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ABSTRAK
Latar Belakang: Hingga saat ini belum ada panduan mengenai paduan terapi antiretroviral (antiretroviral therapy/ART) terpilih pada pasien HIV dewasa dengan riwayat interupsi tidak terencana. Kondisi pasien pada saat reintroduksi ART perlu dievaluasi sebagai dasar pemilihan paduan ART Tujuan: Mengetahui proporsi keberhasilan virologis pada reintroduksi ART lini pertama pasca interupsi tidak terencana. Mengetahui hubungan antara berbagai faktor klinis dan laboratoris dengan keberhasilan virologis pada reintroduksi tersebut. Metode: Penelitian kohort retrospektif dilakukan pada pasien HIV yang mendapatkan reintroduksi ART lini pertama pasca interupsi tidak terencana selama minimal 1 bulan. Data didapatkan dari rekam medis RS dr. Cipto Mangunkusumo di Jakarta. Viral load (VL) dinilai 6-18 bulan setelah reintroduksi ART lini pertama, dinyatakan berhasil bila VL <400 kopi/ml. Dilakukan analisis terhadap faktor yang berhubungan dengan keberhasilan virologis tersebut. Hasil: Selama periode Januari 2005 s.d. Desember 2014 terdapat 100 subjek yang mendapatkan reintroduksi ART lini pertama dan memiliki data viral load 6-18 bulan pasca reintroduksi. Pasca reintroduksi ART didapatkan keberhasilan virologis pada 55 (55%) subjek. Pada analisis didapatkan dua faktor yang berhubungan 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/mm xi 3 (aOR 4,33; IK95% 1,1416,39, p=0,031). Simpulan: Proporsi keberhasilan virologis pada reintroduksi ART lini pertama pasca interupsi tidak terencana adalah 55%. Pasien dengan frekuensi interupsi 1 kali dan pasien dengan nilai CD4 saat reintroduksi ≥200 sel/mm 3 memiliki kecenderungan untuk mencapai keberhasilan virologis pada reintroduksi ART. ABSTRACT
There is no guideline concerning antiretroviral therapy (ART) of choice for adult HIV patients after unplanned interruption. Hence, patients? conditions at time of ART reintroduction need to be evaluated as a basis for selecting ART regiment. Objectives: To know the proportion of virological success of first line ART reintroduction after unplanned interruption. To know the association between either clinical or laboratory factors and virological success in reintroduction. Methods: We conducted a retrospective cohort study in HIV patients that were reintroduced to first line ART after having unplanned interruption for at least one month period. The data were collected from medical records of Dr. Cipto Mangunkusumo Hospital in Jakarta. Viral load (VL) was evaluated at 6-18 months after first line ART reintroduction, declared as a success if VL <400 copies/mL. Analysis was done to factors associated with such virological success. Results: Between January 2005 and December 2014, 100 subjects were reintroduced to first line ART and having VL data in 6 to 18 months after the reintroduction. Virological success was achieved in 55 (55%) subjects. In the analysis 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/mm xii Universitas Indonesia 3 at 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 reintroduction after unplanned interruption was 55%. Patients who were having interrupted once and patients with CD4 ≥200 cell/mm 3 at the time of reintroduction would have higher odds of virological success on first line ART reintroduction. ;Background: There is no guideline concerning antiretroviral therapy (ART) of choice for adult HIV patients after unplanned interruption. Hence, patients? conditions at time of ART reintroduction need to be evaluated as a basis for selecting ART regiment. Objectives: To know the proportion of virological success of first line ART reintroduction after unplanned interruption. To know the association between either clinical or laboratory factors and virological success in reintroduction. Methods: We conducted a retrospective cohort study in HIV patients that were reintroduced to first line ART after having unplanned interruption for at least one month period. The data were collected from medical records of Dr. Cipto Mangunkusumo Hospital in Jakarta. Viral load (VL) was evaluated at 6-18 months after first line ART reintroduction, declared as a success if VL <400 copies/mL. Analysis was done to factors associated with such virological success. Results: Between January 2005 and December 2014, 100 subjects were reintroduced to first line ART and having VL data in 6 to 18 months after the reintroduction. Virological success was achieved in 55 (55%) subjects. In the analysis 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/mm xii Universitas Indonesia 3 at 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 reintroduction after unplanned interruption was 55%. Patients who were having