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"ABSTRAK Latar belakang: Sejak dilaporkan pertama kali pada tahun 1981 di AmerikaSerikat, penyebaran Acquired Immune Deficiency Syndrome (AIDS) di seluruhdunia termasuk Indonesia terjadi dengan pesat. Saluran pencernaan merupakantarget utama infeksi HIV. Enteropati terjadi pada 15-70% kasus anak. Enteropatidapat terjadi walaupun tanpa gejala gastrointestinal. Kondisi enteropati dapatmenimbulkan perburukan gejala gastrointestinal, kegagalan pertumbuhan danmenyebabkan pasien mengarah pada wasting. Enteropati dideteksi denganpemeriksaan alpha 1 antitripsin.Tujuan: (1) Mengetahui proporsi enteropati yang terjadi pada anak denganAIDS stadium lanjut tanpa gejala gastrointestinal. (2) Mengetahui karakteristikenteropati yang terjadi pada anak dengan AIDS stadium lanjut tanpa gejalagastrointestinal. (3) Mengetahui hubungan antara enteropati dengan usia, statusgizi, status imunodefisiensi, jenis dan lama terapi ARV serta lama sakit anakdengan AIDS stadium lanjut tanpa gejala gastrointestinal. Metode: Penelitian potong lintang deskriptif dan analitik yang dilakukan diPoliklinik Alergi Imunologi Departemen Ilmu Kesehatan Anak FKUI- RSCMantara bulan Agustus sampai dengan November 2015 terhadap anak denganAIDS stadium lanjut berusia 0 - 18 tahun tanpa gejala gastrointestinal. Faktorrisiko dianalisis bivariat dan multivariat.Hasil: Total subjek penelitian berjumlah 70 subjek (35 lelaki dan 35 perempuan).Enteropati terjadi pada 31 subjek. Enteropati lebih banyak ditemukan pada anakperempuan, usia >60 bulan, mengalami malnutrisi, tidak ada imunodefisiensi, obatantiretroviral lini kedua dan ketiga, lama pengobatan 0-59 bulan dan lama sakit 059bulan. Pada analisis bivariat tidak didapatkan faktor risiko yang bermakna.Pada analisis multivariat didapatkan lama sakit 0-59 bulan dengan nilai OR 3,451(IK95% 1,026-11,610) merupakan faktor risiko yang berperan dalam terjadinyaenteropati pada anak dengan AIDS stadium lanjut tanpa gejala gastrointestinal. Simpulan : Proporsi enteropati pada anak dengan AIDS stadium lanjut tanpagejala gastrointestinal sebanyak 31 dari 70 subjek. Faktor risiko yang berperanadalah lama sakit 0-59 bulan. ABSTRACT Background: HIV/AIDS is a global pandemic. Digestive tract is a major target forHIV infection. The digestive-absorptive functions are impaired, occurring in 1570%ofchildren.Enteropathycontributestogastrointestinalmanifestation,growthfailureand further immune derangement, leading to wasting. The diagnosticapproach includes alpha 1 antitrypsin fecal level. Objective: (1) to describe frequency of enteropathy in advanced stages of AIDSchildren without gastrointestinal manifestation, (2) to describe characteristic ofchildren with advanced stages of AIDS without gastrointestinal manifestationwho develop enteropathy, (3) to investigate the role of age, nutritional status,immunodeficiency status, type and duration of antiretroviral therapy, and durationof illness as risk for enteropathy in advanced stages of AIDS children withoutgastrointestinal manifestation. Methods: A descriptive and analytic cross-sectional study was conducted at Pediatric Allergy-Immunology Outpatient Clinic RSCM between August toNovember 2015. The inclusion criteria was advanced stages of AIDS childrenage 0-18 years old without gastrointestinal manifestation. Risk factors wereanalyzed with bivariate and multivariate analysis. Results: Seventy children fulfilled the study criteria (35 males and 35 females).Thirty-one subjects were diagnosed as enteropathy. Most subjects are female, age>60 month-old, malnutritional status, no immunodeficiency, received second andthird line antiretroviral regimen with duration 0-59 months and duration ofillness 0-59 months. Bivariate analysis showed that no factor was significantly associated with enteropathy. Based on multivariate analysis, duration of illness0-59 months is a significant risk factor with OR 3.451 (CI 1.026-11.610). Conclusions: The proportion enteropathy in advanced stages of AIDS childrenwithout gastrointestinal manifestation is 31/70. Patients who had been diagnosedas advanced stage of HIV/AIDS for 0-59 months are more likely to developenteropathy.;Background: HIV/AIDS is a global pandemic. Digestive tract is a major target forHIV infection. The digestive-absorptive functions are impaired, occurring in 1570%ofchildren.Enteropathycontributestogastrointestinalmanifestation,growthfailureand further immune derangement, leading to wasting. The diagnosticapproach includes alpha 1 antitrypsin fecal level. Objective: (1) to describe frequency of enteropathy in advanced stages of AIDSchildren without gastrointestinal manifestation, (2) to describe characteristic ofchildren with advanced stages of AIDS without gastrointestinal manifestationwho develop enteropathy, (3) to investigate the role of age, nutritional status,immunodeficiency status, type and duration of antiretroviral therapy, and durationof illness as risk for enteropathy in advanced stages of AIDS children withoutgastrointestinal manifestation. Methods: A descriptive and analytic cross-sectional study was conducted at Pediatric Allergy-Immunology Outpatient Clinic RSCM between August toNovember 2015. The inclusion criteria was advanced stages of AIDS childrenage 0-18 years old without gastrointestinal manifestation. Risk factors wereanalyzed with bivariate and multivariate analysis. Results: Seventy children fulfilled the study criteria (35 males and 35 females).Thirty-one subjects were diagnosed as enteropathy. Most subjects are female, age>60 month-old, malnutritional status, no immunodeficiency, received second andthird line antiretroviral regimen with duration 0-59 months and duration ofillness 0-59 months. Bivariate