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"ABSTRAKLatar belakang: Infeksi HIV masih banyak ditemukan di Indonesia saat ini. Terapi antiretroviral telah merubah morbiditas dan mortalitas pasien terinfeksi HIV, dan juga merubah manifestasi oral HIV/AIDS, termasuk kandidiasis orofaring KOF . Dalam penelitian ini dieksplorasi peran faktor genetik dan respons imun pasien terinfeksi HIV dengan dan tanpa KOF, sebelum dan sesudah terapi ARV.Metode: Subyek penelitian sebesar 82 pasien terinfeksi HIV, ARV-na ve dengan jumlah sel T CD4

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ABSTRACTBackground HIV infection remains common in Indonesia nowadays. Antiretroviral therapy ART has altered morbidity and mortality of HIV infected people, and also altered oral manifestation of HIV AIDS, including oropharyngeal candidiasis OPC . Here we explore the role of host genetic factors and immune responses in HIV infected patients beginning ART.Methods This study included 82 ARV na ve HIV infected patients with "

"Latar Belakang. Walaupun pasien HIV mendapat terapi antiretroviral yang efektif, penurunan fungsi fisik sering ditemukan lebih awal dan menimbulkan masalah baru berupa penuaan dan frailty.Tujuan. Mengetahui proporsi dan faktor-faktor yang berhubungan dengan prefrail dan frail pada pasien HIV dalam terapi antiretroviral.Metode. Desain studi potong lintang pada pasien HIV usia ≥30 tahun dalam terapi ARV minimal 6 bulan. Pasien yang memenuhi inklusi dilakukan pencatatan demografis, penyakit komorbid, faktor terkait HIV seperti lama terdiagnosis, lama ARV, dan CD4, pengukuran antropometri seperti indeks massa tubuh, penilaian depresi dengan Indo BDI-II, dan penilaian frailty dengan kriteria Fried. Pasien dengan riwayat infeksi otak, kanker, dan oportunistik aktif dieksklusi. Analisis bivariat dan multivariat dilakukan pada faktor-faktor tersebut.Hasil. Terdapat 164 pasien yang dianalisis. Proporsi prefrail sebanyak 51,2% (84 pasien) dan frail 3,7% (6 pasien), dengan komponen dominan pada kelemahan genggam. Pasien laki-laki sebanyak 72% dengan median usia (IQR) 40,5 (36-47) tahun, dan median CD4 nadir (IQR) 53 (21–147) sel/mm3, median CD4 awal (IQR) 77 (32 – 206) sel/mm3. Hepatitis C menjadi faktor komorbid terbanyak. Depresi berhubungan dengan prefrail dan frail dengan OR 2,14 (IK95%: 1,034–4,439) dan p = 0,036. Tidak terdapat hubungan faktor usia ≥50 tahun, ≥2 penyakit komorbid, lama terdiagnosis HIV ≥5 tahun, lama ARV ≥5 tahun, CD4 <200 sel/mm3, indeks massa tubuh ≥25 kg/m2, dan pendapatan rendah dengan prefrail dan frail.Kesimpulan. Terdapat proporsi prefrail sebanyak 51,2% dan frail 3,7%. Depresi merupakan salah satu faktor yang terbukti berhubungan terhadap prefrail dan frail pada pasien HIV dalam terapi ARV.

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Background. Although HIV patients receive effective antiretroviral therapy, decrease in physical function is often found earlier and creates new problems in the form of aging and frailty

Aim. to determine the proportion and factors associated with prefrail and frail in HIV patients on antiretroviral therapy.

Method. A cross-sectional study design in HIV patients aged ≥30 years who were on ARV therapy for at least 6 months. Patients who fulfilled the inclusion were recorded demographically, comorbid diseases, HIV-related factors such as length of diagnosis, duration of ARV, CD4, anthropometric measurements such as body mass index, depression assessment with Indo BDI-II, and frailty assessment with Fried criteria. Patients with a history of brain infection, cancer, and active opportunists were excluded. Bivariate and multivariate analysis was carried out on these factors.

