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"ABSTRAKMETODE : Desain penelitian yang akan dilakukan untuk penelitian ini adalah studi eksperimental. Pada penelitian ini akan dilakukan pengambilan darah pada 6 orang subjek sebanyak 10 cc yang dibagi menjadi 4 kelompok yaitu 1 kelompok kontrol dan 3 kelompok perlakuan dengan pemberian DMPA pada konsentrasi 1:10, 1:100, 1:1000 dan dilakukan mikrokultur quantitatif PBMC (Peripheral Blood Mononuclear Cell) dengan quantitative real time PCR untuk melihat pengaruh pemberian DMPA terhadap peningkatan viral load HIV secara in vitro.HASIL :Pada penelitian ini, ditemukan bahwa tidak terdapat peningkatan yang bermakna pada peningkatan viral load HIV pada mikrokultur PBMC, baik pada kontrol yaitu yang tidak diberikan perlakuan DMPA maupun yang diberikan DMPA dengan 3 konsentrasi yang berbeda dengan nilai kemaknaan p = 0,965.KESIMPULAN: Tidak terdapat pengaruh pemberian DMPA terhadap jumlah viral load HIV, baik pada konsentrasi 1:10, konsentrasi 1:100, konsentrasi 1:1000 yang dilakukan secara invitro

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ABSTRACTMETHOD: The design being employed for this study is an experimental study. In this study blood sample of 10 cc will be taken from 6 subjects that will be devided into 4 groups, 1 group is control and the others are treated with DMPA with concentration of 1:10, 1:100, 1:1000 and PBMC (Peripheral Blood Mononuclear Cell) quantitative microculture will be done using real time PCR to examine the effect of DMPA adminstration to the increment of HIV viral load in vitro.RESULT: In this study, it was found that there is no significant increment of HIV viral load in PBMC microculture, whether in the control group, the one that is not treated with DMPA, or the group treated with DMPA using 3 different concentration with the value of statistical analysis of p = 0,965.CONCLUSION: No effect of DMPA administration to the HIV viral load, whether in 1:10 concentration, 1:100 concentration, or 1:1000 concentration, in vitro."

"Kuda laut (Hippocampus comes L.) telah digunakan sebagai Jamu di Indonesia yang diduga memiliki efek afrodisiak. Hal ini dilaporkan dalam studi ekstrak kuda laut (EKL) dapat meningkatkan sel spermatogonia, spermatosit, spermatid dan sel Leydig pada mencit. Penggunaan Depo-medroksiprogesteron asetat (DMPA) dapat menginhibisi poros hipotalamus-hipofisis-testis dalam menurukan testosteron selama 12 minggu. Hal ini menyebabkan spermatogenesis terganggu dan apoptosis sel spermatogenik meningkat. Kemampuan EKL saat ini belum banyak diteliti terkait pengaruhnya pada kajian histologi testikuler terutama populasi sel-sel spermatogenik dan sel Leydig serta apoptosis sel setelah induksi DMPA. Tiga puluh tikus jantan SD diinduksi DMPA 1,25 mg/kgBB pada minggu ke-0 dan 12, kemudian dikelompokkan akuades (K1), CMC 1% (K2), dosis ekstrak 150 mg/kgBB (K3), 225 mg/kgBB (K4) dan 300 mg/kgBB (K5) yang di cekok minggu ke-7 sampai ke-18. Selanjutnya testis diisolasi dan dilakukan pembuatan preparat hematoxylin and eosin (H&E) dan immunohistokimia (IHK) ekspresi Fas L. Sel-sel dihitung manual pada mikroskop dan menentukan IHK-skor. Analisis data dengan uji ANOVA dan Kruskall-Wallis. Dosis EKL 150 dan 225 mg/kgBB secara bermakna (p<0,05) meningkatkan populasi sel-sel spermatogenik dan sel Leydig serta menurunkan apoptosis sel dalam ekspresi Fas L selama 18 minggu sehingga dosis tersebut berpotensi dalam meningkatkan fungsi testikuler reproduksi tikus jantan setelah induksi DMPA.

