sulianti Saroso.DiskusiPengaruh TB terhadap HIV, selain mempercepat progresivitas HIV juga berakibat pada mortalitas HIV. Koinfeksi TB menambah laju hazard terhadap ketahanan hidup pasein. Tingkat mortalitas pengidap HIV yang sekaligus mengidap TB 2 kali lebih tinggi dibandingkan dengan pengidap HIV tanpa TB.SaranMeningkatkan kualitas conselling kepada ODHA yang mendapat ART khususnya pada pasien dengan koinfeksi TB. Meningkatkan pogram kolaborasi TB-HIV di rumah sakit untuk menunjang efektifitas program dan pelayanan kesehatan kepada pasien HIV/AIDS.

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Introduction

Human Immunodeficiency Virus / Acquired Immunodeficiency Syndrome (HIV / AIDS), since this disease syndrome known more than two (2) decades, continuously spread throughout the world with no signs of abatement. Tuberculosis (TB) is a major cause of morbidity and mortality in people with HIV/AIDS around 40%-50%. The purpose of research is to determine the three-year survival rate of patients with HIV / AIDS and TB co-infection influences the 3-year survival of patients with HIV who receive antiretroviral therapy.

Methods:

This study is a retrospective cohort approach in RSPI Prof. Sulianti Saroso Year 2009-2011.

Results:

The cumulative probability of survival of patients with HIV / AIDS who receive antiretroviral treatment in the first year was 84.2%, 2 years was 81.4%, and 3 years was 79.26%. Results of multivariate analysis with the Cox regression Time Dependent covariate find TB affects the speed of death in HIV / AIDS (adjusted HR 1,60; 95% CI: 0,96-2,67)) after controlled by transmission risk factors and CD4 counts before ART. IDU patients had 2 times the risk of a hazard than patients with non-IDU group (adjusted HR 1.95, 95% CI: 1.17 to 3.24). If TB Co-infection can be eliminated from th e susceptible population, then the death of 40% of patients with HIV/AIDS can be prevented in the Infectious Disease Hospital Prof. dr. Sulianti Saroso.

Discussions:

Effect of TB to HIV, besides accelerating the progression of HIV also result in mortality of HIV. TB adds to the hazard rate of survival pasein. The mortality rate of people with HIV who also have tuberculosis 2 times higher compared to HIV without TB.

Recommendations:

Counselling to improve the quality of people living with HIV who received antiretroviral therapy, especially in patients co-infected with TB. Increase pogram TB-HIV collaboration at the hospital to support effective programs and health services to patients with HIV / AIDS."

"ABSTRACTInfeksi Trichomonas vaginalis seringkali terjadi pada pekerja seks komersial PSK , menyebabkan mikrotrauma pada epitel saluran genital perempuan, dan menjadi portal masuk infeksi herpes genitalis; sehingga koinfeksi T. vaginalis dan herpes genitalis dapat terjadi. Penelitian ini merupakan penelitian potong lintang pada 212 PSK yang bertujuan untuk mengetahui apakah terdapat perbedaan proporsi infeksi herpes genitalis antara kelompok T. vaginalis positif dengan kelompok T. vaginalis negatif serta mengetahui faktor-faktor yang berhubungan. Analisis uji Chi-square menunjukkan perbedaan proporsi infeksi herpes genitalis yang bermakna p=0,027.

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ABSTRACTTrichomonas vaginalis infections are commonly found among female sex workers FSWs , causing microtrauma on the female genital epithelium, and predispose the entry of genital herpes infection thus co infection of T. vaginalis and genital herpes may occur. A cross sectional study was applied among 212 FSWs to analyze proportion differences of genital herpes infection between FSWs with T. vaginalis infection and FSWs without T. vaginalis infection, and to identify factors associated to the co infection. Analysis using Chi square revealed a significant association between T. vaginalis infection and genital herpes p 0,027."