Results. There were 164 patients analyzed. The proportions of prefrail and frail were 51.2% and 3.7% respectively, with the dominant component in muscle weakness. Male patients were 72% with median age (IQR) 40.5 (36-47) years, median baseline CD4 (IQR) 77 (32 - 206) cell/mm3, and median nadir CD4 (IQR) 53 (21–147) cells/mm3. Hepatitis C is the most comorbid factor. Depression is related to prefrail and frail with OR 2.14 (95%CI: 1,034-4,439) and p = 0,036. There was no correlation between factors such as age ≥50 years, ≥2 comorbid diseases, length of diagnosis of HIV ≥5 years, duration of ARV ≥5 years, CD4 cell count <200 cells/mm3, body mass index ≥25 kg/m2, and low income with prefrail and frail.

Conclusion. The proportions of prefrail and frail are 51.2% and 3.7% respectively. Depression is one of the factors that is proven to be related to prefrail and frail in HIV patients in ARV therapy."

"Terapi antiretroviral mampu menekan replikasi HIV, mencegah morbilitas dan mortalitas. Kepatuhan pengobatan dibutuhkan untuk mencapai kesuksesan terapi, mencegah resistensi obat antiretroviral dan risiko penularan HIV ditengah masyarakat. Penelitian ini bertujuan untuk mengetahui factor-faktor yang mempengaruhi kepatuhan pengobatan obat antiretroviral pasien HIV/AIDS di empat rumah sakit di DKI Jakarta tahun 2018-2019. Penelitian ini merupakan penelitian observasional dengan rancangan cross sectional dari data baseline penelitian INA-PROACTIVE (data sekunder). dimana sebanyak 666 ODHA dipilih sebagai sampel. Kepatuhan pengobatan diukur berdasarkan self report. Data dianalisa dengan menggunakan cox proportional hazard regression dengan perangkat lunak STATA12. Hasil penelitian menunjukkan proporsi kepatuhan <95% sebesar 17,9%. Analisis faktor determinan kepatuhan berobat pada penelitian ini menggunakan analisis multivariat cox regresi dan besar pengaruh dinyatakan dalam prevalensi rasio (PR) dengan confident interval (CI) 95%. Penelitian ini menunjukkan faktor sosio-demografi yang berhubungan dengan ketidakpatuhan pengobatan pada ODHA yang mendapat terapi ARV adalah variabel jenis kelamin, usia, status pernikahan dan rute transmisi HIV. Faktor klinis yang mempunyai hubungan dengan kepatuhan minum obat ARV adalah variabel adanya riwayat infeksi oportunistik sifilis dan nilai CD4. Faktor pengobatan yang mempunyai hubungan dengan kepatuhan minum obat ARV adalah variabel jenis paduan ARV dan lama pengobatan ARV. Semua variabel tersebut tidak berpengaruh signifkan secara statistik dengan nilai p value > 0,05.

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Antiretroviral therapy suppresses HIV replication, prevent mobility and mortality. Treatment adherence is needed to achieve therapeutic success, prevent antiretroviral drug resistance and the risk of HIV transmission in the community. This study aims to determine the factors that associated with the adherent of antiretroviral drug treatment of HIV / AIDS patients in four hospitals in Jakarta in 2018-2019. This study was an observational study with a cross sectional design from the baseline data of INA-PROACTIVE study (secondary data) from 666 people living with HIV. Treatment compliance was measured by self-report. Data were analyzed using cox proportional hazard regression with STATA12 software. The results showed the proportion of non-adherent by 17.9%, Analysis of determinant factors for compliance with treatment in this study using multivariate cox regression analysis and the magnitude of the effect was expressed in the prevalence ratio (PR) with 95% confidence interval (CI). Our study showed a proportion of ARV treatment adherence ≥ 95% showed 82.1%.

This study showed that the socio-demographic factors associated with ARV treatment adherence among people living with HIV who received ARV therapy were gender, age, marital status and HIV transmission route. Clinical factors that have a relationship with adherence of ARV were the variable history of opportunistic infection syphilis and CD4 value. Treatment factors that have a relationship with adherence of ARV were the variable type of ARV regiment and duration of ARV treatment. All these variables were not statistially significant effect with p value > 0.05."