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The seahorse (Hippocampus comes L.) had been used as ‘Jammu’ which probably have powerful aphrodisiac pharmacological activities. Depot-medroxyprogesterone acetate (DMPA) is a contraceptive drug that can inhibit the hypothalamic-pituitary-testis axis to reduce testosterone levels and could increase cell apoptosis for 12 weeks. In addition to improving testosterone levels, studies in mice reported that seahorse extract (SE) could increase spermatogonia, spermatocytes, spermatids, and Leydig cells, but limited studies are reporting the effects of SE in that population and apoptosis of cells in DMPA induced rats. Thirty male SD rats were induced with DMPA 1,25 mg/kgBW at weeks 0 and 12. Animals were randomly grouped by: aquadest (G1), CMC 1% (G2), SE dose 150 mg/kg BW (G3), SE dose 225 mg/kg bb (G4), SE 300 mg/kg BW (G5), gavage every day at 7-18 weeks. After that, the testis was obtained, and the tissue slide was processed with hematoxylin and eosin (H&E) and observed by immunohistochemistry. Data was collected by manually counting cells and determining H-score and analysed using one-way ANOVA and Kruskall-Wallis test. The reported dose of SE 150 and 225 mg/kg BW significantly increase spermatogenic cells and Leydig cells population also decrease cell apoptosis of Fas L expression, by means potentially increased testicular function in rats after DMPA induction.

 

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"ABSTRACTPada pemakaian kontrasepsi hormonal suntik Depot Medroxyprogesterone Acetate (DMPA) dapat menyebabkan kenaikan hormon tubuh. Hal ini dapat mempengaruhi saliva di rongga mulut yang merupakan salah satu indikator faktor resiko terjadinya karies gigi. Pemeriksaan pH dan viskositas saliva tidak terstimulasi dapat digunakan untuk menilai risiko karies individu. Pada beberapa penelitian, pemakaian DMPA menunjukkan terjadinya efek samping pada tubuh dan rongga mulut. Pemakaian DMPA dapat menimbulkan amenorea dan penurunan densitas tulang. Selain itu ketidakseimbangan hormon pada pemakaian DMPA juga mempengaruhi pH dan viskositas saliva. Tujuan: Menganalisis pengaruh lama pemakaian kontrasepsi hormonal suntik DMPA terhadap pH dan viskositas saliva tidak terstimulasi. Metode: Saliva tidak terstimulasi pada subjek pemakai kontrasepsi hormonal suntik DMPA dibagi ke dalam tiga kelompok, yaitu pemakaian selama 12-23 bulan, 24-35 bulan, dan 36-60 bulan, dan subjek non pemakai kontrasepsi dikumpulkan dan langsung diukur nilai pH dengan menggunakan kertas lakmus merk GC dan nilai viskositas dengan viskometer Oswald. Hasil: Tidak terdapat perbedaan bermakna (p>0,05) nilai pH dan viskositas saliva tidak terstimulasi antara kelompok uji dan kelompok kontrol. Kesimpulan: Tidak terdapat pengaruh lama pemakaian kontrasepsi hormonal suntik DMPA terhadap pH dan viskositas saliva tidak terstimulasi.

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ABSTRACTThe use of hormonal contraceptive injection Depot Medroxyprogesterone Acetate (DMPA) increasing the hormonal productivity. This can affect saliva in the oral cavity, which is one of the indicator of risk factors for dental caries. Examination of pH and viscosity of unstimulated saliva can be used to assess the risk of individual caries. In several studies, the use of DMPA showed the occurrence of side effects on the body and oral cavity. Use of DMPA can cause amenorrhea and reduce bone density. In addition, hormonal imbalances in the use of DMPA also affect the pH and viscosity of saliva. Objective: To analyze the effect of usage duration of hormonal contraceptive injection DMPA on pH and viscosity of unstimulated saliva. Method: Unstimulated saliva in hormonal contraceptive injection DMPA subjects with used duration of 12-23 months, 24-35 months, and 36-60 months, and non-contraceptive were collected and measured directly by using GC pH indicator paper and Oswald viscometer. Results: There were no significant differences (p > 0.05) value of pH and viscosity of unstimulated saliva between the test groups and control group. Conclusion: There were no effects of duration of usage hormonal contraceptive injection DMPA on the pH and viscosity of unstimulated saliva."

