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"Serologic assays are commonly used for screening (ELISA) and for confirmation (Western blot) of HIV-1 infection; however, both assays have potentially yielded the false-positive or false-negative results. In this study, a diagnostic RTPCR assay as an alternative test for detection of HIV-1 was developed. Forty-six plasma specimens from highly risky groups, who visited a voluntary counseling and testing for HIV (VCT) in Sanglah Clinic of General Hospital, Denpasar, Bali, were tested by RT-PCR assay with specific primers for Pol region of HIV-1 genome. The results of the RT-PCR tests were then compared with those of serologic tests to obtain the sensitivity and specificity of RT-PCR assay.The results of this study showed that the RT-PCR assay could detect 17 (sensitivity: 65.4%) of 26 serologically positive specimens and was unexpectedly able to detect 2 (specificity: 90%) of 20 serologically negative specimens. Thus, the RT-PCR assay developed in this study is potential to be used as an alternative test, even though there are numerous aspects, particularly the sensitivity, that need to be improved in further research."

"Tujuan Diagnosis cepat dan spesifik seperti uji RT-PCR sangat diperlukan dalam usaha meminimalisasi penyebaran infeksi HIV-1. Oleh karena itu, dalam studi ini dikembangkan uji RT-PCR yang spesifi k terhadap gen gag HIV-1 sebagai target diagnosis. Metode Uji RT-PCR dievaluasi terhadap 46 spesimen yang diperoleh dari voluntary counseling and testing for HIV(VCT) di Rumah Sakit Umum Pmerintah (RSUP) Sanglah, Bali. Untuk mendapatkan sensitivitas dan spesifi tas uji, hasil uji RT-PCR dibandingkan dengan hasil serologi yang umum digunakan di Indonesia. Hasil Uji RT-PCR dapat mendeteksi 21dari 26 spesimen yang positif uji serologi dan memberikan 19 hasil uji negatif dari 20 spesimen yang negatif uji serologi. Satu spesimen menunjukkan hasil positif dengan RT-PCR tetapi negatif dengan uji serologi. Hasil tersebut kemungkinan menggambarkan hasil yang sebenarnya saat uji serologi tidak dapat mendeteksi infeksi HIV-1. Selain itu, lima spesimen yang positif uji serologi menunjukkan hasil negatif dengan RT-PCR yang diduga disebabkan oleh batas deteksi uji RT-PCR yang rendah. Kesimpulan Uji PCR-RT yang dikembangkan dalam studi ini berpotensi digunakan sebagai uji alternatif untuk mendeteksi infeksi HIV-1 dengan 80.0% sensitivitas dan 95.0% spesifisitas.

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AbstractAim A spesifi c and rapid diagnosis such as RT-PCR asay is the most needed to minimize transmission of HIV-1 infection. Therefore, in this study we developed the RT-PCR assay that was spesifi c against the gag gene of HIV-1. Methods The developed RT-PCR assay was evaluated against 46 specimens that were obtained from voluntary counseling and testing for HIV (VCT) in Rumah Sakit Umum Pemerintah (RSUP) Sanglah, Bali. To get the sensitivity and specificity of RT-PCR assay, the results of assays were compared with the results of commercially serologic tests that were commonly used in Indonesia. Results The RT-PCR assay could detect 21 of 26 serologic test-positive specimens and showed 19 negative results of 20 serologic test-negative specimens. There was one specimen that was positive in RT-PCR but negative in serologic assay which might depict a true yield at particular condition when the serologic assay was unable to detect. Five serologic positive-test specimens were negative by RT-PCR that was possibly caused by low detection level of the assay. Conclusion The RT-PCR assay is potential to be used for the detection of HIV-1 infection with a sensitivity and specificity of 80.8% and 95.0% respectively."

"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.

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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."

