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"Latar Belakang. Gangguan kognitif tanpa disadari dapat terjadi pada orang dengan infeksi Human Immunodeficiency Virus (HIV). Insidens ganguan neurokognitif terkait HIV (HIV Associated Neurocognitive Disorders - HAND) pada era anti retroviral (ARV) mencapai 25-38%, dengan prevalensi 37%. Gejala klinis HAND yaitu kelainan kognitif, fungsi motor dan perilaku. Gangguan kognitif sering tidak terdiagnosis sehingga mengganggu aktivitas keseharian. Gangguan kognitif meningkat seiring dengan lamanya pasien HIV dapat bertahan hidup, dan pemakaian ARV jangka panjang berpotensi toksis yang mungkin dapat mempengaruhi tampilan neurokognitif itu sendiri. Perbaikan neurokognitif terkait HIV mulai tampak setelah pengobatan ARV 18 bulan. Tujuan. Diketahuinya gambaran fungsi kognitif pasien HIV yang sudah dan belum mendapatkan ARV, berdasarkan sebaran umur, jenis kelamin, pendidikan, pekerjaan, CD4, Hepatitis C, anemia dan depresi. Metode. Merupakan studi potong lintang, melibatkan pasien HIV rawat jalan di Unit Pelayanan Terpadu (UPT) HIV RSCM yang memenuhi kriteria inklusi. Dilakukan pencatatan data dasar pasien, nilai CD4, hemoglobin, depresi berdasarkan skala depresi Hamilton. Dilakukan pemeriksaan fungsi kognitif dengan Trial Making Test A dan B (TMT A dan B), digit span forward dan backward, animal naming, Rey Auditory Verbal Learning Test (RAVLT) dan psikomotor Pegboard. Hasil. Dari 100 subjek HIV, 50 sudah dan 50 belum ARV. Rata-rata usia subjek 32 tahun, pria sama banyak dengan wanita. Pendidikan terbanyak SMA. Subjek yang bekerja, rerata CD4, dan Hepatitis C reaktif lebih tinggi pada kelompok yang sudah ARV. Anemia lebih banyak pada kelompok subjek belum ARV. Depresi hanya didapat pada 3 subjek. Didapatkan perbedaan bermakna antara fungsi kognitif HIV dengan nilai CD4, pendidikan dan ARV. Gangguan kognitif ringan lebih tinggi pada kelompok belum ARV (48%) dibanding kelompok sudah ARV (18%) dengan perbedaan bermakna pada pemeriksaan bacward digit span, animal naming dan pegboard. Kesimpulan. Gangguan kognitif ringan terkait HIV lebih tinggi pada kelompok belum ARV, meskipun belum dikeluhkan oleh pasien.

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Background. Cognitive impairment can occure unnoticed in people with HIV. Incidence of HIV infection associated cognitive impairment reach 28-38% with 37% prevalence. HIV Associated Neurocogntive Disorders (HAND) with typicaly clinical symptoms is cognitive impairment, motor function and behavior. Cognitive impairment often under diagnosed and will affect daily activities. HAND as manifestattion of AIDS increased along with HIV patients survival. Long term in Antireroviral (ARV) treatment potentially toxic and may influence the appearance of neurocognitive impairment. After 18 months ARV treatment will make improvement in HIV related neurocognitive impairment.

Purpose. To meassure cognitive function of HIV patients after dan before ARV treatment acording to age, sex, education, employment, CD4, hepatitis C, anemia and depresion.

Method. Cross sectional study involving HIV outpatients in UPT HIV RSCM (Ciptomangunkusomo Hospital) that suitable with the inclusion criteria. Basic patients data, CD4 value, hemoglobin, hamilton depresion scale were collected. Cognitive function assesment with Trial making test (TMT A and B), digit span forward and backward, animal naming, RAVLT and psikomotor pegboard.

Result. From 100 subjects, 50 after and 50 before ARV treatment. The median age in all subject is 23 year old, man and woman in equal subjects. Majority education is senior high school. Employment subjects, CD4 mean, Hepatits C reactive are higher on before ARV group. Depresion only in 3 subjects. Significanly difference found in HIV cognitive fuction with CD4, education, and ARV treatment. Slight cognitive impairment is higher on before ARV group(48%) compare with after ARV group (18%) with significally difference in backward digit span, animal naming and pegboard test.

Conclusion. Slight HIV associated cognitive impairment is higher on before ARV grup, although the patients had no complaint."