analysis showed that no factor was significantly associated with enteropathy. Based on multivariate analysis, duration of illness0-59 months is a significant risk factor with OR 3.451 (CI 1.026-11.610). Conclusions: The proportion enteropathy in advanced stages of AIDS childrenwithout gastrointestinal manifestation is 31/70. Patients who had been diagnosedas advanced stage of HIV/AIDS for 0-59 months are more likely to developenteropathy.;Background: HIV/AIDS is a global pandemic. Digestive tract is a major target forHIV infection. The digestive-absorptive functions are impaired, occurring in 1570%ofchildren.Enteropathycontributestogastrointestinalmanifestation,growthfailureand further immune derangement, leading to wasting. The diagnosticapproach includes alpha 1 antitrypsin fecal level. Objective: (1) to describe frequency of enteropathy in advanced stages of AIDSchildren without gastrointestinal manifestation, (2) to describe characteristic ofchildren with advanced stages of AIDS without gastrointestinal manifestationwho develop enteropathy, (3) to investigate the role of age, nutritional status,immunodeficiency status, type and duration of antiretroviral therapy, and durationof illness as risk for enteropathy in advanced stages of AIDS children withoutgastrointestinal manifestation. Methods: A descriptive and analytic cross-sectional study was conducted at Pediatric Allergy-Immunology Outpatient Clinic RSCM between August toNovember 2015. The inclusion criteria was advanced stages of AIDS childrenage 0-18 years old without gastrointestinal manifestation. Risk factors wereanalyzed with bivariate and multivariate analysis. Results: Seventy children fulfilled the study criteria (35 males and 35 females).Thirty-one subjects were diagnosed as enteropathy. Most subjects are female, age>60 month-old, malnutritional status, no immunodeficiency, received second andthird line antiretroviral regimen with duration 0-59 months and duration ofillness 0-59 months. Bivariate analysis showed that no factor was significantly associated with enteropathy. Based on multivariate analysis, duration of illness0-59 months is a significant risk factor with OR 3.451 (CI 1.026-11.610). Conclusions: The proportion enteropathy in advanced stages of AIDS childrenwithout gastrointestinal manifestation is 31/70. Patients who had been diagnosedas advanced stage of HIV/AIDS for 0-59 months are more likely to developenteropathy."

"Tujuan penelitian ini adalah untuk menentukan data demografi, faktor risiko, gambaran klinis, infeksi oportunis/ko-infeksi dan perbedaannya pada rumah sakit pemerintah dan swasta. Penelitian retrospektif-deskriptif dilakukan di RSUPN-Dr. Cipto Mangunkusumo (RS pemerintah) dan RS Medistra (RS swasta) di Jakarta. Kriteria inklusi mencakup kasus HIV/AIDS yang dirawat pada tahun 2002-2003, dan hasil serologi HIV positif dengan metode Elisa. Data sekunder didapatkan dari rekam medis. Enam puluh enam subyek diikut-sertakan dalam penelitian (RS pemerintah 30 subyek dan RS swasta 36 subyek), terdiri dari 59 pria (89.4%) dan 7 wanita (10.6%). Tiga puluh tujuh persen subyek didiagnosis HIV dan 62% AIDS. Faktor risiko yang didapat mencakup pengguna narkoba (59.1%), homoseksual (13.6%), heteroseksual (21.1%), transfusi (1.5%) dan perinatal (1.5%). Gejala klinis terutama berupa demam akut (56.2%), penurunan berat badan (39.4%), batuk (38.8%), sesak nafas (27.2%), diare kronik (22.8%), demam berkepanjangan (19.7%), penurunan kesadaran (15.3% dan, anoreksia (15.3%). Perbedaan bermakna antara RS pemerintah dan swasta didapatkan pada keluhan demam dan batuk. Presentasi klinis pasien HIV/AIDS selama perawatan mencakup : pnemonia (56%), oral trush (22.6%), anemia (56.5%), lekopenia (32.3%), limfopenia (55.9%), peningkatan SGOT/SGPT (66.1%), hipoalbuminemia (46.9%), limfadenopati (10.6%), lesi serebral (7.6%), ensefalopati (6.0%), tuberkulosis paru dan efusi pleura (10.6%). Infeksi oportunis dan ko-infeksi mencakup kandidosis (25.8%), hepatitis C kronik (24.2%), hepatitis B dan C kronik (4.5%), tb paru, limfadenitis dan tb milier. Kandidosis dan tb paru lebih sering ditemukan di RS pemerintah. Kesimpulan dari penelitian ini bahwa manifestasi klinis HIV/AIDS berupa pria/wanita usia muda dengan satu atau lebih faktor risiko, mengalami demam, keluhan pernapasan, penurunan berat badan, diare kronik, lemah, oral trush, anemia, lekopenia, limfopenia. Pasien yang dirawat di RS swasta menunjukkan gejala yang lebih bervariasi sedangkan yang dirawat di RS pemerintah menunjukkan kondisi yang lebih berat dan stadium lebih lanjut. (Med J Indones 2004; 13: 232-6)

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The aims of this study is to determine the demographic data, risk factors, clinical presentations, opportunistic/co-infections and its difference between public and private hospitals. A retrospective-descriptive study was conducted in Dr. Cipto Mangunkusumo National General Hospital (public hospital) and Medistra Hospital (private hospital), Jakarta. The inclusion criteria were new HIV/AIDS cases admitted in year 2002-2003 and positive HIV serology (Elisa method). Secondary data were collected form medical record. Sixty-six subjects were enrolled in this study (public hospital 30 subjects and private hospital 36 subjects), consist of 59 male (89.4%) and 7 female (10.6%). Thirty-seven percent subjects were defined as HIV and 62% AIDS. Risk factors obtained include drug user (59.1%), homosexual (13.6%), heterosexual (21.1%), transfusion (1.5%) and maternal-child (perinatal) (1.5%). The clinical symptoms mainly present as acute fever (56.2%), weight loss (39.4%), cough (38.8%), shortness of breath (27.2%), chronic diarrhea (22.8%), prolong fever (19.7%), loss of conciousness (15.3%), anorexia (15.3%). Significant differences between public and private hospitals were seen in fever and cough symptoms. Clinical presentation of HIV/AIDS patients during admission were : pneumonia (56%), oral trush (22.6%), anemia (56.5%), leucopenia (32.3%), lymphopenia (55.9%), elevated AST/ALT (66.1%), hypoalbuminemia (46.9%), limphadenopathy (10.6%), brain space occuping lesion (7.6%), encephalopathy (6.0%), pulmonary tb and pleural effusion (10.6%). The opportunistic and co-infections present were candidiasis (25.8%), chronic hepatitis C (24.2%), chronic hepatitis B and C (4.5%), pulmonary tb, lymphadenitis and miliary tb. Candidiasis and pulmonary tb were frequently found in public hospital. In conclusion from this study that clinical manifestation of HIV/AIDS were young man or woman, with one or more possible risk factor, had fever, respiratory complain, loss of body weight, chronic diarrhea, fatique, oral trush, anemia, leucopenia, lymphopenia. Patients admitted in private hospital had varied complain; and patients that admitted in public hospital had more severe and advance condition. (Med J Indones 2004; 13: 232-6)"

"Infeksi HIV menyebabkan menurunnya jumlah sel T helper(Th) yang memudahkan terjadinya infeksi oportunistik. Salah satu infeksi oportunistik tersering adalah infeksi kandida di orofaring dan esofagus. Untuk mendeteksi peningkatan koloni Kandida tidak mudah, jumlah CD4 dapat digunakan sebagai rujukan. Pada kenyataannya hanya sedikit sentra laboratorium yang menyediakan fasilitas pemeriksaan CD4. Dilakukan penelitian cross-sectional untuk menentukan hubungani antara jumlah limfosit total dengan intensitas koloni kandida di orofaring pasien-pasien HIV/AIDS. Penelitian dilakukan di poliklinik dan bangsal rawat inap RS Dr. Cipto Mangunkusumo dari Agustus 2004 sampai Januari 2005. Subyek penelitian diwawancarai, menjalani pemeriksaan fisik, dan pemeriksaan darah dan kultur sampel kumur pasien. Sejumlah 60 subyek terdiri dari 52 pria(86.7%) dan 8 wanita(13.3%). Rata-rata hitung limfosit total adalah 1194.53 sel/µL. Kandidosis orofaring terdapat pada 44 pasien(73.3%).Terdapat kecenderungan jumlah koloni Kandida yang tinggi pada jumlah limfosit total pasien yang rendah, walaupun tidak terdapat korelasi signifikan di antara keduanya. Terdapat perbedaan yang bermakna antara jumlah limfosit total pada klas koloni Kandida yang positif dan negatif. (Med J Indones 2005; 14: 147-51)

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HIV infection causes qualitative and quantitative reduction of the T helper (Th) subset of T lymphocytes, facilitating opportunistic infection. One of the common opportunistic infections among HIV/AIDS patients is Candida infection in the oropharynx and esophagus. Detection of increased Candida colonialization is not always easy, CD4 count is a parameter that could be used as reference. The fact is there?s only few laboratory can provide CD4 count. This study is a cross-sectional correlative study to determine the relation between total lymphocyte count as a much more applicable laboratory parameter and the intensity of Candida colonization in the oropharyngeal cavity of patients with HIV infection/AIDS. It was performed in the outpatient ward and inpatient ward of Dr. Cipto Mangunkusumo Hospital, from August 2004 to January 2005. The selected study subjects underwent interview, physical examination and had their blood samples and gargle samples taken. 60 study subjects were recruited, consisting of 52 males (86.7%) and 8 females (13.3%). The mean total lymphocyte count was 1194.53 cells/μL. Oropharyngeal candidiasis was found in 44 subjects (73.3%). There is a trend of higher Candida colonies number with lower total lymphocyte count despite no significant correlation between total lymphocyte count and the number of Candida colonies in the oral cavity of patients with HIV infection/AIDS. There is significant different between total lymphocyte count in positive and negative Candida colonies. (Med J Indones 2005; 14: 147-51)"

"ABSTRAK Latar Belakang: Hingga saat ini belum ada panduan mengenai paduan terapiantiretroviral (antiretroviral therapy/ART) terpilih pada pasien HIV dewasadengan riwayat interupsi tidak terencana. Kondisi pasien pada saat reintroduksiART perlu dievaluasi sebagai dasar pemilihan paduan ART Tujuan: Mengetahui proporsi keberhasilan virologis pada reintroduksi ART linipertama pasca interupsi tidak terencana. Mengetahui hubungan antara berbagaifaktor klinis dan laboratoris dengan keberhasilan virologis pada reintroduksi tersebut. Metode: Penelitian kohort retrospektif dilakukan pada pasien HIV yangmendapatkan reintroduksi ART lini pertama pasca interupsi tidak terencanaselama minimal 1 bulan. Data didapatkan dari rekam medis RS dr. CiptoMangunkusumo di Jakarta. Viral load (VL) dinilai 6-18 bulan setelah reintroduksiART lini pertama, dinyatakan berhasil bila VL <400 kopi/ml. Dilakukan analisisterhadap faktor yang berhubungan dengan keberhasilan virologis tersebut.Hasil: Selama periode Januari 2005 s.d. Desember 2014 terdapat 100 subjek yangmendapatkan reintroduksi ART lini pertama dan memiliki data viral load 6-18bulan pasca reintroduksi. Pasca reintroduksi ART didapatkan keberhasilanvirologis pada 55 (55%) subjek. Pada analisis didapatkan dua faktor yangberhubungan dengan keberhasilan virologis pada reintroduksi ART lini pertama,yaitu frekuensi interupsi satu kali (adjusted OR/aOR 5,51; IK95% 1,82-16,68;p=0,003), nilai CD4 saat reintroduksi ≥200 sel/mmxi 3 (aOR 4,33; IK95% 1,1416,39,p=0,031).Simpulan:Proporsi keberhasilan virologis pada reintroduksi ART lini pertamapasca interupsi tidak terencana adalah 55%. Pasien dengan frekuensi interupsi 1kali dan pasien dengan nilai CD4 saat reintroduksi ≥200 sel/mm3 memiliki kecenderungan untuk mencapai keberhasilan virologis pada reintroduksi ART.ABSTRACT There is no guideline concerning antiretroviral therapy (ART) ofchoice for adult HIV patients after unplanned interruption. Hence, patients?conditions at time of ART reintroduction need to be evaluated as a basis forselecting ART regiment. Objectives: To know the proportion of virological success of first line ARTreintroduction after unplanned interruption. To know the association betweeneither clinical or laboratory factors and virological success in reintroduction. Methods: We conducted a retrospective cohort study in HIV patients that werereintroduced to first line ART after having unplanned interruption for at least onemonth period. The data were collected from medical records of Dr. CiptoMangunkusumo Hospital in Jakarta. Viral load (VL) was evaluated at 6-18months after first line ART reintroduction, declared as a success if VL <400copies/mL. Analysis was done to factors associated with such virological success.Results: Between January 2005 and December 2014, 100 subjects werereintroduced to first line ART and having VL data in 6 to 18 months after thereintroduction. Virological success was achieved in 55 (55%) subjects. In theanalysis we found that virological success was associated with interrupted once(adjusted OR/aOR 5.51%, 95%CI 1.82-16.68, p=0.003) and CD4 ≥200 cell/mmxii Universitas Indonesia 3at the time of reintroduction (aOR 4.33, 95%CI 1.14-16.39, p=0.031).Conclusions: Proportion of virological success on first line ART reintroductionafter unplanned interruption was 55%. Patients who were having interrupted onceand patients with CD4 ≥200 cell/mm3 at the time of reintroduction would havehigher odds of virological success on first line ART reintroduction.;Background: There is no guideline concerning antiretroviral therapy (ART) ofchoice for adult HIV patients after unplanned interruption. Hence, patients?conditions at time of ART reintroduction need to be evaluated as a basis forselecting ART regiment. Objectives: To know the proportion of virological success of first line ARTreintroduction after unplanned interruption. To know the association betweeneither clinical or laboratory factors and virological success in reintroduction. Methods: We conducted a retrospective cohort study in HIV patients that werereintroduced to first line ART after having unplanned interruption for at least onemonth period. The data were collected from medical records of Dr. CiptoMangunkusumo Hospital in Jakarta. Viral load (VL) was evaluated at 6-18months after first line ART reintroduction, declared as a success if VL <400copies/mL. Analysis was done to factors associated with such virological success.Results: Between January 2005 and December 2014, 100 subjects werereintroduced to first line ART and having VL data in 6 to 18 months after thereintroduction. Virological success was achieved in 55 (55%) subjects. In theanalysis we found that virological success was associated with interrupted once(adjusted OR/aOR 5.51%, 95%CI 1.82-16.68, p=0.003) and CD4 ≥200 cell/mmxii Universitas Indonesia 3at the time of reintroduction (aOR 4.33, 95%CI 1.14-16.39, p=0.031).Conclusions: Proportion of virological success on first line ART reintroductionafter unplanned interruption was 55%. Patients who were having interrupted onceand patients with CD4 ≥200 cell/mm3 at the time of reintroduction would havehigher odds of virological success on first line ART reintroduction.;Background: There is no guideline concerning antiretroviral therapy (ART) ofchoice for adult HIV patients after unplanned interruption. Hence, patients?conditions at time of ART reintroduction need to be evaluated as a basis forselecting ART regiment. Objectives: To know the proportion of virological success of first line ARTreintroduction after unplanned interruption. To know the association betweeneither clinical or laboratory factors and virological success in reintroduction. Methods: We conducted a retrospective cohort study in HIV patients that werereintroduced to first line ART after having unplanned interruption for at least onemonth period. The data were collected from medical records of Dr. CiptoMangunkusumo Hospital in Jakarta. Viral load (VL) was evaluated at 6-18months after first line ART reintroduction, declared as a success if VL <400copies/mL. Analysis was done to factors associated with such virological success.Results: Between January 2005 and December 2014, 100 subjects werereintroduced to first line ART and having VL data in 6 to 18 months after thereintroduction. Virological success was achieved in 55 (55%) subjects. In theanalysis we found that virological success was associated with interrupted once(adjusted OR/aOR 5.51%, 95%CI 1.82-16.68, p=0.003) and CD4 ≥200 cell/mmxii Universitas Indonesia 3at the time of reintroduction (aOR 4.33, 95%CI 1.14-16.39, p=0.031).Conclusions: Proportion of virological success on first line ART reintroductionafter unplanned interruption was 55%. Patients who were having interrupted onceand patients with CD4 ≥200 cell/mm3 at the time of reintroduction would havehigher odds of virological success on first line ART reintroduction.;Background: There is no guideline concerning antiretroviral therapy (ART) ofchoice for adult HIV patients after unplanned interruption. Hence, patients?conditions at time of ART reintroduction need to be evaluated as a basis forselecting ART regiment. Objectives: To know the proportion of virological success of first line ARTreintroduction after unplanned interruption. To know the association betweeneither clinical or laboratory factors and virological success in reintroduction. Methods: We conducted a retrospective cohort