"Kurangnya kepatuhan terhadap pengobatan menjadi faktor risiko munculnya jenis HIV yang resisten terhadap obat, yang dapat ditularkan kepada orang lain. Kepatuhan terhadap pengobatan yang buruk tidak hanya membahayakan kesehatan individu tetapi juga meningkatkan penularan. Penelitian ini bertujuan untuk mengamati faktor-faktor yang berhubungan dengan terjadinya ketidakpatuhan minum obat ARV pada ODHIV yang mendapatkan terapi ARV di Rumah Sakit Umum Daerah Kabupaten Tangerang. Jenis penelitian ini menggunakan penelitian observasional dengan rancangan cross sectional. Penelitian dilakukan di poli HIV Rumah Sakit Umum Daerah Kabupaten Tangerang dan waktu penelitian dilakukan pada bulan November 2023 menggunakan data sekunder. Populasi penelitian berjumlah 1.337 ODHIV yang aktif menjalani pengobatan antiretroviral di Rumah Sakit Umum Daerah Kabupaten Tangerang dengan menggunakan total sampling sesuai dengan kriteria inklusi dan ekslusi sehingga sampel penelitian berjumlah 1.286 ODHIV. Hasil analisis univariat menunjukan bahwa usia ≥ 35 tahun (56,45), laki-laki (61,20%), pendidikan rendah (87,10%), belum kawin atau cerai (51,92%), domisili dalam kabupaten Tangerang (55,88%), mendapatkan konseling kepatuhan (63,73%), memiliki jaminan kesehatan (51,92%), ≥5km akses layanan kesehatan (54,07%), IO non TB (40,90%), stadium lanjut (63,69%), viral load ≥40 mL (46,73%), tidak ada efek samping obat (53,34%), lamanya pengobatan >5 tahun (72,01%), masuk kedalam populasi kunci (88,01%) dan tidak mendapat dukungan (61,12%). Hasil analisis kai kuadrat secara statistik ada hubungan antara umur, jenis kelamin, status pendidikan, status perkawinan, domisili, pelayanan konseling kepatuhan, stadium klinis WHO, viral load, lamanya pengobatan ARV, kelompok populasi kunci dan dukungan teman sebaya (P-Value<0,05) dengan ketidakpatuhan minum obat ARV. Hasil analisis cox regression dengan faktor yang secara statistik berhubungan terhadap ketidakpatuhan minum obat antiretroviral pada ODHIV adalah umur (P-Value=0,01) nilai PR 1,20 dengan 95% CI (1,05-1,38), status perkawinan (P-Value=0,02) nilai PR 1,18 dengan 95% CI (1,03-1,36), domisili (P-Value=0,01) nilai PR 1,19 dengan 95% CI (1,04-1,36), viral load (P-Value=0,001) nilai PR 1,27 dengan 95% CI (1,10-1,43), lamanya pengobatan ARV (P-Value=0,005) nilai PR 1,25 dengan 95% CI (1,07-1,47), kelompok populasi kunci (P-Value=0,02) nilai PR 1,27 dengan 95% CI (1,04-1,56), dukungan teman sebaya (P-Value=0,04) nilai PR 1,15 dengan 95% CI (1,00-1,32). Faktor umur, status perkawinan, domisili, viral load, lamanya pengobatan, kelompok populasi kunci dan dukungan teman sebaya  memiliki pengaruh terhadap ketidakpatuhan minum obat antiretroviral (ARV) pada ODHIV di Rumah Sakit Umum Daerah Kabupaten Tangerang.