interrupted once and patients with CD4 ≥200 cell/mm 3 at the time of reintroduction would have higher odds of virological success on first line ART reintroduction. ;Background: There is no guideline concerning antiretroviral therapy (ART) of choice for adult HIV patients after unplanned interruption. Hence, patients? conditions at time of ART reintroduction need to be evaluated as a basis for selecting ART regiment. Objectives: To know the proportion of virological success of first line ART reintroduction after unplanned interruption. To know the association between either clinical or laboratory factors and virological success in reintroduction. Methods: We conducted a retrospective cohort study in HIV patients that were reintroduced to first line ART after having unplanned interruption for at least one month period. The data were collected from medical records of Dr. Cipto Mangunkusumo Hospital in Jakarta. Viral load (VL) was evaluated at 6-18 months after first line ART reintroduction, declared as a success if VL <400 copies/mL. Analysis was done to factors associated with such virological success. Results: Between January 2005 and December 2014, 100 subjects were reintroduced to first line ART and having VL data in 6 to 18 months after the reintroduction. Virological success was achieved in 55 (55%) subjects. In the analysis 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/mm xii Universitas Indonesia 3 at 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 reintroduction after unplanned interruption was 55%. Patients who were having interrupted once and patients with CD4 ≥200 cell/mm 3 at the time of reintroduction would have higher odds of virological success on first line ART reintroduction. ;Background: There is no guideline concerning antiretroviral therapy (ART) of choice for adult HIV patients after unplanned interruption. Hence, patients? conditions at time of ART reintroduction need to be evaluated as a basis for selecting ART regiment. Objectives: To know the proportion of virological success of first line ART reintroduction after unplanned interruption. To know the association between either clinical or laboratory factors and virological success in reintroduction. Methods: We conducted a retrospective cohort study in HIV patients that were reintroduced to first line ART after having unplanned interruption for at least one month period. The data were collected from medical records of Dr. Cipto Mangunkusumo Hospital in Jakarta. Viral load (VL) was evaluated at 6-18 months after first line ART reintroduction, declared as a success if VL <400 copies/mL. Analysis was done to factors associated with such virological success. Results: Between January 2005 and December 2014, 100 subjects were reintroduced to first line ART and having VL data in 6 to 18 months after the reintroduction. Virological success was achieved in 55 (55%) subjects. In the analysis 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/mm xii Universitas Indonesia 3 at 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 reintroduction after unplanned interruption was 55%. Patients who were having interrupted once and patients with CD4 ≥200 cell/mm 3 at the time of reintroduction would have higher odds of virological success on first line ART reintroduction.

Abstrak :
ABSTRAK
Latar Belakang: Kesinambungan berobat memiliki peran penting dalam keberhasilan tatalaksana pasien HIV. Hingga saat ini, belum dilakukan penelitian untuk melihat proporsi pasien yang masih tetap berobat di UPT HIV RSCM maupun profil dari pasien-pasien tersebut. Tujuan: Mengetahui proporsi dan profil pasien yang masih tetap berobat di UPT HIV RSCM. Metode: Studi dengan metode potong lintang pada pasien HIV yang baru terdiagnosis dan berobat di UPT HIV RSUPNCM dalam periode Januari 2004 - Desember 2013. Data diperoleh melalui ekstraksi data sekunder yang berasal dari rekam medik. Penelitian dilakukan terhadap pasien HIV yang berusia diatas 18 tahun dan belum menjalani terapi ARV. Pasien yang tetap berobat sampai akhir 2014 didefinisikan sebagai pasien yang tetap kontrol ke poliklinik sejak awal pasien datang ke UPT HIV hingga minimal tiga bulan sebelum akhir Desember 2014. Hasil: Sebanyak 4949 subjek diikutkan dalam penelitian ini. Didapatkan proporsi pasien yang tetap berobat sampai akhir 2014 adalah 23% (1136 subjek). Selain itu, subjek dengan jenis kelamin wanita (26,6%), berusia ≥35 tahun (usia 35-44 tahun sebesar 25,5% dan ≥45 tahun sebesar 35,5%), pendidikan terakhir diatas SMU (26,8%), menikah/dengan pasangan (25%), beralamat di Bodetabek (26,1%), stadium klinis IV (28,3%), memiliki angka CD4 awal 201-350 sel/mm3 (35%), dan bukan penasun (28%) adalah subjek terbanyak yang tetap berobat sampai akhir 2014. Simpulan: Proporsi pasien yang tetap berobat sampai akhir 2014 adalah 23% (1136 subjek). Selain itu, pasien dengan jenis kelamin wanita, berusia ≥35 tahun, pendidikan terakhir diatas SMU, menikah/tinggal dengan pasangan, beralamat di Bodetabek, stadium klinis IV, memiliki angka CD4 awal 201-350 sel/mm3, dan bukan penasun merupakan kelompok subjek terbanyak yang tetap berobat sampai akhir 2014.ABSTRACT