"ABSTRAKMedroksiprogesteron asetat merupakan progestin sintetik yang digunakan sebagai kontrasepsi hormonal jangka panjang. Tujuan dari penelitian ini adalah meningkatkan penetrasi subkutan dari medroksiprogesteron asetat. Pada penelitian ini telah dilakukan optimasi formula transfersom yaitu F1, F2 dan F3 dengan perbandingan fosfatidilkolin : Tween 80  berturut-turut adalah 90:10; 85:15; dan 75:25. Hasil karakterisasi menunjukkan F2 adalah formula terbaik dengan efisiensi penjerapan 81,20 ± 0,42 %, Zaverage 81,35 ±0,78 nm, indeks polidispersitas 0,198 ± 0,012 dan potensial zeta -34,83±0,64 mVsehingga digunakan pada formulasi sediaan gel. Sediaan gel yang dibuat terdiri dari dua formula, yaitu gel transfersom (FGT) dan gel non transfersom (FG). Terhadap kedua gel tersebut dilakukan uji penetrasi in vitro menggunakan sel difusi Franz dan uji in vivo pada tikus betina Sprague Dawley. Hasil uji penetrasi in vitro menunjukkan jumlah kumulatif medroksiprogesteron asetat terpenetrasi dari FGT lebih tinggi daripada FG selama 24  jam, dengan nilai fluks untuk FGT dan FG masing-masing adalah 112,77 ± 6,47 ng.cm-2.jam-1 dan 17,99 ± 4,81 ng.cm-2.jam-1. Pada uji in vivo, medroksiprogesteron asetat dalam sediaan FGT memberikan hasil area under the curve (AUC) yang lebih tinggi dari pada dalam sediaan FG. 

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ABSTRACTMedroxyprogesterone acetate is a synthetic progestin which is used as long-acting hormonal contraceptive. The aim of this research was to increase subcutaneous penetration of medroxyprogesterone acetate. In this research three transferosomes formulas were prepared and optimized,e.g.F1,F2 and F3 with posphatidylcoline : tween 80 concentration were 90:10; 85:15; and 75:25, respectively. F2 was the best formula with highest entrapment eficiency 81.20 ± 0.42 %, Zaverage 81.35 ±0.78 nm, indeks polidispersity 0.198±0.012 and zeta potensial was -34.83±0.64 mV, so it was incorporated into gel dosage form. There were two gels prepared, transferosomal (FGT) and non transferosomal gel (FG). Both of them were evaluated, in vitro penetration test using Franz Diffusion cells and in vivo study in Sprague Dawley female rats were also conducted to each dosage forms. According to in vitro penetration study, cummulative penetration of medroxyprogesterone acetate from FGT was higher than FG, which flux value for FGT and FG were 112.77 ± 6,47 ng.cm-2.hr-1 and 17.99 ± 4.81 ng.cm-2.hr-1, respectively. The result of in vivo study showed that medroxyprogesterone acetate in FGT dosage form had higher area under the curve of medroxyprogesterone acetate than in FGdosage form."

"Sejak tahun 2000 jumlah penderita HIV/AIDS di Indonesia meningkat tajam, terutama pada pecandu narkotika suntik. Terapi antiretroviral yang terbukti dapat menurunkan mortalitas dan meningkatkan kualitas hidup pasien, diberikan berdasarkan kondisi klinis, jumlah sel limfosit CD4 dan kadar virus dalam darah. Dalam penelitian ini dilakukan pemeriksaan kadar CD4 dan kadar virus pada 71 pasien HIV asimptomatik yang merupakan pecandu narkotika suntik untuk melihat apakah kadar CD4 berkorelasi dengan kadar virus HIV. Kadar CD4 diperiksa dengan metode imunofluoresensi indirek menggunakan antibodi monoklonal dan kadar virus menggunakan teknik PCR. Pemeriksaan hitung virus dilakukan pada 56 pasien yang mempunyai kadar CD4 lebih dari 200 sel/mm3 (x = 473 + 180,6). Sebanyak 30 orang (55,4%) mempunyai kadar virus dalam darah lebih dari 55.000 kopi/ml dan 35,7% kadar virusnya 5.000-55.000 kopi/ml. Korelasi antara kadar CD4 dengan kadar virus dalam darah memberi nilai r: 0,194. Disimpulkan bahwa pada pecandu narkotika kadar CD4 tidak berkorelasi dengan kadar HIV sehingga pemberian antiretroviral sebaiknya didasarkan pada kadar HIV dalam darah. (Med J Indones 2002; 11: 143-7)

