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

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

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

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

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

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

"Penyakit HIV/AIDS merupakan masalah kesehatan di Indonesia. Masalah yang berkembang adalah karena angka morbiditas dan mortalitas yang masih tinggi, disebabkan antara lain karena keterlambatan mendapatkan pengobatan Anti Retroviral (ARV). Di Indonesia pengobatan ARV umumnya dimulai bila jumlah sel CD4 < 200 sel/mm3 atau bila stadium klinis 3 atau 4. Informasi tentang pengaruh jumlah sel CD4 sebelum pengobatan ARV terhadap ketahanan hidup satu tahun pasien HIV/AIDS berdasarkan kelompok kategori <50 sel/mm3, 50-<200 sel/mm3 dan > 200 sel/mm3, saat ini belum tersedia di Indonesia. Untuk mengetahuinya, maka dilakukan penelitian ini. Desain penelitian kohort retrospektif, dilakukan pengamatan terhadap kematian pada populasi dinamis selama satu tahun (366 hari), dari Januari 2005 hingga Januari 2010. Subjek penelitian 158 pasien HIV/AIDS berusia > 15 tahun, naïve dan mendapat regimen ARV lini pertama di RSPI Prof.DR.Sulianti Saroso pada tahun 2005-2010. Prosedur analisis ketahanan hidup menggunakan metode Kaplan-Meier (product limit), analisis bivariat dengan Log rank test (Mantel cox) dan analisis multivariat dengan cox regression / cox proportional hazard model. Penelitian ini mendapatkan probabilitas ketahanan hidup keseluruhan satu tahun pasien HIV/AIDS dengan pengobatan regimen ARV lini pertama adalah 0,86 (CI 95% 0,79-0,91). Incident rate kematian (Hazard rate) kelompok jumlah sel CD4 <50 sel/mm3 adalah 8/10.000 orang hari (29/100 orang tahun), kelompok jumlah sel CD4 50-<200 sel/mm3 adalah 3/10.000 orang hari (11/100 orang tahun) dan kelompok jumlah sel CD4 > 200 sel/mm3 adalah 2/10.000 orang hari (7/100 orang tahun). Hazard Ratio(HR)-adjusted kelompok jumlah sel CD4 <50 sel/mm3 terhadap kelompok jumlah sel CD4 > 200 sel/mm3 adalah 3,4 (p= 0,058 ; CI 95% : 0,96-12,16), HR-adjusted kelompok jumlah sel CD4 50-<200 sel/mm3 terhadap kelompok jumlah CD4 > 200 sel/mm3 adalah 1,7 (p= 0,48 ; CI 95% : 0,4-7.04). HR-adjusted pasien dengan TB 3,57 kali terhadap pasien tanpa TB (p=0,015 ; CI 95% : 1,27-9,99). Jumlah sel CD4 sebelum pengobatan ARV tidak mempunyai pengaruh secara statistik terhadap ketahanan hidup satu tahun pasien HIV/AIDS yang mendapat regimen ARV lini pertama. Namun penelitian mendapatkan penyakit Tuberkulosis (TB) mempunyai pengaruh secara statistik terhadap ketahanan hidup satu tahun pasien HIV/AIDS yang mendapat regimen ARV lini pertama.

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HIV/AIDS disease is one of public health concerns in Indonesia. The growing issues related to high morbidity and mortality rate. This is due to such as lately initiated of Antiretroviral (ARV) therapy. In Indonesia ARV therapy is begun when the CD4 cell counts dropped below 200 cell/mm3 or if clinical stadium fall into 3rd or 4th. Nowadays in Indonesia, Information about the influenced of baseline CD4 cell count to one year survival among patient HIV/AIDS with first line ARV regimen therapy, base on strata <50 cell/mm3, 50- <200 cell/mm3 and > 200 cell/mm3 was not available, therefore this research will be conducted.