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Lack of treatment adherence becomes a risk factor for the emergence of drug-resistant strains of HIV, which can be transmitted to others. Poor adherence to treatment harms the individual’s health and increases the risk of transmission. This study aims to observe the factors associated with the occurrence of non-adherence to taking ARV drugs in PLHIV who receive ARV therapy at the Regional General Hospital of Tangerang Regency. This type of study uses observational research with a cross-sectional design. The study was conducted at the HIV Specialist of the Regional Govern Hospital of Tangerang Regency and the time of the study was carried out in November 2023 using secondary data. The study population amounted to 1,337 PLHIV who were actively undergoing antiretroviral treatment at the Regional General Hospital of Tangerang Regency using total sampling by inclusion and exclusion criteria so that the study sample amounted to 1,286 PLHIV. The results of the univariate analysis showed that the age of ≥ 35 years (56.45), male (61.20%), low education (87.10%), unmarried or divorced (51.92%), domiciled in Tangerang district (55.88%), received compliance counselling (63.73%), had health insurance (51.92%), ≥5km of health service access area (54.07%), non-TB IO (40.90%), advanced stage (63.69%), viral load ≥40 mL (46.73%), no drug side effects (53.34%), duration of treatment ≥5 years (72.01%), entered into key populations (88.01%) and received no support (61.12%). The results of the kai squared analysis statistically showed there was an association between age, sex, educational status, marital status, domicile, adherence to counselling services, WHO clinical stage, viral load, duration of ARV treatment, key population groups and peer support (P-Value<0.05) with non-adherence to taking ARV drugs. The results of Cox Regression analysis with factors statistically related to non-adherence to taking antiretroviral drugs in ODHIV were age (P-Value = 0.01), PR value 1.20 with 95% CI (1.05-1.38), marital status (P-Value = 0.02), PR value 1.18 with 95% CI (1.03-1.36), domicile (P-Value = 0.01), PR value 1.19 with 95% CI (1.04-1.36), viral load (P-Value = 0.001), PR value 1.27 with 95% CI (1.10-1.43),  duration of ARV treatment (P-Value = 0.005), PR value 1.25 with 95% CI (1.07-1.47), key population group (P-Value = 0.02), PR value 1.27 with 95% CI (1.04-1.56), peer support (P-Value = 0.04), PR value 1.15 with 95% CI (1.00-1.32). Factors such as age, marital status, domicile, viral load, duration of treatment, key population groups and peer support have an influence on non-adherence to taking antiretroviral drugs (ARV) in PLHIV at the Regional General Hospital of Tangerang Regency."

"Human Immunodeficiency Virus HIV merupakan tantangan terbesar dalam pengendalian tuberkulosis. Di Indonesia diperkirakan sekitar 3 pasien TB dengan status HIV positif. Sebaliknya TB merupakan tantangan bagi pengendalian Acquired Immunodeficiency Deficiency Syndrome AIDS karena merupakan infeksi oportunistik terbanyak terdapat 49 pada ODHA. Penelitian ini bertujuan untuk mengetahui pengaruh kepatuhan minum obat antiretroviral terhadap ketahanan hidup pasien TB-HIV di RSUD Koja Tahun 2013 ndash; 2017. Desain studi yang digunakan adalah desain kohort retrospekstif. Jumlah sampel pada studi ini adalah 111 pasien TB-HIV yang diambil secara keseluruhan. Dari studi ini, diketahui pada kelompok yang patuh minum obat antiretroviral ARV mengalami event /meninggal 31 , sebanyak 79,7 pasien masih hidup dan pasien yang lost follow up sebanyak 34,8.Hasil analisis multivariabel dengan regresi cox time dependent menunjukkan bahwa hazard ratio HR kematian menurut kepatuhan minum ARV berbeda-beda sesuai waktu. Dalam 1 tahun pengamatan, pasien yang tidak patuh minum ARV memiliki hazard 2,85 kali lebih cepat mengalami kematian daripada yang patuh minum ARV. Kemudian pasien yang tidak patuh minum ARV selama 4 tahun pengamatan 2013-2017 memiliki hazard terjadinya kematian sebesar 11,49 kali. Terdapat interaksi kepatuhan minum ARV dengan infeksi oportunistik. Pada pasien yang tidak patuh minum ARV dengan infeksi oportunistik lebih dari 2, efeknya lebih rendah 0,4 kali dibandingkan dengan pasien yang patuh minum ARV memiliki infeksi oportunistik kurang dari 2. Dianjurkan kepada pasien untuk melakukan pemeriksaan CD4 secara rutin 6 bulan sekali dan tidak lupa meminum obat secara teratur guna mencapai ketahanan hidup dan kualitas hidup yang lebih baik.

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Human Immunodeficiency Virus HIV is the biggest challenge in tuberculosis control. In Indonesia, approximately 3 of TB patients with HIV status are positive. Conversely, TB is a challenge for the control of Acquired Immunodeficiency Deficiency Syndrome AIDS because it is the most opportunistic infection there is 49 in people living with HIV. This study aims to determine the effect of antiretroviral drug adherence to the survival of HIV TB patients in Koja Hospital Year 2013 2015. The study design used is retrospective cohort design. The number of samples in this study were 111 whole TB HIV patients taken as a whole. From this study, it was found that in the ARV group experienced event dying 31 , 79.7 of patients were still alive and the patients lost follow up 34.8.