"Latar Belakang: Gangguan kognitif merupakan komplikasi yang umum ditemui pada pasien HIV. Hal ini disebabkan oleh kerusakan neuronal oleh infeksi HIV. Gangguan kognitif dapat mempengaruhi kualitas hidup pasien. Dengan berkembangnya terapi antiretroviral (ART) terjadi penurunan derajat keparahan gangguan kognitif dan peningkatan kualitas hidup. Penelitian ini bertujuan untuk mengetahui perubahan fungsi kognitif dan kualitas hidup hidup pasien HIV setelah ART selama 3 bulan.Metode Penelitian: Penelitian ini merupakan studi kohort prospektif bagian dari JacCCANDO study (JAKarta CMV and Candida in HIV patients on ART evaluation in Cardiology, Neurocognitive, Dentistry and Ophtalmology Study) dimana subjek penelitian merupakan pasien HIV dengan imunodefisiensi berat (sel limfosit T CD4 < 200 sel/mL). Data yang digunakan pada penelitian adalah data sebelum dan setelah ART selama 3 bulan. Dilakukan penilaian kognitif lengkap, kualitas hidup (SF-36) serta pemeriksaan laboratorium.Hasil: Didapatkan 51 subjek dengan rentang usia subjek ialah 19-44 tahun. Didapatkan perbaikan skor (p<0,05) pada median Z kognitif,  Z fluensi, Z eksekutif, Z keterampilan motorik, skor kesehatan fisik dan mental setelah ART 3 bulan. Tidak didapatkan korelasi antara perubahan kognitif dengan kualitas hidup baik kesehatan fisik dan mental.Kesimpulan: Terdapat perbaikan fungsi kognitif pada domain fluensi, fungsi eksekutif dan keterampilan motorik serta perbaikan kualitas hidup baik kesehatan fisik maupun mental pada pasien HIV naïve setelah pemberian antiretroviral selama 3 bulan.

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Background: Cognitive impairment is one of the common complications found in patients with HIV. It is caused by neuronal damaged of HIV infection. Cognitive impairment could influencing the patient's quality of life (QoL). However, the development of antiretroviral therapy (ART) results in a decrease of cognitive impairment severity as well as an increase of QoL. This study aims to investigate the cognitive function and QoL changes in HIV patients after 3 months of ART.

Methods: This is a prospective cohort study and a part of JacCCANDO study (JAKarta CMV and Candida in HIV patients on ART evaluation in Cardiology, Neurocognitive, Dentistry and Ophthalmology Study) where all subjects were HIV patients with severe immunodeficiency (CD4 T-lymphocyte cell < 200 cells/mL). In this study, data was taken before and after antiretroviral therapy for 3 months. Complete cognitive assessment was performed, QoL (SF-36), and laboratory examination.

Result: Fifty-one subjects were gathered in this study. The age range was within 19-44 years old. There also a score improvement (p<0.05) in Z cognitive median, Z fluency, Z executive, Z motoric skills, physical health score and mental health score after 3 months of ART. No correlation was found between cognitive changes and QoL in neither physical health nor mental health.

Conclusion: There was an improvement of cognitive function within fluency domain, executive function, and motoric skills as well as the QoL improvement in both physical and mental health amongst naïve HIV patients after 3 months of antiretroviral therapy. Overall changes of cognitive function did not affect the QoL in both physical and mental."

"Infeksi Human Immunodeficiency Virus HIV yang menyebabkan AIDS sampai saat ini masih menjadi salah satu penyebab kematian tertinggi di dunia. Pengobatan infeksi HIV kemudian menjadi sangat penting untuk meningkatkan kualitas hidup dari penderita. Pengobatan infeksi HIV pada anak-anak khususnya sering menemui hambatan dalam hal kepatuhan, baik dari anak itu sendiri maupun dari pengasuh. Dalam penelitian ini dianalisis mengenai hubungan latar belakang pengasuh terhadap kepatuhan minum obat anak terinfeksi HIV di RSCM. Desain penelitian yang digunakan adalah cross-sectional dengan jumlah sampel sebesar 94. Pengambilan data menggunakan kuesioner kepatuhan minum obat yang diambil dari Development of Multi-Method Tool to Measure ART Adherence in Resource-Constrained Settings: The South Africa Experience yang diterbitkan oleh Center for Pharmaceutical Management, Management Sciences for Health pada tahun 2007 yang dikembangkan di Afrika Selatan. Hasil yang ditemukan adalah tidak ada hubungan antara tingkat pendidikan, tingkat pendapatan, status pengasuh, dan keterlibatan pada Kelompok Dukungan Sebaya KDS dengan kepatuhan minum obat p >0,05.

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Human Immunodeficiency Virus HIV infection causes AIDS, and is still one of the most frequent cause of death in the world. HIV medication then becomes highly important to improve the patients'quality of life, and to expand their life expectancies. HIV medication in children, however, is especially problematic in terms of adherence, whether the problems are from the children themselves or from the caregivers. This research was meant to analyze the correlation between caregiver's background and HIV infected children's adherence in RSCM, a hospital in Jakarta, Indonesia. This research used cross sectional method with 94 caregivers as the sample. The data was collected using an adherence questionnaire that was adapted from Development of Multi Method Tool to Measure ART Adherence in Resource Constrained Settings The South Africa Experience which was published by Center for Pharmaceutical Management, Management Sciences for Health in 2007. This questionnaire was developed in Southern Africa. After collection, the data was analyzed statistically using chi square or Kolmogorov Smirnov if using chi square was not possible. The results reveal that there is no correlation between caregiver's background educational background, income per month, caregiver's relation with the child, and caregiver's involvement in an HIV related support groups and HIV infected children's adherence to antiretroviral therapy p 0,05."