study in HIV patients that werereintroduced to first line ART after having unplanned interruption for at least onemonth period. The data were collected from medical records of Dr. CiptoMangunkusumo Hospital in Jakarta. Viral load (VL) was evaluated at 6-18months after first line ART reintroduction, declared as a success if VL <400copies/mL. Analysis was done to factors associated with such virological success.Results: Between January 2005 and December 2014, 100 subjects werereintroduced to first line ART and having VL data in 6 to 18 months after thereintroduction. Virological success was achieved in 55 (55%) subjects. In theanalysis we found that virological success was associated with interrupted once(adjusted OR/aOR 5.51%, 95%CI 1.82-16.68, p=0.003) and CD4 ≥200 cell/mmxii Universitas Indonesia 3at the time of reintroduction (aOR 4.33, 95%CI 1.14-16.39, p=0.031).Conclusions: Proportion of virological success on first line ART reintroductionafter unplanned interruption was 55%. Patients who were having interrupted onceand patients with CD4 ≥200 cell/mm3 at the time of reintroduction would havehigher odds of virological success on first line ART reintroduction."

"ABSTRAK Latar belakang : Cytomegalovirus (CMV) merupakan salah satu infeksi oportunistikpada pasien dengan sindrom immunodefisiensi (AIDS). Gejala klinis dan CT scantidak dapat menegakkan diagnosa definitif ensefalitis CMV. Oleh karena itudiperlukan uji alternatif untuk menegakkan diagnosis infeksi CMV pada pasien HIVdengan infeksi otak. Salah satu uji yang sensitif dan spesifik adalah Real TimePolymerase Chain Reaction (rPCR).Tujuan : Mendapatkan uji deteksi molekular CMV pada pasien HIV dengantersangka infeksi otak.Metode : Penelitian dilakukan dalam 3 tahap. Tahap 1 adalah optimasi konsentrasiprimer, probe, suhu annealing, volume elusi ekstraksi DNA, dan volume cetakan.Tahap 2 adalah uji spesifisitas (reaksi silang) dan uji sensitivitas (ambang batasdeteksi DNA) rPCR dan tahap 3 adalah penerapan uji rPCR yang sudah dioptimasiterhadap sampel plasma, urin, dan LCS.Hasil : Kondisi optimal uji rPCR telah diperoleh dengan konsentrasi primer danprobe 0,1 μM, dengan kondisi suhu reaksi rPCR: aktivasi enzim pada 950C selama 3menit; 45 siklus pada 950C selama 15 detik (denaturasi) dan 560C selama 1 menit(annealing dan ekstensi). Volume elusi ekstraksi DNA yang optimal untuk ketigajenis sampel (LCS, plasma dan urin) adalah 40 μL, dan volume cetakan rPCR untukLCS, plasma, dan urin, masing-masing adalah 5, 4, dan 3 μL. Uji rPCR mampumendeteksi DNA pada 50.000 jumlah kopi/mL dan tidak bereaksi silang denganStaphylococcus aureus, Staphylococcus epidermidis, Staphylococcus saprophyticus,Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Mycobacteriumtuberculosis, Candida spp, Toxoplasma gondii, EBV,HSV,dan VZV. Penerapan ujirPCR pada sampel klinis memberikan hasil negatif pada semua sampel LCS, 72,22%positif pada sampel plasma, dan 72,22% positif pada sampel urin.Kesimpulan: Telah dilakukan optimasi uji rPCR dengan minimal deteksi DNACMV 50.000 jumlah kopi/mL dan tidak bereaksi silang dengan mikroorganisme yangberpotensi menyebabkan positif palsu (false positive).ABSTRACT Background: Cytomegalovirus (CMV) is one of opportunistic infections in patientswith Aquired Immunodeficiency Syndrome (AIDS). Clinical manifestations are nottypical, and CT scans can not define encephalitis CMV specifically. Therefore, it isimportant to apply an alternative assay for sensitive and specific detection of CMVinfection in HIV patients with suspected central nervous system (CNS) infections.One of the assays is real time polymerase chain reaction (rPCR).Objective: To obtain a molecular assay for detection of CMV in HIV patients withsuspect CNS infections.Methods: This study was conducted in three phases. The first is optimization ofconcentrations of primers, probe, annealing temperature, final elution of DNAextraction, and volume of PCR template. The second is determinations of sensitivity(minimal detection of DNA) and specificity (cross-reaction) of the optimized rPCR,and the third is application of the rPCR for clinical samples of plasma, urine, andliquor cerebrospinal (LCS).Results: The rPCR reaction showed optimal concentrations of primers and probe at0.1 μM, with thermal cycler: 950C for 3 min (enzyme activation), followed by 45cycles of 950C for 15 sec (denaturation) and 560C for 1 min (annealing andextension). Final elution of DNA extraction was 40 μL and volume of PCR templatesfor urine, plasma, and LCS was 3, 4, and 5 μL, respectively. The rPCR had minimaldetection of DNA at 50,000 copies/mL and was not cross-reacted withStaphylococcus aureus, Staphylococcus epidermidis, Staphylococcus saprophyticus,Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Mycobacteriumtuberculosis, Candida spp, Toxoplasma gondii, Epstein-Bar Virus (EBV), HerpesSimplex Virus (HSV) and Varicella Zoster Virus (VZV). Application of rPCR forclinical samples showed that the rPCR yielded 72.22% positive for plasma or urine,and negative for all LCS samples.Conclusion: The rPCR has been optimized in this study with minimal DNA detectionat 50,000 copies/mL and was not cross-reacted with other microorganisms that arepotential to cause false positive results.;Background: Cytomegalovirus (CMV) is one of opportunistic infections in patientswith Aquired Immunodeficiency Syndrome (AIDS). Clinical manifestations are nottypical, and CT scans can not define encephalitis CMV specifically. Therefore, it isimportant to apply an alternative assay for sensitive and specific detection of CMVinfection in HIV patients with suspected central nervous system (CNS) infections.One of the assays is real time polymerase chain reaction (rPCR).Objective: To obtain a