The result of multivariable analysis with cox time dependent regression showed that hazard ratio HR mortality according to ARV adherence was different according to time. Within 1 year of observation, patients who did not adhere to taking antiretroviral drugs had a hazard of 2.85 times faster mortality than those who were obedient to taking ARVs. Then patients who did not adhere to taking antiretrovirals for 4 years of observation 2013 2017 had a death hazard of 11.49 times. There is an interaction of antiretroviral adherence with opportunistic infections. In patients who did not adhere to taking antiretroviral drugs with more than 2 opportunistic infections, the effect was 0.4 times lower than those who were adherent on taking ARVs had less than 2 opportunistic infections. It is advisable to patients to have routine CD4 checks every 6 months and not forget taking medication regularly to achieve better survival and quality of life."

"Liver disease has been identified as a leading cause of death in HIV-infected patients since the introduction of highly active antiretroviral therapy (HAART) in 1996. The HIV treatment community has been caught largely unaware of this emerging dilemma. Many HIV care providers are ill-equipped to understand and interpret liver injury patterns, or to provide comprehensive care and management for viral coinfections which they are not familiar with.HIV and liver disease provides a comprehensive update of the field covering the epidemiology, pathogenesis, management and treatment of liver disease in patients with HIV infection. The volume will help HIV care providers understand and interpret liver injury patterns, and/or provide comprehensive care and management for viral coinfections. Gastroenterologists and hepatologists will gain an understanding of complex drug regimens that are used to treat HIV and which may impact HCV and HBV treatment. Written by expert clinicians and researchers across multiple disciplines, HIV and Liver Disease will be of great value to gastroenterologists, hepatologists, infectious disease practitioners, as well as other health care providers who provide care or participate in research in the field of HIV."

"Keberhasilan terapi ARV sangat ditentukan oleh kepatuhan minum obat ARV. YPImerupakan salah satu yayasan peduli HIV/AIDS tertua di Indonesia yang terletak diTebet, Jakarta Selatan. Beberapa pasien HIV/AIDS di YPI ditemukan pernahmengalami putus obat yang dapat berisiko kematian akibat kegagalan terapi ARV. Penelitian ini bertujuan untuk melihat gambaran kepatuhan minum obat ARV padapasien HIV/AIDS di YPI. Penelitian ini merupakan penelitian kualitatif denganmenggunakan wawancara mendalam. Pengambilan data dilakukan pada 10 orang darikelompok ODHA, keluarga, dan pihak YPI. Penelitian ini menunjukkan bahwa masih terdapat pasien yang tidak patuh minum obat ARV. 5 informan yang penelitiwawancarai, 2 informan menyatakan pernah mengalami putus obat, 2 informan lainpernah terlambat minum obat dan 1 informan patuh minum obat. Penelitian ini menunjukkan faktor penyebab ketidakpatuhan minum obat ARV yaitu kesibukan, kejenuhan minum obat, takut efek samping, dan merasa sudah sehat.

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The success of antiretroviral therapy is largely determined by the adherence of taking an tiretroviral drugs. YPI is one of the foundation care HIV AIDS located in Tebet,South Jakarta. Several HIV AIDS patients in YPI have been found to have experienced drug withdrawal that could be at risk of death due to ARV therapy failure.

This study aims to look at the picture of adherence to taking ARV drugs and factors that influence adherence in HIV AIDS patients at YPI. This research is a qualitative research using in depth interviews. Data were collected on 10 people from HIV patients, family, andYPI groups.

This study shows that there are still patients who do not adhere to taking ARV drugs. 2 of 5 informants had a drug break, 2 informan not on time in taking medication. This study shows the factors that cause non adherence to take medication ARV that is busy, saturation of medicine, fear of side effects, and feel healthy."