"ABSTRAKLatar belakang: Epidemi infeksi human immunodeficiency virus (HIV) masih terus berlangsung di seluruh dunia. Infeksi HIV telah diketahui memengaruhi berbagai sistem organ termasuk jantung. Komplikasi jantung akibat infeksi HIV bersifat multifaktorial dan berperan pada morbiditas dan mortalitas anak. Seiring peningkatan ketersediaan anti retroviral therapy (ART), angka kesintasan pasien juga meningkat. ART selain mempunyai efek kardioprotektif melalui mekanisme penekanan replikasi virus, juga mempunyai efek kardiotoksik. Hingga saat ini belum ada studi pada anak yang membandingkan antara kelompok pasien yang belum mendapatkan terapi (ART-naïve) dan yang telah mendapatkan terapi (ART-exposed).Tujuan: Mendapatkan data prevalens komplikasi jantung pada anak dengan infeksi HIV, baik ART-naïve maupun ART-exposed. Komplikasi jantung yang diteliti antara lain kardiomiopati dilatasi, hipertensi pulmonal, efusi perikardial, dan kelainan elektrokardiografi (EKG).Metode: Penelitian studi potong lintang dilakukan pada 106 anak dengan infeksi HIV usia 1-18 tahun yang datang ke Poliklinik Alergi dan Imunologi Departemen Ilmu Kesehatan Anak RSCM Pengambilan data dilakukan dengan menggunakan data sekunder dari penelitian kohort berjudul ''Cardiovascular Consequences of Paediatric HIV infection: Early Life Cardiovascular Risk and Immediate Cardiac Complications'' yang dilakukan dari bulan Juni 2013 hingga September 2015. Hasil: Komplikasi jantung ditemukan pada 75 (70,8%) anak dengan infeksi HIV, dengan 34 (68%) anak dari kelompok ART-naive dan 41 (73,2%) dari kelompok ART-exposed. Prevalens kardiomiopati dilatasi dan efusi perikardial lebih tinggi secara bermakna pada kelompok ART-naïve (p=0,024; p=0,002), sedangkan prevalens hipertensi pulmonal lebih tinggi secara bemakna pada kelompok ART-exposed (p=0,004). Tidak ditemukan perbedaan bermakna prevalens kelainan EKG antara dua kelompok tersebut.Simpulan: Prevalens komplikasi jantung pada anak dengan infeksi HIV adalah 70,8% dengan prevalens pada anak ART-naive sebesar 68% sedangkan pada anak ART-exposed sebesar 73,2%."

"ABSTRAKLatar Belakang. Infeksi HIV masih merupakan masalah kesehatan mayor baik di dunia maupun Indonesia. Sejak dimulainya terapi antiretroviral (ARV), terdapat pergeseran penyebab morbiditas dan mortalitas pasien HIV. Pasien HIV berisiko lebih tinggi mengalami cardiac event melalui berbagai mekanisme. Penilaian risiko kardiovaskular dan faktor-faktor yang memengaruhinya penting untuk dilakukan terhadap semua pasien HIV.Tujuan. Penelitian ini bertujuan untuk mengetahui prediksi risiko kardiovaskular pasien HIV dalam terapi ARV, perbedaan karakteristik klinis antara pasien risiko kardiovaskular tinggi dan rendah, serta hubungan lama penggunaan ARV, kepatuhan minum obat, hitung limfosit T CD4 nadir, serta perubahan indeks massa tubuh (IMT) terhadap risiko kardiovaskular.Metode. Penelitian ini merupakan studi potong lintang yang melibatkan pasien HIV dalam terapi ARV minimal 6 bulan. Setiap pasien yang masuk penelitian dicatat data demografis, riwayat penyakit, pengobatan, dan kebiasaan serta dilakukan pengukuran antropometri. Pasien kemudian diminta datang kembali untuk pemeriksaan profil lipid. Risiko kardiovaskular dihitung dengan D:A:D risk scores dan dituangkan dalam bentuk persentase. Uji hipotesis yang dilakukan adalah uji T atau Mann-Whitney untuk data numerik, dan Chi-square untuk data kategorik.Hasil. Terdapat 186 subjek penelitian yang dimasukkan ke dalam analisis. Proporsi subjek penelitian dengan risiko kadiovaskular tinggi adalah 14,52%. Seluruh subjek yang termasuk ke dalam kelompok risiko tinggi adalah laki-laki dengan usia yang relatif muda. Dislipidemia dan obesitas sentral lazim terjadi pada kelompok risiko tinggi. Terdapat perbedaan bermakna antara hitung limfosit T CD4 nadir dan riwayat putus obat antara subjek risiko tinggi dan rendah (OR:7,072,IK 95%: 0,92-54,006, p:0,032 dan OR: 3,364, IK 95%: 1,458-7,784, p: 0,003. Selain itu, terdapat perbedaan bermakna median lama penggunaan ARV dan rerata delta IMT antara kelompok risiko tinggi dan rendah (p:0,002 dan p: 0,018).Kesimpulan. Proporsi pasien HIV dengan risiko kardiovaskular tinggi pada penelitian ini sebesar 14,5%. Terdapat beberapa perbedaan bermakna dalam hal hitung limfosit T CD4 nadir, riwayat putus ARV, lama penggunaan ARV dan delta IMT antara subjek dengan risiko kardiovaskular tinggi dan rendah