molecular assay for detection of CMV in HIV patients withsuspect CNS infections.Methods: This study was conducted in three phases. The first is optimization ofconcentrations of primers, probe, annealing temperature, final elution of DNAextraction, and volume of PCR template. The second is determinations of sensitivity(minimal detection of DNA) and specificity (cross-reaction) of the optimized rPCR,and the third is application of the rPCR for clinical samples of plasma, urine, andliquor cerebrospinal (LCS).Results: The rPCR reaction showed optimal concentrations of primers and probe at0.1 μM, with thermal cycler: 950C for 3 min (enzyme activation), followed by 45cycles of 950C for 15 sec (denaturation) and 560C for 1 min (annealing andextension). Final elution of DNA extraction was 40 μL and volume of PCR templatesfor urine, plasma, and LCS was 3, 4, and 5 μL, respectively. The rPCR had minimaldetection of DNA at 50,000 copies/mL and was not cross-reacted withStaphylococcus aureus, Staphylococcus epidermidis, Staphylococcus saprophyticus,Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Mycobacteriumtuberculosis, Candida spp, Toxoplasma gondii, Epstein-Bar Virus (EBV), HerpesSimplex Virus (HSV) and Varicella Zoster Virus (VZV). Application of rPCR forclinical samples showed that the rPCR yielded 72.22% positive for plasma or urine,and negative for all LCS samples.Conclusion: The rPCR has been optimized in this study with minimal DNA detectionat 50,000 copies/mL and was not cross-reacted with other microorganisms that arepotential to cause false positive results.;Background: Cytomegalovirus (CMV) is one of opportunistic infections in patientswith Aquired Immunodeficiency Syndrome (AIDS). Clinical manifestations are nottypical, and CT scans can not define encephalitis CMV specifically. Therefore, it isimportant to apply an alternative assay for sensitive and specific detection of CMVinfection in HIV patients with suspected central nervous system (CNS) infections.One of the assays is real time polymerase chain reaction (rPCR).Objective: To obtain a molecular assay for detection of CMV in HIV patients withsuspect CNS infections.Methods: This study was conducted in three phases. The first is optimization ofconcentrations of primers, probe, annealing temperature, final elution of DNAextraction, and volume of PCR template. The second is determinations of sensitivity(minimal detection of DNA) and specificity (cross-reaction) of the optimized rPCR,and the third is application of the rPCR for clinical samples of plasma, urine, andliquor cerebrospinal (LCS).Results: The rPCR reaction showed optimal concentrations of primers and probe at0.1 μM, with thermal cycler: 950C for 3 min (enzyme activation), followed by 45cycles of 950C for 15 sec (denaturation) and 560C for 1 min (annealing andextension). Final elution of DNA extraction was 40 μL and volume of PCR templatesfor urine, plasma, and LCS was 3, 4, and 5 μL, respectively. The rPCR had minimaldetection of DNA at 50,000 copies/mL and was not cross-reacted withStaphylococcus aureus, Staphylococcus epidermidis, Staphylococcus saprophyticus,Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Mycobacteriumtuberculosis, Candida spp, Toxoplasma gondii, Epstein-Bar Virus (EBV), HerpesSimplex Virus (HSV) and Varicella Zoster Virus (VZV). Application of rPCR forclinical samples showed that the rPCR yielded 72.22% positive for plasma or urine,and negative for all LCS samples.Conclusion: The rPCR has been optimized in this study with minimal DNA detectionat 50,000 copies/mL and was not cross-reacted with other microorganisms that arepotential to cause false positive results.;Background: Cytomegalovirus (CMV) is one of opportunistic infections in patientswith Aquired Immunodeficiency Syndrome (AIDS). Clinical manifestations are nottypical, and CT scans can not define encephalitis CMV specifically. Therefore, it isimportant to apply an alternative assay for sensitive and specific detection of CMVinfection in HIV patients with suspected central nervous system (CNS) infections.One of the assays is real time polymerase chain reaction (rPCR).Objective: To obtain a molecular assay for detection of CMV in HIV patients withsuspect CNS infections.Methods: This study was conducted in three phases. The first is optimization ofconcentrations of primers, probe, annealing temperature, final elution of DNAextraction, and volume of PCR template. The second is determinations of sensitivity(minimal detection of DNA) and specificity (cross-reaction) of the optimized rPCR,and the third is application of the rPCR for clinical samples of plasma, urine, andliquor cerebrospinal (LCS).Results: The rPCR reaction showed optimal concentrations of primers and probe at0.1 μM, with thermal cycler: 950C for 3 min (enzyme activation), followed by 45cycles of 950C for 15 sec (denaturation) and 560C for 1 min (annealing andextension). Final elution of DNA extraction was 40 μL and volume of PCR templatesfor urine, plasma, and LCS was 3, 4, and 5 μL, respectively. The rPCR had minimaldetection of DNA at 50,000 copies/mL and was not cross-reacted withStaphylococcus aureus, Staphylococcus epidermidis, Staphylococcus saprophyticus,Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Mycobacteriumtuberculosis, Candida spp, Toxoplasma gondii, Epstein-Bar Virus (EBV), HerpesSimplex Virus (HSV) and Varicella Zoster Virus (VZV). Application of rPCR forclinical samples showed that the rPCR yielded 72.22% positive for plasma or urine,and negative for all LCS samples.Conclusion: The rPCR has been optimized in this study with minimal DNA detectionat 50,000 copies/mL and was not cross-reacted with other microorganisms that arepotential to cause false positive results."