"Pendahuluan Infeksi human immunodeficiency virus menyebabkan penurunan CD4 absolut. Terapi antiretrovirus (ARV) jangka panjang tidak selalu dapat memulihkan CD4 absolut ke angka normal. Tujuan dari penelitian ini adalah untuk mencari faktor klinis yang mungkin terkait dengan perubahan CD4 absolut pada orang dengan HIV (ODHIV) yang mendapat terapi ARV kombinasi tenofovir, lamivudine dan dolutegravir (TLD) selama enam bulan. Metode Penelitian ini melibatkan 95 pasien yang terinfeksi HIV dengan terapi ARV TLD. Pemeriksaan CD4 dilakukan setelah minimal enam bulan sejak dimulainya terapi ARV. Data terkait klinis didapatkan dari rekam medis. Hasil Median CD4 absolut awal 173 (6-784) naik menjadi 328 (48-932) pada enam bulan setelah terapi ARV TLD (p < 0,001). Didapatkan 80 (84.2%) subjek dengan viral load (VL) tidak terdeteksi (<50 kopi/mL), 14 subjek (14,7%) dengan VL tersupresi (50-1000 kopi/mL) dan 1 subjek (1,1 %) dengan VL > 1000 kopi/mL. Subjek dengan median indeks massa tubuh (IMT) awal 25 (17,6-39,8) kg/m2 dapat mencapai CD4 absolut ≥ 500 sel/μL dibanding kelompok dengan median 23,2 (15,6-35,5) kg/m2 (p < 0,04). Tidak didapatkan perbedaan yang signifikan secara statistik pada perubahan CD4 absolut yang dipengaruhi usia saat mulai ARV (p= 0,7). Subjek dengan infeksi oportunistik lebih sulit mencapai CD4 absolut enam bulan ≥ 500 sel/μL (p= 0,003) sedangkan subjek dengan CD4 absolut awal ≥ 200 sel/μL lebih mudah mencapai CD4 absolut enam bulan ≥ 500 sel/μL (p < 0,001). Kesimpulan Indeks massa tubuh awal yang lebih tinggi dikaitkan dengan kemungkinan yang lebih besar dalam mencapai CD4 absolut ≥ 500 sel/μL pascaterapi ARV TLD selama enam bulan. Faktor usia saat mulai ARV didapatkan tidak berpengaruh terhadap perubahan CD4 absolut menjadi ≥ 500 sel/μL sedangkan faktor infeksi oportunistik berpengaruh negatif terhadap perubahan CD4 absolut menjadi ≥ 500 sel/μL. Jumlah CD4 absolut awal ≥ 200 sel/μL berperan positif dalam tercapainya perubahan CD4 absolut enam bulan ≥ 500 sel/μL.

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Introduction Human immunodeficiency virus infection causes a decrease in absolute CD4. Long-term antiretroviral (ARV) therapy cannot always restore absolute CD4 to normal levels. This study aimed to find clinical factors that may be associated with absolute CD4 recovery in people living with HIV (PLHIV) who received combination ARV therapy of tenofovir, lamivudine, and dolutegravir (TLD) for six months. Methods This study involved 95 HIV-infected patients undergoing ARV therapy with TLD. The CD4 assessment is performed at least six months following the initiation of ARV therapy. Relevant clinical information was gathered from medical records. Results The median baseline absolute CD4 was 173 (6-784) increasing to 328 (48-932) at six months after ARV therapy with TLD (p < 0.001). There were 80 (84,2%) subjects with undetectable viral load (VL) (<50 copies/mL), 14 subjects (14,7%) with suppressed VL (50-1000 copies/mL), and 1 subject (1,1%) with VL > 1000 copies/mL. Subjects with an initial median body mass index (BMI) of 25 (17.6-39.8) kg/m2 were able to achieve absolute CD4 ≥ 500 cells/μL compared to the group with a median of 23.2 (15.6-35.5) kg/m2 (p < 0.04). There was no statistically significant difference in the change in absolute CD4 influenced by age at initiation of ARV (p = 0.7). Subjects with opportunistic infections had more difficulty achieving six-month absolute CD4 ≥ 500 cells/μL (p = 0.003). In comparison, subjects with initial absolute CD4 ≥ 200 cells/μL had an easier time achieving six-month absolute CD4 ≥ 500 cells/μL (p < 0.001). Conclusion Higher baseline BMI was associated with a greater likelihood of reaching an absolute CD4 count ≥ 500 cells/μL post-treatment with TLD ARVs for six months. The age at which ARVs were started did not influence the increase in absolute CD4 to ≥ 500 cells/μL, whereas opportunistic infections negatively affected the rise in absolute CD4 to ≥ 500 cells/μL. A baseline absolute CD4 count ≥ 200 cells/μL contributed positively to achieving an increase of ≥ 500 cells/μL in absolute CD4 levels after six months."