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Since the year 2000 there has been a steep increased in the number of HIV/AIDS patients in Indonesia , coming mostly from intravenous drug users. Antiretroviral treatment has been proved to decrease mortality and increase quality of life of HIV/AIDS patients. The treatment is given according to clinical condition of the patients, number of CD4 and viral load. In this study, CD4 and viral load were examined in 71 asymptomatic HIV patients originated from injecting-drug users. CD4 counting was performed by indirect immunoflouresence method using monoclonal antibody, and viral load was tested using PCR technique. Among 56 patients who has the number of CD4 more than 200/mm3, 30 patients (55,4 %) has viral load more than 55,000 copies/ml and 35,7% has viral load 5,000-55,000 copies/ml. Correlation between the number of CD 4 and viral load gave the r value of 0,194. It is concluded that there is no association between the number of CD 4 and viral load in drug user HIV/AIDS patients. The treatment of HIV/AIDS for these patients should be given according to the viral load. (Med J Indones 2002; 11: 143-7)"

"Latar Belakang : Infeksi Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) merupakan penyakit imunodefisiensi sekunder terbanyak dan masih merupakan masalah kesehatan penting di dunia. Terapi antiretroviral (ART) diharapkan dapat mengurangi angka kejadian baru dan angka kematian karena HIV/AIDS. Data untuk mengevaluasi keberhasilan ART, gambaran pola viral load (VL) sebagai respos ART serta faktor-faktor yang memengaruhi keberhasilan terapi belum ada di Indonesia.Metode : Penelitian kohort retrospektif, memakai data rekam medis di Poliklinik Alergi-Imunologi Anak RSCM Jakarta sejak Juli 2003 sampai September 2022 pada anak sampai usia 18 tahun yang terdiagnosis HIV dan minimal mempunyai 3 hasil pemeriksaan VL.Hasil : Terdapat 137 anak yang memenuhi kriteria inklusi dan eksklusi. Keberhasilan ART setelah 12 bulan terapi sebesar 50,36% dan setelah 24 bulan terapi sebesar 64,23%. Pola VL terbanyak sebagai respons ART adalah Pola VL tersupresi 48,2%, kemudian early viral failure sebesar 34,3%, persistent low level viremia sebesar 15,3%, 1,5% sebagai viral failure dan 0,7% sebagai viral blips. Faktor-faktor yang memengaruhi keberhasilan terapi setelah 12 bulan terapi secara bermakna adalah status nutrisi baseline gizi baik dengan RR : 2,15 (IK 95% : 1,07-2,59) nilai p : 0,026. Setelah 24 bulan terapi adalah status nutrisi baseline gizi baik dengan RR 1,66 (IK 95% 1,09-1,86) dengan nilai p : 0,024.Kesimpulan : Keberhasilan terapi ARV setelah 12 bulan 50,36% dan 64,23% dicapai setelah 24 bulan. Faktor-faktor yang memengaruhi keberhasilan terapi secara bermakna pada 12 bulan dan pada 24 bulan adalah status nutrisi baseline gizi baik. Pelaksanaan pemeriksaan VL untuk diagnostik dan pemantauan terapi ARV memerlukan dukungan ketersediaan fasilitas diagnostik yang konsisten. Didapatkan 3 pola VL terbanyak adalah virus tersupresi, early viral failure dan persistent low level viremia.

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Background : Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS is still main health problem in the world. The use of antiretroviral therapy (ART) is expected to reduce new cases, and mortality of HIV/AIDS. Data to evaluate the success of ART, description of Viral Load (VL) patterns in response to ART and factors that affected VL suppression doesn’t yet exist in Indonesia.

Methods: A retrospective cohort study, using medical record at the Pediatric Allergy-Immunology outpatient clinic RSCM Jakarta from July 2003 to September 2022 in children up to 18 years of age who were diagnosed with HIV and had at least 3 VL test results

Results: There were 137 children who met the criteria. The success of ART after 12 months was 50.36% and after 24 months was 64.23%. The highest VL pattern in response to ART was a suppressed VL pattern of 48.2%, then early viral failure of 34.3% and persistent low-level viremia of 15.3%, viral failure of 1.5% and 0.7% as viral blips. Factors that significantly affected the success of therapy after 12 months of therapy was good nutritional status RR 2.15 (95% CI : 1.1-4.2) p : 0.026. After 24 months of therapy was good nutritional status with RR 1.66 (95% CI : 1.07-2.59) p : 0.024.