"Disertasi ini membahas konstruksi pengetahuan dan praktik/tindakan pengelolaan illness yang dilakukan orang dengan HIV-AIDS (ODHA) serta berbagai faktor kontekstual yang terkait dalam mewujudkan praktik/tindakan tersebut. Penelitian dilakukan kepada 6 ODHA di Jakarta: laki-laki homoseksual, laki-laki biseksual, pekerja seksual komersial perempuan, intravenous drug user (IDU) laki-laki, dan perempuan heteroseksual yang terinfeksi dari suaminya. Data penelitian juga diperoleh dari significant others setiap ODHA. Konstruksi pengetahuan ODHA dalam mengelola illness dilihat melalui pendekatan connectionism. Hasil penelitian menunjukkan bahwa Pengetahuan ODHA dalam mengelola illness berkembang melalui pengalaman pribadi dari upaya memahami illness (learning what illness means) hingga beradaptasi terhadap illness. Praktik/tindakan pengelolaan illness terwujud karena adanya makna yang terbentuk dari interaksi antara struktur ekstrapersonal dan intrapersonal individu.

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This study discussed about knowledge construction and illness managing practices that conducted by people with HIV-AIDS (ODHA), also contextual factors related to bring into reality those practices. Study conducted to 6 ODHAs in Jakarta that consisted of a male homosexual, a female bisexual, a female prostitute, an intravenous drug user (IDU), and females that were infected HIV- AIDS from their husbands. The data also were collected from the significant others of ODHAs. The ODHA's knowledge construction in managing illness was viewed through connectionism approach.

The study showed that the ODHAs' knowledge in managing illness developed through personal experiences from the effort to understanding the illness (learning what illness means) to becoming adaptive to the illness. The practices brought into reality because there was a meaning which was formed from interaction between individual extrapersonal and intrapersonal structure."

"HIV menjadi penyebab utama menurunnya sistem imun sekunder, yang lambat laun mengarah pada stadium AIDS. AIDS merupakan masalah epidemik dunia yang memerlukan penanganan serius karena mengancam eksistensi manusia, sehingga perlu dilakukan tindakan pencegahan penularan HIV, khususnya oleh ODHA. Penelitian ini bertujuan untuk mengetahui faktor-faktor yang mempengaruhi tindakan pencegahan penularan HIV oleh ODHA. Desain penelitian ini adalah deskriptif analitik dengan pendekatan cross sectional. Jumlah responden yang diperoleh adalah 75 orang. Hasil penelitian ini menunjukkan bahwa faktor yang berhubungan dengan tindakan pencegahan penularan HIV oleh ODHA adalah umur (p=0,040). Faktor-faktor lain yang juga mempengaruhi adalah pengetahuan, tingkat pendidikan dan status perkawinan ( nilai p berturut-turut 0,102; 0,165; 0,165; 0,138). Pada analisis regresi logistik ganda diketahui bahwa umur merupakan faktor yang paling mempengaruhi tindakan pencegahan penularan HIV oleh ODHA (p=0,310 95% CI: 1.169-26.423). Pemberian asuhan keperawatan oleh perawat hendaknya lebih difokuskan pada intervensi yang mengupayakan optimalisasi preventif dan promotif, yaitu penyuluhan bagaimana menghindari perilaku berisiko, penggunaan kondom yang benar dan penggunakan jarum steril oleh IDU baik pada ODHA umur muda maupun tua.

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HIV has become a major causes of secondary immune system decreasing, which is gradually leads to stage of AIDS. AIDS is an epidemic problem that requires serious treatment of the world because it threatens the human existence, so it needs to be taken to prevent the HIV transmission, particularly by PLWHA. The aim of this study was to determine the factors that influence the act of HIV transmission prevention by PLWHA. The study design was cross sectional descriptive approach. The number of respondent who had obtained was 75 people. The result of analysed showed that factors corellated with HIV transmission prevention measures were ages (p=0,040). Other factors which also influence to the act of HIV transmission prevention by PLWHA are knowledge, level of education, and marital status (p-value are respectively 0,102; 0,165; 0,165; & 0,138). In multiple logistic regression analysis was known that ages is the most influence factor of the act of HIV transmission prevention by PLWHA (p=0,310 95% CI: 1.169-26.423). The provision of nursing care by nurse should be more focused on interventions that promote preventive and promotion optimization, that is to teaching how to avoid risk behavior, how to use right condom before any kind of sex and how to use sterile disposable injection by IDU in both older and younger PLWHA."