"In this book, expert HIV researchers critically review every aspect of this highly evolving and topical subject. The opening chapters deal with the epidemiology, global magnitude and biologic mechanisms of HIV-1 transmission from mother to child through breastfeeding and include considerations of the virus (quantity, compartments, characteristics) and the host (genetic, immunity-innate, cellular, humoral). The effects of breastfeeding on the HIV-infected mother’s health and nutritional status, and the social and cultural issues associated with the practice of breastfeeding are also discussed. The next few chapters provide cutting-edge reviews of the latest approaches to prevention of HIV transmission to the infant through breastfeeding, including antiretroviral strategies, nutritional and immune-based approaches, and treatment of expressed breast milk. The remaining chapters provide a fascinating review of the many iterations this subject has received, as reflected in the several different sets of guidelines for infant feeding by HIV-infected mothers issued by the World Health Organization, and a debate by leading scientists on whether HIV-infected mothers should breastfeed their infants-in resource-limited and in resource-rich settings. A comprehensive overview of the current state of implementing the new evidence for prevention of breastfeeding transmission of HIV all over the world is also presented."

"Acquired Immunodeficiency Syndrome disebabkan oleh infeksi Human Immunodeficiency Virus (HIV) terhadap sel-sel T CD4+, limfosit, dan makrofag. Sebanyak 90.7% penderita HIV di Indonesia terinfeksi oleh HIV-1 subtipe CRF01_AE. Protein Gag P7 yang dikode oleh gen gag p7 dan terdapat di dalam genom HIV-1 merupakan protein yang dapat digunakan sebagai obat antiretrovirus dan kandidat antigen untuk sistem diagnostik. Penelitian bertujuan untuk memperoleh fragmen DNA gag p7 (nukleokapsid) HIV-1 yang berukuran 210 pb. Fragmen gen gag p7 diperoleh dari hasil Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) dengan menggunakan primer forward AE_p7F dan primer reverse AE_p7R. Cetakan DNA (template) berasal dari RNA virus yang diambil dari serum pasien penderita HIV-1 di Indonesia. Hasil visualisasi pada gel poliakrilamida 10% menunjukkan bahwa fragmen gen gag p7 (nukleokapsid) berhasil teramplifikasi dengan ukuran 210 pb.

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Acquired immunodeficiency syndrome caused by human immunodeficiency virus infections to the CD4+ cells, lymphocyte, and macrophage. More than 90.7 % HIV patient in Indonesia were infected by HIV-1 subtype CRF01_AE. The Gag P7 protein coded by gag p7 gene which found in HIV genome was known as protein in which could be used for antiretroviral drugs (ARV) and diagnosis of HIV-1 infections. The purpose of research is to get DNA fragment of gag p7 (nucleocapsid) gene of HIV-1 which has length 210 bp. Fragment of gag p7 gene could be gotten from the process of reverse transcriptase polymerase chain reaction (RT-PCR) in which use primer forward AE_p7F and primer reverse AE_p7R. The templates is RNA virus that taken from patient?s serum of HIV-1 in Indonesia. The electrophoresis visualization shown that fragment of gag p7 (nucleocapsid) gene was success amplified in which has length 210 bp."

"Salah satu penyakit oportunis penyerta infeksi HIV/AIDS adalah hipertensi. Hipertensi umum ditemukan di populasi ODHA dengan prevalensi antara 15,6-46%.1-6 Namun, pada anak dengan infeksi perinatally-acquired HIV/AIDS, data prevalensi hipertensi masih sangat minim. Studi tahun 2016 pada 51 anak dengan infeksi HIV/AIDS menunjukkan proporsi hipertensi sebesar 37,3%.7 Penelitian ini bertujuan mengetahui proporsi dan hubungan infeksi perinatally-acquired HIV dengan hipertensi primer pada anak menggunakan desain studi analitik potong lintang dan data sekunder penelitian CHIC Study. Populasi penelitian ini adalah 89 anak partisipan CHIC Study berusia 0-18 tahun dengan status HIV positif (41 anak) dan non-HIV (48 anak). Hasil analisis multivariabel menggunakan analisis regresi logistik menunjukkan anak dengan infeksi HIV memiliki odds risiko 1,24 kali (95% CI: 0,024-65,002; nilai p 0,917) untuk mengalami hipertensi dibandingkan dengan anak non-HIV. Penelitian ini menyimpulkan ada hubungan antara infeksi HIV dengan hipertensi primer pada anak dengan infeksi HIV meskipun masih belum dapat dibuktikan validitas hubungan tersebut secara statistik dikarenakan jumlah sampel yang tidak mencukupi. Peneliti mengharapkan penelitian lanjutan dilakukan dengan desain studi yang lebih baik dan jumlah sampel yang mencukupi.