Conclusion: The success of therapy after 12 months was 50.36% and 64.23% after 24 months. Factors that affected the success of therapy at 12 months and 24 months of therapy was good nutritional status. The VL examination as confirmation of the diagnostic and success of therapy required consistent diagnostic tools availability. It was found 3 most patterns of VL was virus suppression, early viral failure and persistent low level viremia."

"Latar belakang: Pengembangan kontrasepsi hormonal pria didasarkan pada penekanan gonadotropin sehingga mengbnmbat spermatogenesis dan berdampak pada penurunan konsentrasi spermatozoa. Pemberian depot medroksiprogesteron aselat (DMPA) efektif mengbambat spermatogenesis dan sekresi testosteron namun berakibat menurunnya libido dan potensi seksual. Berbagai tanaman yang dapat menstimulasi pembentukan androgen endogen telah ditemukan di dalam tanaman obat, salah satunya adalah cabe jawa (Piper retrofractum Vahl.). Secara tradisional buah cabe jawa digunakan untuk obat lemah syahwat dan telah terbukti dapat meningkatkan kadar hormon testosteron darah. Tujuan: Mengetahui pengaruh komhinasi DMPA dan ekstrak cabe jawa terbadap konsent:rasi serta viabUitas spermatozoa vas deferenskadar hormon testosteron darah, berat badan, hernarologi, dan biokimia darah tikos (Rattus norvegicus L.). Metode: Penelitian ini menggunakan rancangan acak 1engkap (RAL), equal size sample yaitu terdiri dari satu kelompok kontrol dan dua kelompok perlakuan yang menggunakan tikus jantan galur Sprague Dawley sebagal model. Kelompok perlakuan pertama adalah tikus kastrasi yang dicekok dengan ekstrak cabe jawa dosis 0 mg (plasebo), 0,94 mg, 1,88 mg, 2,82 mg, dan 3,76 mg. Kelompok perlakuan kedua adalah tikos yang disuntik dengan doais 1,25 mg DMPA dan dicekok dcngan ekstrak cabe jawa dosis 0 mg (plasebo), 0,94 mg, 1,88 mg, 2,82 mg, dan 3,76 mg. Penyuntikan DMPA dilakukan pada minggu ke-0 dan minggu ke-12 perlakuan, sedangkan pencekokan ekstrak cabe jawa dilakukan setiap hari dimulai dari minggu ke-7 sampai minggu ke-18 perlakuan.Hasil: Terjadi penurunan konsentrasi spermatozoa yang siguifikan dibanding kontrol (p<0,05) pada kelompok DMPA + cabe jawa (0,94 mg dan 1,88 mg). Penurunan konsentrasi spermatozoa kelompok DMPA + cabe jawa (2,82 mg dan 3,76 mg) tidak berbeda signifikan dibanding kontrol (p>0,05). Terjadi penurunan viabililas spennatozoa pada kelompok DMPA + berbagai dosis ekstrak cabe jawa. Kadar hormon testosteron darah kelompok DMPA + cabe jawa 3,76 mg lebih tinggi dibandingkan kontrol (p>0,05) antara praperlakuan dan selama perlakuan. Penyuntikan dosis minimal DMPA dan pencekokan berbagai dosis ekstrak cabe jawa tidak mempengaruhi hemotologi dan biokimia darah tikus.

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Background: The development of hormonal male contraception retied on suppression of gonadotropin so that inhibit spermatogenesis and reduced sperm concentration. 1njection of DMPA will inhibit spermatogenesis and testosterone secretion but also cause degradation of sexual potency and libido. Various plants able to stimulate forming of androgen endogen. one of them is javanese long pepper (Piper retrofractum Vahl.). Traditionally, the fruits of javanese long pepper was used to cure weaken lust and have been proven to improve blood testosterone level.

Purpose: Knowing the effect of combination of DMPA and javanese long pepper extract on concentration and viability of sperm in was deferens, blood testosterone level, haematology and blood chemistry level of rat (Rattus norvegicus L.).