Study design was retrospective cohort, with one year (366 days) duration of observation to death, in dynamic population from January 2005 to January 2010. The subjects of study were 158 HIV/AIDS patients, with inclusion criteria: > 15 years old, naïve, and were treated by first line ARV regimen at RSPI Prof.DR. Sulianti Saroso in year 2005-2010. The procedures of survival analysis used Kaplan-Meier method (product limit), and Log rank test (Mantel cox) for bivariate analysis and cox regression / cox proportional hazard model for multivariat analysis.

The overall of one year survival probability in HIV/AIDS patients with first line ARV regimen therapy was 0,86 (CI 95% 0,79-0,91). Incident rate of death (Hazard rate) in CD4 <50 cell/mm3 group was 8/10.000 persons days (29/100 persons years), in CD4 50-<200 cell/mm3 group was 3/10.000 persons days (11/100 persons years) and in CD4 > 200 cell/mm3 group was 2/10.000 persons days (7/100 persons years).

The Hazard Ratio(HR)-adjusted CD4 <50 cell/mm3 patients compared to CD4 > 200 cell/mm3 patients was 3,4 (p= 0,058 ; CI 95% : 0,96-12,16), the HR-adjusted CD4 50-<200 cell/mm3 patients compared to CD4 > 200 cell/mm3 patients was 1,7 (p= 0,479 ; CI 95% : 0,4-7.04). HRadjusted tuberculosis patients was 3,57 time more risk to death than patients without tuberculosis (p=0,015 ; CI 95% : 1,27-9,99).

This study found that the baseline CD4 cell counts have not significant statistical associated to one year survival of HIV/AIDS patients with first line ARV regimen therapy, after has controlled to other independent variables. But this study found that tuberculosis has significant statistical association to one year survival of HIV/AIDS patients who received first line ARV regimen therapy."

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

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

"Infeksi HIV dan bakteri Mycobacterium tuberculosis (Mtb) telah lama dianggap sebagai faktor risiko dari satu sama lain. Penelitian ini merupakan observasi potong lintang terhadap rekam medis dari pasien poliklinik paru RSUP Persahabatan selama bulan September-Oktober 2018. Pengambilan sampel dilakukan secara acak konsekutif. Hasil penelitian menemukan 94 pasien TB paru tanpa koinfeksi HIV (22 BTA positif, 72 BTA negatif; 52 lesi paru luas, 42 lesi paru minimal pada diagnosis) dan 14 pasien TB paru dengan koinfeksi HIV (1 BTA positif, 13 BTA negatif; 8 lesi paru luas, 6 lesi paru minimal pada diagnosis). Penelitian menemukan bahwa pasien infeksi TB tanpa HIV cenderung memiliki hasil BTA negatif yang tidak signifikan secara statistik (OR=0,202, p=0,163). Infeksi TB tanpa HIV memiliki kecenderungan sedikit lebih rendah untuk mengalami lesi paru minimal, namun tidak signifikan secara statistik (OR=0,941, p=1). Dari penelitian ini, dapat disimpulkan bahwa koinfeksi HIV pada TB paru tidak menyebabkan perbedaan kecenderungan Bacterial Load yang signifikan.

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HIV Infection and Mycobacterium tuberculosis (Mtb) infection has long been thought as a risk factor of each other. This study is a cross-sectional observation of the medical records of RSUP Persahabatan Lung Polyclinics patients in September-October 2018. The sampling was done using the consecutive random sampling method. The study found 94 pulmonary Tuberculosis patients without HIV coinfection (22 positive AFB, 72 negative AFB; 52 extensive lung lesion, 42 minimal lung lesion) and 14 pulmonary Tuberculosis patients with HIV coinfection (1 positive AFB, 13 negative AFB; 8 extensive lung lesion, 6 minimal lung lesion).

This study found that lung TB without HIV infection is a statistically insignificant risk factor of positive AFB result (OR=0.202, p=0.163). TB infection without HIV also has a slightly lower odd of having minimal lung lesion, however, this is neither statistically nor clinically significant. From this study, it can be inferred that HIV coinfection in pulmonary TB does not cause significant difference in Bacterial Load tendency."