"Antiretroviral therapy (ART) given to HIV patients to improve their immune response that damaged by HIV infection. Some patients with ART experience Immune Restoration Disease (IRD) as worsening of clinical symptoms from certain pathogens infection. The incidence of IRD concided with an increased number of CD4+ T cells. Hepatitis C virus can also infect HIV patients and may also lead to HCV IRD. The immunopathogenecity of IRD has not known yet. This study aims to look at the function of dendritic cells producing IL-12 and IFNα, and IFNγ-producing T cell responses in incidence of HCV IRD. Research subjects were 50 patients with HIV/HCV who were initiating antiretroviral therapy (ART) for up to 6 months of therapy. There are 9 people with HCV IRD who compared with non HCV IRD patients. Blood specimens were collected from study subjects at months 0, 1, 3 and 6 after ART. Then PBMC isolation was done and used for flowsitometri and ELISpot analysis.The results showed that the percentage of myeloid (mDC) and plasmacytoid dendritic cells (pDC) did not differ between HCV IRD patients and non-HCV IRD patients. It appears that the percentage of IL-12-producing mDC did not correlate significantly with IFNγ- producing T cells both in HCV IRD and non-IRD HCV patients. The percentage of IL-12-producing mDC in HCV IRD patients were lower than in non-IRD patients (p=0.003). While percentage of IFNα-producing pDC and IFNγ- producing T cells did not differ significantly between the two groups of patients. Antibody response to HCV proteins (core, NS3, NS4, and NS5) did not differ between HCV IRD and non-HCV IRD patients. The role of dendritic cells and T cell responses in HCV IRD incidence have not clearly seen.

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Terapi antiretroviral (ART) diberikan kepada pasien HIV akan memperbaiki respon imun tubuh yang rusak karena infeksi HIV. Beberapa pasien dengan ART mengalami sindrom pulih imun atau Immune Restoration Disease (IRD) berupa perburukan gejala klinis dari infeksi patogen tertentu. Kejadian sindrom pulih imun ini terjadi bersamaan dengan peningkatan jumlah sel T CD4+. Virus Hepatitis C yang menjadi patogen penyerta pada pasien HIV juga menjadi penyebab sindrom pulih imun. Belum diketahui dengan jelas imunopatogenesitas dari sindrom pulih imun ini. Penelitian ini bertujuan untuk melihat fungsi sel dendritik penghasil IL-12 dan IFNα, serta respon sel T penghasil IFNγ pada kejadian sindrom pulih imun HCV. Subyek penelitian adalah 50 pasien HIV/HCV yang sedang memulai terapi antiretroviral (ART). Terdapat 9 orang pasien dengan sindrom pulih imun HCV yang dibandingkan dengan pasien tanpa sindrom pulih imun HCV. Spesimen darah lengkap dikumpulkan dari subyek penelitian pada bulan ke-0, 1, 3 dan 6 setelah ART. Kemudian dilakukan isolasi PBMC dan analisis flowsitometri dan ELISpot.Hasil penelitian menunjukkan bahwa persentase sel dendritik mieloid (mDC) dan plasmasitoid (pDC) tidak berbeda antara pasien dengan dan tanpa sindrom pulih imun HCV. Persentase sel mDC penghasil IL-12 tidak berkorelasi secara signifikan dengan jumlah sel T penghasil IFNγ baik pada pasien dengan maupun tanpa sindrom pulih imun HCV. Pasien dengan sindrom pulih imun HCV memiliki persentase sel mDC penghasil IL-12 yang lebih rendah dibandingkan pasien tanpa sindrom pulih imun HCV (p=0,003). Sedangkan persentase sel pDC penghasil IFNα dan jumlah sel T penghasil IFNγ tidak berbeda secara signifikan antara kedua kelompok pasien. Respon antibodi terhadap protein HCV (core, NS3, NS4 dan NS5) pun tidak berbeda antara kedua kelompok pasien. Disimpulkan bahwa belum terlihat adanya peran dari sel dendritik dan respon sel T terhadap kejadian sindrom pulih imun HCV."