Method: This research is using complete random device, equal size sample that is consisting of one group of control and two groups of treatment which is taking male rat strain Sprague-Dawley as a model. The fast group of treatment is castration rat that feed with javanese long pepper exiract dosis 0 mg (placebo), 0.94 mg, 1.88 mg, 2.82 mg and 3.76 mg. The second group of treatment is injected rat with DMPA dosis 1.25 mg and also feed with javaoese long pepper extract dosis 0 mg (placebo), 0.94 mg, 1.88 mg, 2.82 mgand 3.76 mg. Injection of DMPA done at week 0 aod 12 oftrealment while feed ofjavanese long pepper extract done every day started from week 7 until week 18 of treatment.

Result: There was decreasing of spenn concentrstion significantly (p<0.05) at group of DMPA + (0.94 mg and 1.88 mg) of javanese long pepper extract which compered to controL Sperm concentration in group ofDMPA + (2.82 mg and 3.76 mg) of javanese long pepper extract was decreased but not significantly differ to control (p>O,OS). The sperm viability was decreased in group of DMPA + various dosis of javanese long pepper extract. The blood testosterone level was higher than control in group of DMPA + 3.76 mg of javanese long pepper extract (p>0.05). The body mass index was increased significantly (p<0.05) between before and during treatment. In general, injection of minimal dosis of DMPA and feeding various dosis of javanese long pepper extract do not influence to the rat haemotology and blood chemistry level."

"Latar Belakang: Human immuno deficiency virus/ Acquired Immune Deficiency Syndrome HIV/AIDS merupakan masalah global yang menunjukkan adanya keterkaitan antara kasus HIV/AIDS dengan adanya kejadian aterosklerosis sebagai pemicu terjadinya kasus Penyakit Jantung Koroner PJK . Pemberian Antiretroviral ARV tersebut juga berisiko untuk kejadian PJK melalui mekanisme dislipidemia, lipodistrofi, resistensi insulin dan gangguan hati, yang juga bisa menyebabkan penebalan tunika intima media.Tujuan: Mendapatkan korelasi perubahan kadar CD 4, kadar viral load dan Indeks Massa Tubuh terhadap perubahan ketebalan tunika intima media arteri karotis pada pasien HIV yang mendapat ARV lini pertama selama 12 bulanMetode: Penelitian ini merupakan studi uji korelasi terhadap 54 pasien HIV yang menggunakan data sekunder penelitian JACCANDO PROJECT. Data yang digunakan adalah data USG doppler arteri karotis, hasil CD 4, hasil viral load dan hasil Indeks Massa Tubuh IMT .Hasil: Median CD 4 sebelum pemberian ARV ialah 68 sel/ l, sedangkan median CD 4 sesudah pemberian ARV 286,5 sel/ l. Median kadar viral load sebelum ARV sebesar 1.79 log10 copy/ml, sedangkan median viral load sesudah ARV yaitu 0 log10 copy/ml. Median IMT sebelum ARV 19.6, sedangkan median sesudah 12 bulan ARV 19.72. Rerata tunika intima media arteri karotis kiri sebelum dan sesudah pemberian ARV selama 12 bulan ialah 0.58 dan 0.63 dengan p-value 0.031. Korelasi perubahan kadar CD 4 dengan ketebalan tunika intima media arteri karotis kanan r= 0.08, p=0,58 , dan kiri r= 0.01, p=0,965 . Korelasi perubahan kadar viral load dengan ketebalan tunika intima media arteri karotis kanan r= 0.09, p=0,54 dan arteri karotis kiri r= 0.06, p=0,66 . Korelasi perubahan kadar IMT dengan perubahan ketebalan tunika intima kanan r= - 0.11, p=0,37 dan kiri r= -0.18, p=0,19 .Simpulan: Ketebalan tunika intima mengalami peningkatan antara sebelum dan sesudah pengobatan antiretroviral, namun tidak didapatkan korelasi antara kadar CD4, Viral load dan indeks massa tubuh dengan ketebalan tunika intima arteri karotis.