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One of the opportunistic diseases that accompany HIV/AIDS infection is hypertension. Hypertension is common in people living with HIV/AIDS populations with a prevalence of 15.6-46% .1-6 However, in children with perinatally-acquired HIV/AIDS infection, hypertension prevalence data is still minimal. The 2016 study of 51 children with HIV/AIDS infection showed a proportion of hypertension of 37.3% .7 This study aimed to determine the proportion and relationship of perinatally-acquired HIV infection with primary hypertension in children using cross-sectional analytic study design and secondary data of CHIC Study. The population of this study were 89 children of CHIC Study participants aged 0-18 years with HIV positive status (41 children) and non-HIV (48 children). The results of a multivariable analysis using logistic regression analysis showed that children with HIV infection had a risk odds of 1.24 (95% CI: 0.024-65,002; p-value 0.917) for hypertension compared with non-HIV children. This study concludes that there is a relationship between HIV infection with primary hypertension in children with HIV infection although it’s validity of the relationship can not be proven statistically due to insufficient sample size. Researcher expects further research done with better study design and sufficient number of samples."

"Infeksi Human Immunodeficiency Virus tipe I (HIV-1) sebagai penyebab AIDS (Acquired Immunodeficiency Syndrome) merupakan salah satu masalah utama kesehatan dunia yang barns segem diatasi. Sejak ditemukannya penyakit tersebut, vaksin yang dihampkan tidak kanjung tersedia karena berbagai usaha I pengembangan vaksia HIV-1 mengalami hambatan besar oleh karena keanekar&gaman HIV·I yang tinggi. Strategi mutakhir untuk mengatasi hambatan tersebut adalah pengembangan vaksin HIV-I yang spesifik pada subtipe dan populasi di regional tertentu. menggunakan isolat identik dengan sekuen konsensus yang telah ditentukan, sebagai kandidat vaksin.Tujuan pcnelitian ini adalah menentukan sekuen konsensus HlV-1 di Indonesia dengan menggunakan sekuen - sekuen gen protease dan gen reverse transcriptase HN - 1 subtipe paling dominan isola!Indonesia dati isolat damb plasma omng terinfeksi HIV akibat penggunaan narkoba dengan jarum suntik (penasnn). Berdasarkan analisis dalam penelitian ini diketahui bahwa CRFO I_AE merupakan subtipe paling dominan di Indonesia dan telah berhasH diperoleh sekuen konsensus protease dan reverse transcriptase HIV-1 CRFOl_AE Indonesia Sekuen konsensus protease Indonesia tersebut. memiliki perbedaan dengan sekuen konsensus dari database Los Alomos National Laboratory (LANL) sebesar 2,7% untuk sekuen nukleotida (p = 0,030); 5,1% untuk sekuen asam amino (p = 0,000). Sedangkan sekuen konsensus reverse trancriptase Indonesia merniliki perbedaan dengan sekuen konsensus dari LANL sebesar 2,0% nntuk nuklootida (p = 0,208) dan 3,0% untuk asam amiao (p = 0,015).