"Pendahuluan: Penelitian ini bertujuan untuk mengetahui hubungan antara jumlah CD4, infeksi HPV, faktor risiko, dan terjadinya lesi prakanker pada pasien terinfeksi HIV.Metode: Studi potong-lintang ini dilakukan di Rumah Sakit Umum Dr. Cipto Mangunkusumo, Indonesia. 80 subjek penelitian dikumpulkan dari bulan Juli-Oktober 2021. Data subjek penelitian dikumpulkan menggunakan kuesioner terstruktur, meliputi usia, pendidikan, paritas, inisiasi seksual dini, jumlah pasangan seksual, riwayat merokok, riwayat kontrasepsi oral, riwayat penyakit menular seksual, dan jumlah CD4 terendah. Pemeriksaan sitologi, kolposkopi, dan tes HPV-DNA dilakukan pada seluruh subjek penelitian, dan 11 subjek melakukan pemeriksaan lanjutan histopatologi karena ditemukan abnormalitas pada pemeriksaan awal. Penginputan dan analisis data dilakukan dengan menggunakan IBM SPSS versi 25. Analisis bivariat, perhitungan odd ratio dan p value dilakukan untuk mengidentifikasi jumlah CD4, HPV-DNA, dan faktor risiko yang terkait dengan lesi prankanker serviks.Hasil: Dari data penelitian didapatkan bahwa 81,2% memiliki jumlah CD4 yang baik, dengan rata-rata jumlah CD4 sebesar 437,05 sel/mm3. Sebagian besar subjek memiliki HPV-negatif; namun, terdapat 22,2% subjek yang diketahui HPV-positif, memiliki lesi prakanker. Penelitian kami juga menemukan bahwa jumlah CD4 (p=0,01, OR 7,625; CI 95% 1,744-33,331) dan HPV-DNA (p<0,01, OR 12,286; CI 95% 1,456–103,65) secara signifikan berhubungan dengan lesi prakanker serviks. Kami juga menemukan korelasi antara inisiasi seksual dini dan hasil sitologi (p=0,05, OR 6,4; CI 95% 1,1306–36,2292).Kesimpulan: Jumlah CD4 yang rendah dan HPV-DNA positif berhubungan dengan perkembangan lesi prakanker. Pasien terinfeksi HIV dengan jumlah CD4 rendah juga dikaitkan dengan hasil HPV-DNA positif. Inisiasi seksual dini, sebagai faktor risiko kanker serviks, diketahui meningkatkan hasil skrining yang tidak normal. Oleh karena itu, metode skrining co-testing direkomendasikan sebagai strategi untuk mencegah kanker serviks pada semua pasien terinfeksi HIV.

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Introduction: This study aimed to determine the association between CD4 count, human papillomavirus (HPV) infection, risk factors, and the occurrence of precancerous lesions among HIV-infected patients.

Methods: This cross-sectional study was conducted at the Dr. Cipto Mangunkusumo General Hospital, Indonesia. All samples were collected between July and October 2021, and 80 HIV-infected subjects were included in the study. All participant data were collected using a structured questionnaire, including age, education, parity, early sexual initiation, number of sexual partners, history of smoking, history of oral contraception, history of sexually transmitted diseases, and the lowest CD4 count. Cytological examination, Colposcopy, and HPV DNA tests were performed on all participants, and 11 subjects underwent biopsy due to abnormalities. Data entry and analysis were performed using IBM SPSS 25th version. Bivariate analysis was performed, and odds ratios and p-values were computed to identify the CD4 count, HPV DNA, and risk factors associated with histopathology results.

Results: Among the participants, 81.2% had a good CD4 count, with a mean CD4 count of 437.05 cells/mm3. Most of the subjects were HPV-negative; however, 22.2% of HPV-positive subjects had precancerous lesions based on histopathologic results. Our study found that CD4 count was correlated with precancerous lesions (p=0.01, OR 7.625; CI 95% 1.744-33.331) and HPV DNA was significantly associated with cervical precancerous lesions (p<0.01, OR 12.286; CI 95% 1.456–103.65). Another finding was the correlation between early sexual initiation and cytology results (p = 0.05, OR 6.4; CI 95% 1.1306–36.2292).