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Background Human immuno deficiency virus Acquired Immune Deficiency Syndrome HIV AIDS is currently a global issue related with coronary artery disease. The effects of antiretroviral ARV is accompanied with some negative features such as dyslipidemia, lipodystrophy, insulin resistance and liver dysfunction which all contribute to increasing tunima intima thickness.Objective To acquire correlation between level of CD4, viral load, and Body Mass Index BMI with changes in tunica intima of carotid artery thickness in HIV patients receiving first line ARV for 12 monthsMethods This study is a correlation study involving 54 HIV patients using secondary data from the JACCANDO PROJECT research data such as Doppler ultrasound of the carotid artery, CD4 values, viral load as well as BMI.Results Median CD before antiretroviral treatment was 68 cells l, median CD 4 after ARV 286.5 cell l. The median viral load rate before ARV was 1.79 log10 copy ml, while median viral load after ARV was 0 log10 copy ml. The median BMI before ARV was 19.6, while median after 12 months of ARV was 19.72. The mean of the left artery carotid artery intima media before and after ARV administration for 12 months was 0.58 and 0.63 with p value 0.031. Correlation of changes in CD4 levels with the thickness of tunica intima medium of right carotid artery r 0.08, p 0,58 , and left r 0.01, p 0,965 . Correlation of changes in viral load levels with the tunica thickness of the right carotid artery medium r 0.09, p 0,54 and left carotid artery r 0.06, p 0.66 . Correlation of changes in BMI levels with changes in thickness of the right tunica intima r 0.11, p 0.37 and left carotid artery r 0.18, p 0.19 .Conclusion The thickness of intima tunica increased after antiretroviral treatment, but no correlation found between CD4, viral load and BMI level with the thickness of the intima tunica carotid artery."

"[ABSTRAKLatar Belakang : Penggunaan efavirenz dan rifampisin secara bersamaan menjadi suatu tantangan dalam penanganan HIV/AIDS-Tuberkulosis. Rifampisin sebagai penginduksi enzim pemetabolisme efavirenz dapat menurunkan kadar plasma efavirenz, dan dapat menyebabkan gagal terapi HIV.Tujuan: Penelitian ini dilakukan untuk mengetahui pengaruh rifampisin terhadap kadar plasma efavirenz dan viral load viral load pasien HIV/AIDS-Tuberkulosis yang telah mendapat terapi antiretrovirus 3-6 bulan. Metode : Penelitian ini mengukur kadar efavirenz dan viral load pasien HIV/AIDS yang mendapat antiretroviral berbasis efavirenz dosis 600 mg/hari setelah 3-6 bulanterapi dan pasien HIV/AIDS-Tuberkulosis dengan terapi antiretroviral yang sama dan terapi antituberkulosis berbasis rifampisin di RSPI Prof. DR Sulianti Saroso, hasilnya akan dibandingkan. Hasil : Subjek penelitian berjumlah 45 pasien, terdiri dari 27 pasien kelompok HIV/AIDS dan 18 pasien kelompok HIV/AIDS-Tuberkulosis. Pada pemeriksaan kadar plasma efavirenz didapat median (min-maks) kelompok HIV/AIDS 0,680 mg/L (0,24-5,67 mg/L), median (min-maks) kadar plasma kelompok HIV/AIDS-Tuberkulosis 0,685 mg/L (0,12-2,23 mg/L), berarti tidak terdapat perbedaan kadar plasma efavirenz yang bermakna secara statistik antara kedua kelompok (MannWhitney, p=0,480). Proporsi pasien dengan viral load ≥ 40 kopi/ml pada kelompok HIV/AIDS sebesar 51,9%, sedangkan pada kelompok HIV/AIDS-Tuberkulosis sebesar 72,2% (ChiSquare, p=0,291), tidak terdapat perbedaan proporsi pasien yang viral load < 40 kopi/ml maupun ≥ 40 kopi/ml antar kelompok. Tidak terdapat perbedaan secara statistik (Chi Square, p=0,470) antara proporsi pasien yang mempunyai kadar subterapetik dalam kelompok, dengan hasil viral load < 40 kopi/ml (45,2%) maupun ≥ 40 kopi/ml (54,8%). Kesimpulan: Kadar plasma efavirenz maupun viral load pasien HIV/AIDS-Tuberkulosis yang mendapat antiretroviral bersama antituberkulosis berbasis rifampisin tidak berbeda bermakna dengan pasien HIV/AIDS setelah 3-6 bulan terapi antiretroviral.