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Human Immunodeficiency Virus type I (HIV-I) infection as the etiology of AIDS (Acquired Immunodeficiency Syndrome) is a major health problem which need to be urgently solved. Since the discovery of the desease, the effective vaccine is still not available. It is caused by widely the diversity of HIV-I. Novel strategy to overcome this problem is to develop country-specific HIV-1 vaccine, which use the most identical isolate with consensus sequences that had been determined, as vaccine candidate.This study aims to determine consensus sequences (CS) of HIV-1 in Indonesia by using sequences of protease gene and reverse transcriptase l gene of the most predominant subtype HIV-1 sequences from HIV-infected intravenous drog users' blood plasma. This study concluded that CRFOl_AE is I the most predominant subtype HIV-1 in Indonesia Nucleotide and amino acid of Iprotease which determine as CS has 2.7% (p = 0,030) and 5.1% (p = 0,000) differences with CS of CRFOI AE respectively. While nucleotide and amino acid of reverse trancriptase of the CS has 2,0% (p = 0,208) and 3,0".4 (p = 0,015) differences with CS of CRFOI_AE of the LANL, respectively."

"Perilaku resiko tinggi terinfeksi HIV pada narapidana pria terdiri dari perilaku seksual dan perilaku penggunaan jarum tidak steril bergantian. Untuk memperoleh model yang dapat menjelaskan faktor-faktor yang berhubungan dengan perilaku resiko sangat tinggi terinfeksi HIV, yaitu perilaku seksual, perilaku penggunaan NAZA-IV dan perilaku pembuatan tattoo maka dilakukan penelitian dengan rancangan Cross Sectional dengan metode kuantitatif dan kualitatif pada narapidana dan petugas selama bulan November dan Desember 2002 di Lembaga Pemasyarakatan Kelas 1 Cipinang.Dari 100 responden narapidana didapatkan 100 % berperilaku seksual resiko tinggi, 55 % berperilaku membuat tattoo dengan jarum tidak steril bergantian, 3 % menggunakan NAZA-IV bergantian. 55 % narapidana berada pada kelompok resiko sangat tinggi terinfeksi HIV, usia 30 tahun atau kurang 71 %, pendidikan SLP atau ke bawah 53 %, belum menikah 61 %, jenis pelanggaran hukum NAZA dan pemerkosaan 67 %, lama menghuni lapas di atas setahun 44 %, usia hubungan seks pertama di bawah atau 20 tahun 71 %, pernah mengalami PMS setahun terakhir 52 %, pengetahuan buruk 64 %.Hasil analisa bivariat, terdapat delapan variabel yang mempunyai hubungan bermakna dengan perilaku resiko sangat tinggi terinfeksi HIV yaitu usia, tingkat pendidikan, status pernikahan, jenis pelanggaran hukum, lama di dalam lapas, usia hubungan seks pertama, pernah alami PMS setahun terakhir dan pengetahuan responden.Analisis multivariat diantara delapan variabel yang menjadi model, ternyata terdapat lima variabel yang berhubungan secara bermakna, yaitu umur, lama di dalam lapas, jenis pelanggaran hukum, usia hubungan seks pertama, pengetahuan narapidana, tanpa adanya interaksi.Penelitian ini menunjukkan bahwa perilaku seks yang dilakukan narapidana di lapas adalah homoseks baik secara sukarela ataupun dipaksa, tanpa menggunakan kondom. Seluruh responden merasa tidak senang hidup terpisah dari wanita. Berdasarkan penelitian ternyata NAZA dapat melewati sistem Lapas Cipinang, dan narapidana dapat melanjutkan perilaku IDU di dalam lapas. Perilaku pembuatan tattoo banyak dilakukan oleh narapidana dengan menggunakan jarum dan tinta tidak steril bergantian. Jumlah penghuni overkapasitas. Studi ini memperlihatkan bahwa sistem pemasyarakatan menempatkan narapidana dalam kelompok resiko sangat tinggi terinfeksi HIV, hampir seluruh responden menyadari mereka dapat terinfeksi HIV selama tinggal di lapas. Pengkajian terhadap sumber daya (dana, tenaga, dan sarana) belum maksimal, masih menunggu atau tidak pro aktif. Pengetahuan kepala dan petugas lapas masih kurang tentang infeksi HIV.Sebagai saran untuk mengantisipasi dan mencegah penularan infeksi HIV , jangka pendek : meningkatkan penyuluhan tentang cara penularan dan pencegahan infeksi HIV, pelatihan kepada kepala dan petugas lapas, diusahakan penyediaan kondom di lapas, disediakan ruangan khusus di lapas untuk melakukan hubungan seks narapidana yang memiliki istri yang syah dan berkumpul dengan anaknya, disediakan disinfekstan untuk mensterilkan jarum, perlu dibuat lapas khusus NAZA, dipersiapkan program harm reduction, perlu dianggarkan dana operasional RS lapas, perlu dibuat RS khusus untuk narapidana HIV + di lapas besar seperti di Cipinang, serta UU Republik Indonesia No. 12 tahun 1995 Tentang Pemasyarakatan perlu direvisi. Jangka panjang ditingkatkan kerjasama lintas program dan lintas sektoral dalam penanganan narapidana sebagai salah satu sumber daya manusia Indonesia.