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ABSTRACTBackground. Human immunodeficienncy virus (HIV) infection remains a major health problem worldwide. Ever since the discovery ov antiretroviral (ARV), there are shift in causes of morbidity and mortality among HIV patients. Patients with HIV are at greater risk to cardiac event due to different mechanisms. Cardiovascular risk assessment and the associated factors are indispensible to do for all HIV patients.Objective. This study aims to predict cardiovascular risk among HIV patients on ARV therapy, to investigate clinical characteristic differences between high risk and low risk group, and to examine the relationship of , nadir limfosit T CD4count, compliance, duration of ARV, and body mass index (BMI) changes toward cardiovascular risk.Method. This study was a cross sectional study involving HIV patient on ARV therapy for at least 6 months. Demographic data, history of illness, therapy, and habit were taken from each patients. Antropometry measurement was also conducted and blood drawing for lipid profile test was performed in the next appointment. Cardiovascular risk was assessed using D:A:D risk score and the proportion was presented in percentage. Hipothesis tests were performed using T test or Mann-Whitney test for numerical data and x2 test for categorical data.Results. There were 186 subjects included in the analysis. Proportion of subjects with high cardiovascular risk was 14.52%. All subjects with high cardiovascular risk was male with relatively young age. Dyslipidemia and central obesity were very common among patints in high risk group. There were significant difference in proportion of patients with nadir limfosit T CD4 count <200 cell/mm3 and history of bad compliance between high and low risk group (OR:7,072, 95% CI: 0,92-54,006, p:0,032; OR: 3,364,95% CI: 1,458-7,784, p: 0,003, respectively). Furthermore, there was also significant differences between median duration of ARV use and mean of IMT changes between two groups (p:0,002 dan p: 0,018).Conclusion. Proportion of HIV patients with high cardiovascular risk in this study was 14.5%. There were significant differences regarding nadir limfosit T CD4 count, history of compliance, duration of ARV use, and IMT changes between subjects with high and low cardiovascular risk."

"[ABSTRAKLatar Belakang: Terapi kombinasi antiretroviral (ARV)telah berhasil menurunkan angka morbiditas dan mortalitas pasien HIV, namun efek samping jangka panjang dapat menimbulkan perubahan distribusi lemak tubuh yang dikenal dengan sindrom lipodistrofi. Pasien HIV yang mengalami lipodistrofi berisiko mengalami gangguan metabolik yang dapat menyebabkan terjadinya penyakit kardiovaskular.Tujuan: Mengidentifikasi adanya lipodistrofi dan dislipidemia pada pasien prepubertas dengan HIV yang mendapatkan terapi ARV jangka panjang.Metode: Penelitian potong lintang dilakukan pada 76 pasien HIV usia prepubertas yang kontrol rutin di Poli Alergi Imunologi RSCM. Subyek dilakukan pemeriksaan klinis lipodistrofi oleh tenaga klinis terlatih menggunakan kriteria dari the European Paediatric Group of Lipodystrophy. Selain itu juga dilakukan pemeriksaan tebal lipatan kulit (TLK) triceps dan subscapular, lingkar pinggang, serta rasio lingkar pinggang-panggul. Data kadar CD4 awal, status gizi awal terdiagnosis, jenis terapi ARV, dan lama terapi ARV diambil dari rekam medis. Subyek juga dilakukan analisis diet, pemeriksaan profil lipid dan gula darah puasa.Hasil: Pada subyek prepubertas dengan HIV yang mendapatkan terapi ARV yang mengalami lipodistrofi dan dislipidemia berturut-turut sebanyak 47% dan 46%. Subyek yang mengalami lipodistrofi berupa lipohipertrofi (35%), lipoatrofi (5%), dan tipe campuran (7%). Subyek yang mengalami lipodistrofi pada umumnya memiliki massa lemak tubuh, serta TLK triceps dan subscapular yang normal. Pada subyek dengan lipohipertrofi dan tipe campuran seluruhnya memiliki rasio lingkar pinggang-panggul yang meningkat.Terdapat hubungan yang signifikan antara penggunaan regimen ARV kombinasi 2 nucleoside reverse transcriptase inhibitor (NRTI)+ protease inhibitor (PI) meningkatkan risiko 6,9 kali untuk terjadinya dislipidemia (p=0,001, IK95% 2,03-23,7) dibandingkan regimen 2NRTI+ non-nucleoside reverse transcriptase inhibitor (NNRTI).Simpulan: Prevalens lipodistrofi dan dislipidemia cukup tinggi pada pasien prepubertas dengan HIV yang mendapatkan terapi ARV. Pada umumnya subyek yang mengalami lipodistrofi pada penelitian ini adalah tipe lipohipertrofi.