"Beberapa hasil uji serologi HIV indeterminate pada tes skrining darah ditemukan di Indonesia. Prosedur skrining darahyang dilakukan saat ini sesuai ketentuan yang ditetapkan oleh WHO untuk skrining darah, yaitu 3 tes uji serologi HIVselama pemeriksaan darah. Ketidaksesuaian hasil yang satu dengan yang lain didefinisikan sebagai hasil indeterminate.Penelitian ini bertujuan untuk mengidentifikasi galur-galur HIV yang sulit teridentifikasi dari darah dengan uji serologiHIV intermediate dan mengevaluasi apakah galur HIV yang beredar di Indonesia mempunyai kemungkinan lolos darisistem pendeteksian yang ada. Deteksi RT-PCR dilakukan pada 40 sampel RNA HIV dari donor darah yangmempunyai hasil uji serologi indeterminate dengan sebelumnya melakukan uji konfirmasi dengan menggunakanwestern blot. Deteksi RT-PCR menunjukkan bahwa sebanyak 24/32 (75%) sampel positif LTR, 4/31 (13%) positif poldan 3/5 (60%) positif env. Amplifikasi pada daerah p24, pita-pita yang ditemukan pada sampel selalu lebih rendah dariyang diharapkan. Sekuensing dilakukan untuk mengkonfirmasi hasil amplifikasi menunjukkan bahwa perlu analisislebih lanjut untuk mengetahui apakah perubahan ini yang menyebabkan hasil indeterminate.Indeterminate results ofserological HIV test have been found in Indonesia. The screening procedure is following the prescribed by WHO forscreening of blood donors which is based on 3 different serological HIV test during screening of blood donors.Discordant results are interpreted as indeterminate. This research aims to identify GIV strains that previously difficult todetermine, and to evaluate whether the HIV strains present in Indonesia could pass the existing screening system. RTPCRdetection test of HIV RNA were conducted for 40 blood donors samples with indeterminate serological HIV-testafter a confirmatory test using western blot. Preliminary results showed that 24/32 (75%) of the samples are positiveLTR, 4/31 (12%) positive pol and 1/3 (33%) positive env. Amplification in p24 region showed that bands found havelower size than expected. Sequencing performed to confirm these findings show that further analysis is needed todetermine whether this change is what behind the indeterminate results."

"Penelitian ini bertujuan untuk mengetahui prevalensi Human Immunodeficiency Virus (HIV) pada ibu hamil di komunitas dan estimasi jumlah bayi yang mengidap HIV melalui penularan perinatal, dengan menggunakan data sekunder 11.693 ibu hamil dari program Prevention of Mother-to-Child Transmission of HIV (PMTCT) Yayasan Pelita Ilmu tahun 2003-2010 di delapan ibu kota provinsi di Indonesia. Diagnosis HIV ditegakkan berdasarkan test Enzyme-Linked Immunosorbent Assay (ELISA). Prevalensi HIV dihitung dari mereka yang ikut konseling post-test dan uji Mantel Haenszel Chi square dilakukan untuk melihat kecenderungannya. Sebanyak 98% responden menyatakan keinginannya untuk tes HIV dan diberi konseling pre-test. Dari partisipan yang mendapat konseling pre-test, 95% bersedia melakukan tes HIV, dan 88% dari mereka mengikuti konseling post-test. Prevalensi HIV yang ditemukan adalah sebesar 0,41% dan angkanya cukup bervariasi serta cenderung meningkat dari 2003 ke 2009, dari 0,36% tahun 2003-2006, naik menjadi 0,52% tahun 2008, naik menjadi 0,54% tahun 2009, kemudian turun menjadi 0,25% tahun 2010. Diperkirakan 8.604 bayi dengan HIV lahir setiap tahun, namun apabila dilakukan program PMTCT akan dapat dicegah 8.112 bayi dengan HIV dan dihemat biaya sekitar Rp 42 miliar per-tahun. Dapat disimpulkan, prevalensi HIV pada ibu hamil dari data di komunitas antara tahun 2003-2010 masih rendah dan cukup bervariasi dalam lima waktu pengamatan. Disarankan untuk memperluas cakupan program PMTCT dan mengintegrasikannya dengan pelayanan maternal dan keluarga berencana.

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This study has aims to determine the prevalence of Human Immunodeficiency Virus (HIV) among pregnant women in the community and to estimate the number of babies born with HIV, using secondary data of 11.693 pregnant women from Prevention of Mother-to-Child Transmission of HIV (PMTCT) program conducted the Pelita Ilmu Foundation during 2003-2010 in eight provincial capitals in Indonesia. The HIV diagnosis was based on Enzyme-Linked Immunosorbent Assay (ELISA). The HIV prevalence was calculated from those who participated in the post-test counseling. Mantel Haenszel Chi-square test was performed to see the trend. Of all pregnant women, 98% expressed their desire for HIV testing. The women, then, were given pre-test counseling. Of the pre-test counseled respondents, 95% were willing to do HIV test and of the HIV tested respondents 88% followed the post-test counseling to get the test result, and as much as 0.41% are HIV positive. HIV prevalence quite vary and there is an increasing trend from 2003 to 2009, from 0.36% in 2003-2006, rose to 0.52% in 2008, rose to 0.54% in 2009, then fell to 0.25% in 2010. An estimated 8.604 infants were born with HIV every year. However, if PMTCT program was implemented there will be 8.112 babies averted with HIV and will save around 42 billion rupiah per year. It is concluded that the prevalence of HIV among pregnant women in the community were still low and vary in five-time observations. It is recommended that the government should implement a PMTCT program and integrated it with maternal & child health and family planning program."