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ABSTRACTBackground: Concomitant use of efavirenz and rifampicin is a challenge in the treatment of HIV/AIDS-Tuberculosis infection. Rifampicin may decrease plasma concentration of efavirenz through induction of its metabolism, and could lead to HIV treatment failure Objective: To determine the effect of rifampicin-containing tuberculosis regimen on efavirenz plasma concentrations and viral load in HIV/AIDS-Tuberculosis infection patients who received efavirenz-based antiretroviral therapy. Methods: plasma efavirenz concentrations and HIV viral load were measured in HIV/AIDS patients treated with 600 mg efavirenz-based antiretroviral for 3 to 6 months and in HIV/AIDS-Tuberculosis infection patients treated with similar antiretroviral regimen plus rifampicin-containing antituberculosis in Prof. DR. Sulianti Saroso, Hospital Jakarta, Indonesia, The results were compared Results: Forty five patients (27 with HIV/AIDS and 18 with HIV/AIDSTuberculosis infections) were recruited during the period of March to May 2015. The median (min-max) efavirenz plasma concentration obtained from HIV/AIDS group [0,680 mg/L(0,24 to 5,67 mg/L] and that obtained from HIV/AIDSTuberculosis group[0.685 mg/L (0.12 -2.23 mg/L)] was not significantly different (Mann-Whitney U test, p = 0.480) .The proportion of patients with viral load ≥ 40 copies/ml after 3-6 months of ARV treatment in the HIV/AIDS group (51.9%), and the HIV/AIDS-Tuberculosis group (72.2%) was not significantly different (Chi Square test, p = 0.291). There was no significant difference (Chi Square, p=0,470) between the proportions of patients with subtherapeuticefavirenz plasma concentration in the groups with viral load < 40 copies/mL (45,2%) and ≥ 40 copies/mL (54,8%) Conclusions: Plasma efavirenz concentrations and viral load measurements in HIV/AIDS-Tuberculosis patients in antiretroviral and rifampicin-containing antituberculosis regimen were not significantly different with those in HIV/AIDS patients in 3 to 6 months antiretroviral therapy., Background: Concomitant use of efavirenz and rifampicin is a challenge in the treatment of HIV/AIDS-Tuberculosis infection. Rifampicin may decrease plasma concentration of efavirenz through induction of its metabolism, and could lead to HIV treatment failure Objective: To determine the effect of rifampicin-containing tuberculosis regimen on efavirenz plasma concentrations and viral load in HIV/AIDS-Tuberculosis infection patients who received efavirenz-based antiretroviral therapy. Methods: plasma efavirenz concentrations and HIV viral load were measured in HIV/AIDS patients treated with 600 mg efavirenz-based antiretroviral for 3 to 6 months and in HIV/AIDS-Tuberculosis infection patients treated with similar antiretroviral regimen plus rifampicin-containing antituberculosis in Prof. DR. Sulianti Saroso, Hospital Jakarta, Indonesia, The results were compared Results: Forty five patients (27 with HIV/AIDS and 18 with HIV/AIDSTuberculosis infections) were recruited during the period of March to May 2015. The median (min-max) efavirenz plasma concentration obtained from HIV/AIDS group [0,680 mg/L(0,24 to 5,67 mg/L] and that obtained from HIV/AIDSTuberculosis group[0.685 mg/L (0.12 -2.23 mg/L)] was not significantly different (Mann-Whitney U test, p = 0.480) .The proportion of patients with viral load ≥ 40 copies/ml after 3-6 months of ARV treatment in the HIV/AIDS group (51.9%), and the HIV/AIDS-Tuberculosis group (72.2%) was not significantly different (Chi Square test, p = 0.291). There was no significant difference (Chi Square, p=0,470) between the proportions of patients with subtherapeuticefavirenz plasma concentration in the groups with viral load < 40 copies/mL (45,2%) and ≥ 40 copies/mL (54,8%) Conclusions: Plasma efavirenz concentrations and viral load measurements in HIV/AIDS-Tuberculosis patients in antiretroviral and rifampicin-containing antituberculosis regimen were not significantly different with those in HIV/AIDS patients in 3 to 6 months antiretroviral therapy.]"