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ABSTRACTBackground: Antiretroviral (ARV) combination therapy has significantly reduced morbidity and mortality in HIV-infected children. Long-term adverse effect of ARV is lipodystrophy syndrome. Lipodystrophy associated with metabolic disturbances which can cause cardiovascular disease.Objective: To identify lipodystrophy and dyslipidemia in prepubertal HIV-infected patients receiving long-term ARV therapy.Methods: Cross sectional study including 76 prepuberty HIV-infected children was performed by clinical and medical records review in Allergy Immunology Ward Cipto Mangunkusumo Hospital. Clinical examination of lipodystrophy was assesed by a trained clinician using the European Pediatric Group of Lipodystrophy criteria. We also assesed triceps and subscapular skinfold thicknesses, waist ratio, and waist-hip ratio. CD4 level and nutritional status at beginning therapy, ARV regiments, and duration ARV therapy were reviewed from medical records. We also performed diet analysis and laboratory examination such as lipid profiles and fasting glucose.Results: Prevalenceof lipodystrophy and dyslipidemia inprepubertalinfected-HIV children who receiving ARV were 47% and 46%. Subjects with lipodystrophy consisted of lipohypertrophy (35%), lipoatrophy (5%), and mixed type (7%). Subjects with lipodystrophy majority had normal triceps and subscapular skinfold thicknesses and normal total body fat. All subjects with lipohipertrophy and mixed type had an increasing waist-hip ratio. Regiment of 2 nucleoside reverse transcriptase inhibitors (NRTI) + protease inhibitor (PI) increased 6,9 times risk of dyslipidemia compare with 2NRTI+ non-nucleoside reverse transcriptase inhibitor (NNRTI) regiment (p=0,001, 95%CI 2,03-23,7).Conclusion: The prevalence of lipodystrophy and dyslipidemia are high among prepuberty HIV-infected children on antiretroviral therapy. Majority of subjects with lipodystrophy in this study were lipohypertrophy type., Background: Antiretroviral (ARV) combination therapy has significantly reduced morbidityand mortality in HIV-infected children. Long-term adverse effect of ARV is lipodystrophysyndrome. Lipodystrophy associated with metabolic disturbances which can causecardiovascular disease. Objective: To identify lipodystrophy and dyslipidemia in prepubertal HIV-infected patientsreceiving long-term ARV therapy.Methods: Cross sectional study including 76 prepuberty HIV-infected children wasperformed by clinical and medical records review in Allergy Immunology Ward CiptoMangunkusumo Hospital. Clinical examination of lipodystrophy was assesed by a trainedclinician using the European Pediatric Group of Lipodystrophy criteria. We also assesedtriceps and subscapular skinfold thicknesses, waist ratio, and waist-hip ratio. CD4 level andnutritional status at beginning therapy, ARV regiments, and duration ARV therapy werereviewed from medical records. We also performed diet analysis and laboratory examinationsuch as lipid profiles and fasting glucose. Results: Prevalenceof lipodystrophy and dyslipidemia inprepubertalinfected-HIV childrenwho receiving ARV were 47% and 46%. Subjects with lipodystrophy consisted oflipohypertrophy (35%), lipoatrophy (5%), and mixed type (7%). Subjects with lipodystrophymajority had normal triceps and subscapular skinfold thicknesses and normal total body fat.All subjects with lipohipertrophy and mixed type had an increasing waist-hip ratio. Regimentof 2 nucleoside reverse transcriptase inhibitors (NRTI) + protease inhibitor (PI) increased 6,9times risk of dyslipidemia compare with 2NRTI+ non-nucleoside reverse transcriptaseinhibitor (NNRTI) regiment (p=0,001, 95%CI 2,03-23,7).Conclusion: The prevalence of lipodystrophy and dyslipidemia are high among prepubertyHIV-infected children on antiretroviral therapy. Majority of subjects with lipodystrophy inthis study were lipohypertrophy type.]"

"Pembukaan status merupakan faktor penting yang diketahui mempengaruhi kepatuhan minum obat antiretroviral dan telah banyak diteliti di negara-negara dengan beban infeksi HIV tinggi. Penelitian ini bertujuan menganalisis hubungan pembukaan status dengan kepatuhan minum obat pada pasien anak terinfeksi HIV di RSUPN Dr. Cipto Mangunkusumo. Penelitian menggunakan desain potong lintang dengan sampel sebanyak 94 pengasuh dari 101 pasien anak terinfeksi HIV. Pengumpulan data pembukaan status dilakukan melalui kuesioner yang dibuat oleh peneliti, sedangkan data kepatuhan minum obat diambil menggunakan kuesioner yang diadaptasi dari instrumen multimetode yang dikembangkan oleh Gavin Steel, dkk. Penelitian ini menunjukkan sebagian besar pengasuh berjenis kelamin perempuan 89,4 , memiliki pendidikan terakhir SMP-SMA 64,9 , memiliki pendapatan di bawah upah minimum provinsi UMP Jakarta 75,5 , tergabung ke dalam kelompok dukungan sebaya 55,3 , dan bukan orangtua kandung dari pasien anak terinfeksi HIV 51,1 . Sebagian besar pasien anak terinfeksi HIV berusia 7 hingga di bawah 12 tahun 69,3 , berjenis kelamin perempuan 50,5 , menjalani terapi ARV lini 1 66,3 , belum mengalami pembukaan status HIV 71,3 , dan memiliki kepatuhan minum obat sedang 50,5 . Dari uji Chi-square diperoleh bahwa tidak terdapat perbedaan proporsi kepatuhan minum obat antara pasien anak terinfeksi HIV yang telah mengalami pembukaan status dengan yang belum mengalami pembukaan status p 0,367.