"Latar Belakang: HIV (Human Immunodeficiency Virus) merupakan virus yang menyerang sistem kekebalan tubuh manusia, sehingga penderita yang terpapar akan lebih rentan mengalami infeksi. Sesuai dengan strategi global yang sejalan dengan target Sustainable Development Global (SDG) 3.3 pada tahun 2025 di Indonesia baru 81% orang dengan HIV sudah terdiagnosis atau mengetahui status, 41% ODHIV sudah menjalani pengobatan ARV, dan sebanyak 19% ODHIV yang menjalani pengobatan ARV virusnya sudah tersupresi. Penekanan viral load tergantung berdasarkan kepatuhan pasien dalam menjalani terapi ARV. Penelitian ini bertujuan untuk mengetahui hubungan kepatuhan terapi ARV dengan viral load non-suppression pada ODHIV di RSUD Khidmat Sehat Afiat Kota Depok Tahun 2021-2024. Metode: sampel yang dianalisis dalam penelitian ini sebanyak 365 di RSUD KiSA Kota Depok setelah memenuhi kriteria inklusi dan eksklusi. Analisis multivariat menggunakan multiple cox regression untuk mengetahui hubungan kepatuhan terapi ARV dengan viral load non-suppression. Hasil: hasil studi ini menunjukkan bahwa proporsi seluruh pasien ODHIV sebagian besar berusia £ 35 tahun (53.42%), laki-laki (76.16%), bekerja (69.32%), lajang/cerai hidup/cerai mati (64.38%), memiliki jaminan kesehatan (76.16%), berstatus stadium klinis 1 (54.25%), dan telah menjalani pengobatan ART selama £ 2 tahun (47.95%). Proporsi viral load non-suppression pada ODHIV di RSUD KiSA Kota Depok tahun 2021-2024 adalah sebesar 54 (14.79%). Terdapat hubungan antara kepatuhan terapi ARV dengan viral load non-suppression pada ODHIV di RSUD KiSA Kota Depok tahun 2021-2024 setelah dikontrol oleh variabel stadium klinis dan usia dengan hasil kepatuhan rendah memiliki risiko 9.97 kali (95% CI 4.07-24.39) untuk terjadinya viral load non-suppression yang dibuktikan dengan hasil berhubungan bermakna secara statistik dengan nilai p-value < 0.05. Kesimpulan: terdapat hubungan antara kepatuhan terapi ARV dengan kejadian viral load non-suppression di RSUD KiSA Kota Depok dengan kepatuhan rendah memiliki risiko 9.97 kali lebih tinggi untuk mengalami viral load non-suppression. Penguatan peran pendamping serta penguatan program penting dilakukan untuk meningkatkan kepatuhan.

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Background: HIV (Human Immunodeficiency Virus) is a virus that attacks the human immune system, so people who are exposed to it will be more susceptible to infection. In accordance with the global strategy in line with the Sustainable Development Global (SDG) target 3.3 by 2025 in Indonesia only 81% of people with HIV have been diagnosed or know their status, 41% of ODHIV have undergone ARV treatment, and as many as 19% of ODHIV who are undergoing ARV treatment have their virus suppressed. Viral load suppression depends on the patient's adherence to ARV therapy. This study aims to determine the relationship between ARV therapy adherence and non-suppression viral load in ODHIV at Khidmat Sehat Afiat Hospital in Depok City in 2021-2024. Methods: There were 365 samples analyzed in this study at KiSA Hospital in Depok City after meeting the inclusion and exclusion criteria. Multivariate analysis used multiple cox regression to determine the relationship between ARV therapy compliance and non-suppression viral load. Results: The results of this study showed that the proportion of all ODHIV patients were mostly aged £ 35 years (53.42%), male (76.16%), employed (69.32%), single/living divorced/dead divorced (64.38%), had health insurance (76.16%), clinical stage 1 status (54.25%), and had undergone ART treatment for £ 2 years (47.95%). The proportion of non-suppression viral load in ODHIV at KiSA Depok City Hospital in 2021-2024 was 54 (14.79%). There is an association between ARV therapy non-adherence and non-suppression viral load in ODHIV at KiSA Depok City Hospital in 2021-2024 after being controlled by clinical stage and age variables with the results of low adherence having a risk of 9.97 times (95% CI 4.07 - 24.39) for non-suppression viral load as evidenced by the results of a statistically significant association with a p-value <0.05. Conclusion: There is an association between adherence to ARV therapy and the incidence of viral load non-suppression at KiSA Hospital in Depok City with low adherence having a 9.97 times higher risk of experiencing viral load non-suppression. Strengthening the role of facilitators as well as strengthening the program is important to improve compliance."