Conclusion: Low CD4 counts and HPV DNA positivity are associated with the development of precancerous lesions. HIV-infected patients with low CD4 counts were also associated with positive HPV DNA results. Early sexual initiation, as a risk factor for cervical cancer, was found to increase abnormal screening results. Therefore, co-testing screening methods are recommended as a strategy to prevent cervical cancer in all HIV-infected patients."

"Kejadian AIDS (Acquired Immunodeficiency Syndrome) yang disebabkan Human Immunodeficiency Virus tipe 1 (HIV-1) terus meningkat setiap tahunnya. Pencegahan penularan virus HIV-1 masih sulit karena belum ada vaksin yang telah ditemukan untuk mencegah penularan atau transmisi virus ini. Selain itu, faktor lainnya adalah jarangnya diagnostik yang tersedia untuk awal infeksi, serta variasi genetik virus HIV-1 yang meningkat dengan cepat. Penelitian bertujuan untuk mengembangkan virus dengan menggunakan klona galur sel T CD4 yaitu CEM-GFP dengan virus HIV-1 CRF01_AE untuk mendapatkan virus dengan sifat genetik yang relatif homogen dan sifat virus yang sama. Ekspresi virus dalam sel target dimonitor melalui induksi green fluorescent protein yang akan diekspresikan oleh CEM-GFP ketika sel ini terinfeksi oleh virus HIV-1. Infeksi dilakukan dengan dua metode yaitu direct cell to cell transmission dan cell-free virus infection, hasil infeksi kedua metode ini dibandingkan fluoresensinya dengan mikroskop fluoresensi dan pengukuran ekspresi GFP dengan sitometer.Setelah 7 hari kultur, pengamatan dengan mikroskop fluoresensi menunjukkan bahwa sel terinfeksi dengan metode direct cell to cell transmission lebih banyak dibandingkan dengan cell-free virus infection. Pengukuran ekspresi GFP dengan sitometer pun menunjukkan hal serupa dimana ekspresi GFP sel terinfeksi dengan metode direct cell to cell transmission lebih banyak dibanding dengan cell-free virus infection. Untuk melihat apakah virus berhasil dikeluarkan dari sel terinfeksi dilakukan dengan metode Polymerase Chain Reaction. Hasil menunjukkan bahwa virus telah berhasil terdeteksi pada supernatan kultur sel CEM-GFP terinfeksi virus HIV-1.

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The incidents of AIDS (Acquired Immunodeficiency Syndrome) that caused by Human Immunodeficiency Virus type 1 (HIV-1) are increasing every year. The prevention of HIV transmission is still difficult to be done because HIV vaccine has not been found yet. Besides, another factor in HIV therapy is the rare early diagnostic available and the genetic variation of HIV-1 virus that increased rapidly. This study was aimed for propagating virus by using CEM-GFP clones, the derivative of CD4 T cells infected with CRF01_AE for obtaining virus with relatively homogen genetic variation and possessing the same characteristic. The virus expression in the target cell was observed by the induction of green fluorescent protein expressed by CEM-GFP when this cell was infected by HIV-Virus. The infection was held by two methods, cell-to-cell transmission and cellfree virus infection, the fluorescent of infected cell of this two methods was compared with fluorescent microscope and GFP expression assay with cytometer.

Within 7 days of culture, observation with fluorescent microscope showed that the infected cells of direct cell-to-cell transmission method was higher than the cellfree virus infection. GFP expression assay also showed the same result. The GFP expression of infected cells with direct cell-to-cell transmission was higher than cell-free virus infection. To investigate whether the virus was released from the infected cells, Polymerase Chain Reaction, were applied in this study. The result showed that the cell-free virus can be detected in culture supernatant of CEMGFP cells infected with HIV-1."