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Disclosure is an important factor known affecting adherence to antiretroviral therapy that has been extensively studied in high burden countries. This research aims to determine relationship between disclosure and adherence among HIV infeceted children in Dr. Cipto Mangunkusumo Hospital, Indonesia. This research is a cross sectional study with samples of 94 caregivers from 101 HIV infected children. Disclosure data was collected using questionnaire reproduced by researcher, while adherence data was collected using questionnaire adapted from a multi method instrument developed by Gavin Steel, et.al. in West Africa. Demographic data shows that most caregivers are women 89.4 , have middle school education 64.9 , have income less than minimum regional wage of Jakarta 75.5 , join peer group 55.3 , and are not the biological parents of infected children 51.1 . Most children are girls 50.5 , currently in 1st line antiretroviral therapy 66.3 , have not been disclosed 71.3 , dan have moderate level of adherence 50.5 . Statistical analysis using Chi Square shows no relationship between disclosure and adherence among HIV infected children in Dr. Cipto Mangunkusumo Hospital p 0.367."

"[ABSTRAKLatar Belakang. Penderita HIV/AIDS di Indonesia semakin meningkat, sedangkan infeksi HIV/AIDS maupun terapi ARV dapat menyebabkan penurunan kadar testosteron yang sangat memengaruhi kualitas hidup penyandang HIV/AIDS. Gejala dan tanda penurunan kadar testosteron pada pria dengan HIV sangat tidak spesifik, sedangkan pemeriksaan laboratorium sangat mahal, sehingga perlu diketahui faktor-faktor pada pasien yang dapat memprediksi penurunan kadar testosteron.Tujuan. Mengetahui apakah jumlah CD4 awal, lamanya terapi ARV, jenis ARV, lipodistrofi dan besarnya lingkar pinggang memengaruhi kadar testosteron bebas pada pria dengan HIV yang mendapat ARV.Metode. Penelitian potong lintang dilakukan pada bulan Maret 2015 di Unit Pelayanan HIV Terpadu RSCM, Jakarta. Subjek adalah pria dengan HIV berusia 18-40 tahun, mendapat ARV teratur sekurangnya dalam 1 tahun terakhir. Pemeriksaan meliputi anamnesis, pengukuran lingkar pinggang dan lipodistrofi, pemeriksaan kadar testosteron total, SHBG dan testosteron bebas (Free Testosteron Index: FTi). Uji regresi linier digunakan untuk menilai faktor-faktor yang berhubungan dengan kadar testosteron bebas pada penelitian ini.Hasil. Dari 54 subjek, didapatkan median usia 35,11 tahun (21-40), median lamanya ARV 59 bulan (16-129), median CD4 awal 57/mm3 (3-443), rerata lingkar pinggang 82,4cm (SB 10,33). Subjek yang mengalami lipodistrofi sebanyak 17 orang (32%). Subjek yang menggunakan ARV lini pertama 48 orang. Median kadar testosteron bebas 30,87% (9,78-85,64) dan subjek yang memiliki kadar testosteron bebas rendah sebanyak 32 orang(59%). Terdapatnya lipodistrofi (p=0,003, OR= -12,25) dan lamanya menggunakan ARV (p=0,002, OR=-0,182) berhubungan dengan kadar testosteron bebas pada penelitian ini.Simpulan : Pada pria dengan HIV yang mendapat terapi ARV, adanya lipodistrofi dan lamanya terapi ARV berhubungan dengan kadar testosteron bebas. Kadar CD4 awal, jenis ARV dan lingkar pinggang tidak berhubungan dengan kadar testosteron bebas.