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The Very High Risk Behavior Infected of Human Immunodeficiency Virus (HIV) on The Male Prisoners at the Cipinang Prison Class 1 In 2002The high risk behavior of HIV infected for man prisoner are consist of sex behavior and user of unsterile hypodermic needle by turns. For getting model to explain factors of high risk behavior of HIV infected, that sex behavior, intravenous drug user behavior and tattoo making behavior, so we do the research by cross sectional structure with quantitative and qualitative method to prisoner and the official in charge for November and December 2002 in the class I prison in Cipinang.

From 100 respondents of prisoners get 100 % high risk sex behavior, 55 % tattoo making by unsterile needle by turns, 3 % IDU by turns. Prisoner with very high risk infected HIV 55%, 30 years or less 71%, secondary school or under 53%, single 61%, drug offenses and rapes 67%, having punishment above one year 44%, sex relations under or 20 years 71%, having STD experience one last year 52%, bad experience 64%.

Based on the analyze of bi-variances has been founded eight variables of meaningful relationship between very high risk behavior namely with ages, education level, marital status, the kind of offenses, the staying duration in prison, the first sex relations, experiencing STD, the knowledge.

The analysis multi-variance among eight variances becoming a model was founded five variables meaningfully related, namely; age, duration of staying in the prison, kind of offense, age of first sexual relations, prisoner's knowledge without having interactions.

The research showed that the sex behavior conducted by prisoners in the prison is homosexual either being voluntarily or forced without condom. All respondents did not feel comfortable separated from woman, Based on the research was appeared that drug could pass (across) the Cipinang Prison System, and prisoners could follow the IDU behavior in the prison. The prisoners often make tattoo by using the unsterile injection and ink in turn. Overcapacity inmate. This study shows that Sistem Pemasyarakatan to place the prisoners are in very high risk infected HIV, almost all respondents realize that they may be infected HIV during living in the Prison. The study about resources (funds, power, and facilities) is not maximal yet, it is still waiting not proactive. Headmaster's and official free lance's acknowledge are still minim about HIV infection.

In order to anticipate and prevent the HIV infection could be suggested, in the short-term, to provide enough information about the infection and how to prevent HIV infection, it need training for headmaster and official freelances, to prepare condom in the prison, to prepare the special room in the prison for whom have a legal wife and children, to prepare the disinfectant to sterilize the needle, then it is necessary to prepare a special prison for drug, to prepare harm reduction program. Furthermore, it is necessary to plan a budget in operating prison hospital and preparing a special hospital for HIV prisoners + big prison like Cipinang Prison, it is necessary to revise UU Republik Indonesia No. 12 Tahun 1995 Tentang Pemasyarakatan. In the long-term, it is necessary to create a collaboration inter-program and inter-sectors in handling the prisoners as one of human resources.