Background: Continued medical treatment serves an important role in the successful management of patients with HIV. Until this present day, there has never been any research which seeks to examine the proportion of patients who continue their medical treatment at HIV Integrated Service Unit of National Central General Hospital Cipto Mangunkusumo (RSUPNCM) and the profiles of those patients. Objectives: To discover the proportion and to generate the profiles of patients who continued their medical treatment at HIV Integrated Service Unit, RSUPNCM. Methods: This research was conducted by applying the cross-sectional method on patients who were diagnosed with HIV and were subsequently undergoing medical treatment at HIV Integrated Service Unit, RSUPNCM, during the period of January 2004 to December 2013. Data were obtained by extracting secondary data in the form of medical records. The subjects of the research are HIV patients who are more than 18 years of age and have not undergone anti-retroviral (ARV) treatments. Patients who continued their medical treatment until the end of 2014 are defined as patients who have undergone medical treatment at the polyclinic starting from their first visit to HIV Integrated Service Unit until at least three months prior to the end of December 2014. Results: As many as 4949 subjects participated in this research. We found that the proportion of patients who continued their medical treatment until the end of 2014 is 23% (1136 subjects). In addition to that, we also found that female subjects (26.6%) who are ≥35 years of age (25.5% for those between 35 and 44 years of age and 35.5% for those ≥45 years of age); whose education is higher than Senior High School level (26.8%); who have married or live with their respective partners (25%); who reside in Bogor, Depok, Tangerang, or Bekasi areas (26.1%); who have reached clinical stage IV (28.3%); whose initial CD4 count is 201?350 cells/mm 3 (35%); and who are not injecting drug users (IDUs) (28%) constitute the largest group of subjects who continued their medical treatment until the end of 2014. Conclusion: The proportion of patients who continued their medical treatment until the end of 2014 is 23% (1136 subjects). In addition to that, female patients who are ≥35 years of age; whose education is higher than Senior High School level; who have married or live with their respective partners; who reside in Bogor, Depok, Tangerang, or Bekasi areas; who have reached clinical stage IV (28.3%); whose initial CD4 count is 201?350 cells/mm 3 , and who are not injecting drug users (IDUs) constitute the largest group of subjects who continued their medical treatment until the end of 2014.;Background: Continued medical treatment serves an important role in the successful management of patients with HIV. Until this present day, there has never been any research which seeks to examine the proportion of patients who continue their medical treatment at HIV Integrated Service Unit of National Central General Hospital Cipto Mangunkusumo (RSUPNCM) and the profiles of those patients. Objectives: To discover the proportion and to generate the profiles of patients who continued their medical treatment at HIV Integrated Service Unit, RSUPNCM. Methods: This research was conducted by applying the cross-sectional method on patients who were diagnosed with HIV and were subsequently undergoing medical treatment at HIV Integrated Service Unit, RSUPNCM, during the period of January 2004 to December 2013. Data were obtained by extracting secondary data in the form of medical records. The subjects of the research are HIV patients who are more than 18 years of age and have not undergone anti-retroviral (ARV) treatments. Patients who continued their medical treatment until the end of 2014 are defined as patients who have undergone medical treatment at the polyclinic starting from their first visit to HIV Integrated Service Unit until at least three months prior to the end of December 2014. Results: As many as 4949 subjects participated in this research. We found that the proportion of patients who continued their medical treatment until the end of 2014 is 23% (1136 subjects). In addition to that, we also found that female subjects (26.6%) who are ≥35 years of age (25.5% for