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ABSTRACTBackground. There are increasing numbers of people living with HIV/AIDS in Indonesia. HIV/AIDS infection could cause a decrease in testosterone level which affect patients? quality of life. Symptoms of decreasing testosterone level in HIV infected male are very unspecific, while laboratory tests are costly. Therefore it is important to know factors that could predict a decrease in HIV patient?s testosterone level.Purpose. To know the correlation between initial CD4 count, duration and type of ARV, lipodystrophy, size of waist circumference with free testosterone level of HIV infected male on ARV.Method. A cross-sectional study was conducted March 2015 in HIV Integrated Clinic, RSCM, Jakarta. The subjects were 18-40 years old, got regular ARV therapy for at least 1 year. Examination includes measuring waist circumference, presence of lipodystrophy, examination of total testosterone, SHBG and free testosterone level (Free Testosterone Index:FTi). Linear regression used to analyze factors associated with free testosterone level in this study.Results. Of 54 subjects examined, the median age was 35.11 years (21-40), median duration of antiretroviral therapy was 59 months (16-129), mean of waist circumference was 82.4 cm (SB 10.33), median of initial CD4 level was 57/mm3 (3-443). Total subjects with lipodystrophy were 17 subjects (32%), subjects who used first-line combination were 48 and 6 subjects used a second line combination. Median level of free testosterone levels was 30.87% (9.78-85.64) and there were 32 subjects with a low free testosterone level (59%). The presence of lipodystrophy (p=0,003, OR=-12,225) and duration of antiretroviral therapy (p=0,002, OR=-0,182) are associated with free testosterone level.Conclusions. Among HIV infected male who receiving antiretroviral therapy, the presence of lipodystrophy and duration of antiretroviral therapy are associated with free testosterone levels. There were no association between initial CD4 count, type of antiretroviral therapy and waist circumference with free testosterone levels.;Background. There are increasing numbers of people living with HIV/AIDS in Indonesia. HIV/AIDS infection could cause a decrease in testosterone level which affect patients? quality of life. Symptoms of decreasing testosterone level in HIV infected male are very unspecific, while laboratory tests are costly. Therefore it is important to know factors that could predict a decrease in HIV patient?s testosterone level.Purpose. To know the correlation between initial CD4 count, duration and type of ARV, lipodystrophy, size of waist circumference with free testosterone level of HIV infected male on ARV.Method. A cross-sectional study was conducted March 2015 in HIV Integrated Clinic, RSCM, Jakarta. The subjects were 18-40 years old, got regular ARV therapy for at least 1 year. Examination includes measuring waist circumference, presence of lipodystrophy, examination of total testosterone, SHBG and free testosterone level (Free Testosterone Index:FTi). Linear regression used to analyze factors associated with free testosterone level in this study.Results. Of 54 subjects examined, the median age was 35.11 years (21-40), median duration of antiretroviral therapy was 59 months (16-129), mean of waist circumference was 82.4 cm (SB 10.33), median of initial CD4 level was 57/mm3 (3-443). Total subjects with lipodystrophy were 17 subjects (32%), subjects who used first-line combination were 48 and 6 subjects used a second line combination. Median level of free testosterone levels was 30.87% (9.78-85.64) and there were 32 subjects with a low free testosterone level (59%). The presence of lipodystrophy (p=0,003, OR=-12,225) and duration of antiretroviral therapy (p=0,002, OR=-0,182) are associated with free testosterone level.Conclusions. Among HIV infected male who receiving antiretroviral therapy, the presence of lipodystrophy and duration of antiretroviral therapy are associated with free testosterone levels. There were no association between initial CD4 count, type of antiretroviral therapy and waist circumference with free testosterone levels.;Background. There are increasing numbers of people living with HIV/AIDS in Indonesia. HIV/AIDS infection could cause a decrease in testosterone level which affect patients? quality of life. Symptoms of decreasing testosterone level in HIV infected male are very unspecific, while laboratory tests are costly. Therefore it is important to know factors that could predict a decrease in HIV patient?s testosterone level.Purpose. To know the correlation between initial CD4 count, duration and type of ARV, lipodystrophy, size of waist circumference with free testosterone level of HIV infected male on ARV.Method. A cross-sectional study was conducted March 2015 in HIV Integrated Clinic, RSCM, Jakarta. The subjects were 18-40 years old, got regular ARV therapy for at least 1 year. Examination includes measuring waist circumference, presence of lipodystrophy, examination of total testosterone, SHBG and free testosterone level (Free Testosterone Index:FTi). Linear regression used to analyze factors associated with free testosterone level in this study.Results. Of 54 subjects examined, the median age was 35.11 years (21-40), median duration of antiretroviral therapy was 59 months (16-129), mean of waist circumference was 82.4 cm (SB 10.33), median of initial CD4 level was 57/mm3 (3-443). Total subjects with lipodystrophy were 17 subjects (32%), subjects who used first-line combination were 48 and 6 subjects used a second line combination. Median level of free testosterone levels was 30.87% (9.78-85.64) and there were 32 subjects with a low free testosterone level (59%). The presence of lipodystrophy (p=0,003, OR=-12,225) and duration of antiretroviral therapy (p=0,002, OR=-0,182) are associated with free testosterone level.Conclusions. Among HIV infected male who receiving antiretroviral therapy, the presence of lipodystrophy and duration of antiretroviral therapy are associated with free testosterone levels. There were no association between initial CD4 count, type of antiretroviral therapy and waist circumference with free testosterone levels.;Background. There are increasing numbers of people living with HIV/AIDS in Indonesia. HIV/AIDS infection could cause a decrease in testosterone level which affect patients? quality of life. Symptoms of decreasing testosterone level in HIV infected male are very unspecific, while laboratory tests are costly. Therefore it is important to know factors that could predict a decrease in HIV patient?s testosterone level.Purpose. To know the correlation between initial CD4 count, duration and type of ARV, lipodystrophy, size of waist circumference with free testosterone level of HIV infected male on ARV.Method. A cross-sectional study was conducted March 2015 in HIV Integrated Clinic, RSCM, Jakarta. The subjects were 18-40 years old, got regular ARV therapy for at least 1 year. Examination includes measuring waist circumference, presence of lipodystrophy, examination of total testosterone, SHBG and free testosterone level (Free Testosterone Index:FTi). Linear regression used to analyze factors associated with free testosterone level in this study.Results. Of 54 subjects examined, the median age was 35.11 years (21-40), median duration of antiretroviral therapy was 59 months (16-129), mean of waist circumference was 82.4 cm (SB 10.33), median of initial CD4 level was 57/mm3 (3-443). Total subjects with lipodystrophy were 17 subjects (32%), subjects who used first-line combination were 48 and 6 subjects used a second line combination. Median level of free testosterone levels was 30.87% (9.78-85.64) and there were 32 subjects with a low free testosterone level (59%). The presence of lipodystrophy (p=0,003, OR=-12,225) and duration of antiretroviral therapy (p=0,002, OR=-0,182) are associated with free testosterone level.Conclusions. Among HIV infected male who receiving antiretroviral therapy, the presence of lipodystrophy and duration of antiretroviral therapy are associated with free testosterone levels. There were no association between initial CD4 count, type of antiretroviral therapy and waist circumference with free testosterone levels.;Background. There are increasing numbers of people living with HIV/AIDS in Indonesia. HIV/AIDS infection could cause a decrease in testosterone level which affect patients? quality of life. Symptoms of decreasing testosterone level in HIV infected male are very unspecific, while laboratory tests are costly. Therefore it is important to know factors that could predict a decrease in HIV patient?s testosterone level.Purpose. To know the correlation between initial CD4 count, duration and type of ARV, lipodystrophy, size of waist circumference with free testosterone level of HIV infected male on ARV.Method. A cross-sectional study was conducted March 2015 in HIV Integrated Clinic, RSCM, Jakarta. The subjects were 18-40 years old, got regular ARV therapy for at least 1 year. Examination includes measuring waist circumference, presence of lipodystrophy, examination of total testosterone, SHBG and free testosterone level (Free Testosterone Index:FTi). Linear regression used to analyze factors associated with free testosterone level in this study.Results. Of 54 subjects examined, the median age was 35.11 years (21-40), median duration of antiretroviral therapy was 59 months (16-129), mean of waist circumference was 82.4 cm (SB 10.33), median of initial CD4 level was 57/mm3 (3-443). Total subjects with lipodystrophy were 17 subjects (32%), subjects who used first-line combination were 48 and 6 subjects used a second line combination. Median level of free testosterone levels was 30.87% (9.78-85.64) and there were 32 subjects with a low free testosterone level (59%). The presence of lipodystrophy (p=0,003, OR=-12,225) and duration of antiretroviral therapy (p=0,002, OR=-0,182) are associated with free testosterone level.Conclusions. Among HIV infected male who receiving antiretroviral therapy, the presence of lipodystrophy and duration of antiretroviral therapy are associated with free testosterone levels. There were no association between initial CD4 count, type of antiretroviral therapy and waist circumference with free testosterone levels., Background. There are increasing numbers of people living with HIV/AIDS in Indonesia. HIV/AIDS infection could cause a decrease in testosterone level which affect patients? quality of life. Symptoms of decreasing testosterone level in HIV infected male are very unspecific, while laboratory tests are costly. Therefore it is important to know factors that could predict a decrease in HIV patient?s testosterone level.Purpose. To know the correlation between initial CD4 count, duration and type of ARV, lipodystrophy, size of waist circumference with free testosterone level of HIV infected male on ARV.Method. A cross-sectional study was conducted March 2015 in HIV Integrated Clinic, RSCM, Jakarta. The subjects were 18-40 years old, got regular ARV therapy for at least 1 year. Examination includes measuring waist circumference, presence of lipodystrophy, examination of total testosterone, SHBG and free testosterone level (Free Testosterone Index:FTi). Linear regression used to analyze factors associated with free testosterone level in this study.Results. Of 54 subjects examined, the median age was 35.11 years (21-40), median duration of antiretroviral therapy was 59 months (16-129), mean of waist circumference was 82.4 cm (SB 10.33), median of initial CD4 level was 57/mm3 (3-443). Total subjects with lipodystrophy were 17 subjects (32%), subjects who used first-line combination were 48 and 6 subjects used a second line combination. Median level of free testosterone levels was 30.87% (9.78-85.64) and there were 32 subjects with a low free testosterone level (59%). The presence of lipodystrophy (p=0,003, OR=-12,225) and duration of antiretroviral therapy (p=0,002, OR=-0,182) are associated with free testosterone level.Conclusions. Among HIV infected male who receiving antiretroviral therapy, the presence of lipodystrophy and duration of antiretroviral therapy are associated with free testosterone levels. There were no association between initial CD4 count, type of antiretroviral therapy and waist circumference with free testosterone levels.]"