Bibliography: 54 (1978-2003)"

"Penggunaan antibodi poliklonal dalam sis tern pondeteksi antigen P24 HIV- 1 layak untuk dipertimbangkan mengingat variasi susunan epitop P24 pada berbagai subtipe HIV -I berpotensi mengaldbatksn kegagalan pengenalan epitop oleh antibndi monoklonal. Antibodi poliklonal yang dipero!eh melalui induksi dengan antigen rekombinan berpotensi bereaksi seeara non spesifik terhadap protein kontaminan yang terdapat dalam sediaan antigen rekombinan sehingga dapat berpengaruh pada spesifisitas sistem pendeteksi antigen.Pada penelitian sebelumnya diperoleh informasi mengenai reaksi non spesifik serum anti P24 HIV -I poliklonal yang dihasilkan melalui imunisasi kelinci, khnsusnya terhadap antigen E.coli dan Bovine Serum Albumin (BSA). Oleh ksrena penelitian ini, maka diteliti efek purifikssi dengan kromatografi afinitas dalam menghilangkan reaktivitas non spesifik antara serum anti P24 dengan E.coli dan BSA. Dampak ini dinilai dengan menggunakan teknik sandwich Enzyme Linked Immunoassay (ELISA).Purifikasi dilaknkan dengan menggunakan dua kolom kromatografi afinitas dengan ligan E.coli pada kolom pertama dan ligan P24 rekombinan HIV-1 pada kolom kedua CnBr -.sepharose digunakan sebagai matriks. Proses elusi menggunakan glycine HCI, pH 2,7. Eluen basil purifikasi dikonfirmasi dengan teknik SDS PAGE, western blot dan sandwich ELISA pendeteksi antigen P24 HIV -I. Pada SDS PAGE terbentuk pita an tara berat molekul 45-116 kDa yang menunjukkan pita antibodi. Pada uji western blot terdapat pita spesifik protein P24 rekombinan H!V -! dan tidak muncul pita non spesiflk terhadnp E.ooli. Sedangkan pada uji sandwich ELISA, eluen menunjukkan nilai abwrbansi yang lebih tinggi dibandingkan dengan kontrol negatif, dan terdapat penurunan nilai absorbansi dibandingkan dengan sistem laripa antibodi yang dipurifikasi. Nilai absorbansi cluen juga tidak menunjukkan hasil yang berbeda dengan kontrol negatif jika direaksikan dengan antigen E.coli. Namun reaktifitas non spesiflk e]uen dengan BSA pacta sistem sandwich ELISA tidak berbeda dengan reaktifitas serum prepuriflkasi. Pada uji western blot dan sandwich ELISA diperoleh pula informasi yang menunjukkan adanya reaksi non spesifik antara antibedi anti-kelinci yang digunakan dengan protein E.eo!LPuriflkasi antibedi dengan menggunakan metode kromatografi afmitas telah berhasil dilaknkan dengan kondisi optimal pemurnian dan telah diperoleh eluen yang mengandung antibodi terhadap P24 rekombinan HIV -1 yang tidak bereaksi dengan protein E.coli Reagensia yang digunakan dalam sistem pendeteksi berpotensi menimbulkan ikatan non spesiflk yang dapat mengganggu nilai absorbansi sehingga sebelum digunakan harus dinilai kelayakannya untuk digunakan dalam sistem diagnostik tertentu.