those between 35 and 44 years of age and 35.5% for those ≥45 years of age); whose education is higher than Senior High School level (26.8%); who have married or live with their respective partners (25%); who reside in Bogor, Depok, Tangerang, or Bekasi areas (26.1%); who have reached clinical stage IV (28.3%); whose initial CD4 count is 201?350 cells/mm 3 (35%); and who are not injecting drug users (IDUs) (28%) constitute the largest group of subjects who continued their medical treatment until the end of 2014. Conclusion: The proportion of patients who continued their medical treatment until the end of 2014 is 23% (1136 subjects). In addition to that, female patients who are ≥35 years of age; whose education is higher than Senior High School level; who have married or live with their respective partners; who reside in Bogor, Depok, Tangerang, or Bekasi areas; who have reached clinical stage IV (28.3%); whose initial CD4 count is 201?350 cells/mm 3 , and who are not injecting drug users (IDUs) constitute the largest group of subjects who continued their medical treatment until the end of 2014.;Background: Continued medical treatment serves an important role in the successful management of patients with HIV. Until this present day, there has never been any research which seeks to examine the proportion of patients who continue their medical treatment at HIV Integrated Service Unit of National Central General Hospital Cipto Mangunkusumo (RSUPNCM) and the profiles of those patients. Objectives: To discover the proportion and to generate the profiles of patients who continued their medical treatment at HIV Integrated Service Unit, RSUPNCM. Methods: This research was conducted by applying the cross-sectional method on patients who were diagnosed with HIV and were subsequently undergoing medical treatment at HIV Integrated Service Unit, RSUPNCM, during the period of January 2004 to December 2013. Data were obtained by extracting secondary data in the form of medical records. The subjects of the research are HIV patients who are more than 18 years of age and have not undergone anti-retroviral (ARV) treatments. Patients who continued their medical treatment until the end of 2014 are defined as patients who have undergone medical treatment at the polyclinic starting from their first visit to HIV Integrated Service Unit until at least three months prior to the end of December 2014. Results: As many as 4949 subjects participated in this research. We found that the proportion of patients who continued their medical treatment until the end of 2014 is 23% (1136 subjects). In addition to that, we also found that female subjects (26.6%) who are ≥35 years of age (25.5% for those between 35 and 44 years of age and 35.5% for those ≥45 years of age); whose education is higher than Senior High School level (26.8%); who have married or live with their respective partners (25%); who reside in Bogor, Depok, Tangerang, or Bekasi areas (26.1%); who have reached clinical stage IV (28.3%); whose initial CD4 count is 201?350 cells/mm 3 (35%); and who are not injecting drug users (IDUs) (28%) constitute the largest group of subjects who continued their medical treatment until the end of 2014. Conclusion: The proportion of patients who continued their medical treatment until the end of 2014 is 23% (1136 subjects). In addition to that, female patients who are ≥35 years of age; whose education is higher than Senior High School level; who have married or live with their respective partners; who reside in Bogor, Depok, Tangerang, or Bekasi areas; who have reached clinical stage IV (28.3%); whose initial CD4 count is 201?350 cells/mm 3 , and who are not injecting drug users (IDUs) constitute the largest group of subjects who continued their medical treatment until the end of 2014.;Background: Continued medical treatment serves an important role in the successful management of patients with HIV. Until this present day, there has never been any research which seeks to examine the proportion of patients who continue their medical treatment at HIV Integrated Service Unit of National Central General Hospital Cipto Mangunkusumo (RSUPNCM) and the profiles of those patients. Objectives: To discover the proportion and to generate the profiles of patients who continued their medical treatment at HIV Integrated Service Unit, RSUPNCM. Methods: This research was conducted by applying the cross-sectional method on patients who were diagnosed with HIV and were subsequently undergoing medical treatment at HIV Integrated Service Unit, RSUPNCM, during the period of January 2004 to December 2013. Data were obtained by extracting secondary data in the form of medical records. The subjects of the