"Latar belakang. Infeksi HIV dapat memicu inflamasi kronik dan reaktifasi CMV yang dan dapat mempengaruhi limfosit T. Gambaran seperti ini juga ditemukan pada usia lanjut dan berhubungan dengan penyakit degeneratif termasuk gangguan kognitif. Penelitian ini bertujuan untuk mengetahui pengaruh CMV dan limfosit T terhadap fungsi kognitif pada pasien HIV usia muda.Metode. JakCCANDO JAKarta CMV and Candida in HIV patients on ART, evaluation in CArdiology, Neurocognitive, Dentistry and Ophthalmology study, merupakan studi prospektif yang dilakukan di RSUPN. dr. Cipto Mangunkusumo. Studi ini melibatkan 80 pasien HIV 19-44 tahun yang belum pernah mendapat terapi antiretroviral ARV dengan limfosit T CD4

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Background. HIV can trigger chronic inflammation and CMV reactivation that affect T cell. These feature is also found in old age population and associated with degenerative disease including cognitive impairment. In this study we investigated the effects of CMV and T cells on cognitive function of younger HIV patients.Methods. JakCCANDO JAKarta CMV and Candida in HIV patients on ART, evaluation in CArdiology, Neurocognitive, Dentistry and Ophthalmology is a prospective study of patients at Cipto Mangunkusumo hospital. This study involved 80 HIV antiretroviral therapy ART naive patients 19 44 years with baseline CD4 T cell counts "