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Polyclonal antibody may be important to be considered in sandwich ELISA which detected HIV-1 P24 due tO the existing variations in P24 epitope structure. Variations in epitope structure has the potential to produce false negative result in serologic diagnostic system that utilize monoclonal antibody. Polyclonal antibody induced by recombinant antigen could exhibit non specific reaction due to the presence of coniaminanl in antigen preparation that originates from the host used for expression of the recombinant antigen.In the previous research, we have already known that our polycional antibody in P24 H!V recombinant immunized rabbit serum had non specific reaction with E. coli protein and Bovine Serum Albumin (BSA) in sandwich ELISA system for detecting HIV-1 P24 recombinant protein. This was the ma}or reason to purifY the antibody with affinity chromatography. Our goal war to reduce the non specific reaction. We used sandwich Enzyme Linked Immunoassay (ELISA) to see the effect of purification.We used two columns affinity chromatography with different ligand in each column and CnBr sepharose as solid support. The first column utilized E.coli protein as ligand and the second one used HIV-1 P24 recombinant protein. We used glycine HCI, pH 2, 7 to elute antibody from qfflnity chromatography column. Eluen from the second column was coNfirmed with SDS PAGE, western blot and sandwich ELISA. SDS PAGE followed by comassie blue staining showed specific bands between 45-116 kDa molecular weight, which were interpreted as heavy and light chain fragments of antibody. Purified antibody in the second eluen was shown to be reactive with HIV-1 P24 recombinant protein but not E. coli protein by western blot analysis. There was a decline in the absorbance when eluen was used as detection antibody in sandwich ELISA system, compared with the system that utilized pre purified antibody. We also observed there was non specific reaction between the components in sandwich ELISA for detection of H/V-1 P24 recombinant antigen, in that we found the antibody against anti- rabbit JgG which was used in sandwich ELISA system had non specific reaction with E,cali protein.We concluded that we gained optimal condition in polyclonal antibody purification to reduce non specific reaction between polyclonal antibody to HW-1 P24 recombinant antigen with E.coli protein. Reagents which used in our sandwich ELISA system potentially Caused non specific reaction so we have to consider their application."

"Ibu hamil, melahirkan dan pasca persalinan bedah sesar dengan HIV/AIDS memiliki tantangan yang lebih unik dan kompleks jika dibandingkan penderita HIV/AIDS lainnya. Hal ini mengharuskan perawat untuk dapat lebih menyadari kebutuhan mereka yang khusus dan komprehensif. Penelitian fenomenologi ini menggunakan analisis data Stevick-Colaizzi. Penelitian ini mengidentifikasi enam tema sebagai intisari dari pengalaman ibu dengan HIV positif pasca bedah sesar dalam merawat diri dan bayinya yaitu Ibu terlambat mengetahui status diri dan anak; Ibu merawat kehamilan melalui program Pervention Mother to Child Transmision (PMTCT); Ibu memutuskan persalinan sesar meskipun ditawari opsi persalinan normal; Ibu mendapatkan perlakuan berbeda dari tenaga kesehatan; Ibu melakukan perawatan khusus bagi diri dan bayi-nya pasca bedah sesar; Ibu merasakan respon emosional saat merawat bayi. Hasil temuan merekomendasikan perawat maternitas untuk mengoptimalkan peran agar dapat memberikan dampak nyata dalam penanganan ibu dengan HIV dalam merawat diri dan bayinya.Mothers during pregnancy, birth and postpartum cesarean section with HIV has a more problems and complex when compared to people with HIV / AIDS. This requires nurses to be more aware of their specific and comprehensive need. This phenomenological study used data analysis Stevick-Colaizzi. This study identified six themes as the essential meaning of the experience with HIV-positive mothers in taking care of themselves and the babies post cesarean delivery. The six themes namely become late to know their status ; Participants took pregnancy care through Prevention Mother to Child Transmission program (PMTCT); Decided cesarean eventhough they have been other a normal delivery; Mother were being treated differently by healthcare provider; Mother took special care of herself and her baby after cesarean section; Participant?s emotional response feeling during giving care for the baby. The findings recommended a maternity nurse to optimize their role in order to have a real impact in treatment of women living with HIV who dealing with themselves and their babies."