research are HIV patients who are more than 18 years of age and have not undergone anti-retroviral (ARV) treatments. Patients who continued their medical treatment until the end of 2014 are defined as patients who have undergone medical treatment at the polyclinic starting from their first visit to HIV Integrated Service Unit until at least three months prior to the end of December 2014. Results: As many as 4949 subjects participated in this research. We found that the proportion of patients who continued their medical treatment until the end of 2014 is 23% (1136 subjects). In addition to that, we also found that female subjects (26.6%) who are ≥35 years of age (25.5% for those between 35 and 44 years of age and 35.5% for those ≥45 years of age); whose education is higher than Senior High School level (26.8%); who have married or live with their respective partners (25%); who reside in Bogor, Depok, Tangerang, or Bekasi areas (26.1%); who have reached clinical stage IV (28.3%); whose initial CD4 count is 201?350 cells/mm 3 (35%); and who are not injecting drug users (IDUs) (28%) constitute the largest group of subjects who continued their medical treatment until the end of 2014. Conclusion: The proportion of patients who continued their medical treatment until the end of 2014 is 23% (1136 subjects). In addition to that, female patients who are ≥35 years of age; whose education is higher than Senior High School level; who have married or live with their respective partners; who reside in Bogor, Depok, Tangerang, or Bekasi areas; who have reached clinical stage IV (28.3%); whose initial CD4 count is 201?350 cells/mm 3 , and who are not injecting drug users (IDUs) constitute the largest group of subjects who continued their medical treatment until the end of 2014.;Background: Continued medical treatment serves an important role in the successful management of patients with HIV. Until this present day, there has never been any research which seeks to examine the proportion of patients who continue their medical treatment at HIV Integrated Service Unit of National Central General Hospital Cipto Mangunkusumo (RSUPNCM) and the profiles of those patients. Objectives: To discover the proportion and to generate the profiles of patients who continued their medical treatment at HIV Integrated Service Unit, RSUPNCM. Methods: This research was conducted by applying the cross-sectional method on patients who were diagnosed with HIV and were subsequently undergoing medical treatment at HIV Integrated Service Unit, RSUPNCM, during the period of January 2004 to December 2013. Data were obtained by extracting secondary data in the form of medical records. The subjects of the research are HIV patients who are more than 18 years of age and have not undergone anti-retroviral (ARV) treatments. Patients who continued their medical treatment until the end of 2014 are defined as patients who have undergone medical treatment at the polyclinic starting from their first visit to HIV Integrated Service Unit until at least three months prior to the end of December 2014. Results: As many as 4949 subjects participated in this research. We found that the proportion of patients who continued their medical treatment until the end of 2014 is 23% (1136 subjects). In addition to that, we also found that female subjects (26.6%) who are ≥35 years of age (25.5% for those between 35 and 44 years of age and 35.5% for those ≥45 years of age); whose education is higher than Senior High School level (26.8%); who have married or live with their respective partners (25%); who reside in Bogor, Depok, Tangerang, or Bekasi areas (26.1%); who have reached clinical stage IV (28.3%); whose initial CD4 count is 201?350 cells/mm 3 (35%); and who are not injecting drug users (IDUs) (28%) constitute the largest group of subjects who continued their medical treatment until the end of 2014. Conclusion: The proportion of patients who continued their medical treatment until the end of 2014 is 23% (1136 subjects). In addition to that, female patients who are ≥35 years of age; whose education is higher than Senior High School level; who have married or live with their respective partners; who reside in Bogor, Depok, Tangerang, or Bekasi areas; who have reached clinical stage IV (28.3%); whose initial CD4 count is 201?350 cells/mm 3 , and who are not injecting drug users (IDUs) constitute the largest group of subjects who continued their medical treatment until the end of 2014.

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ABSTRAK
Latar belakang: Sejak dilaporkan pertama kali pada tahun 1981 di Amerika Serikat, penyebaran Acquired Immune Deficiency Syndrome (AIDS) di seluruh dunia termasuk Indonesia terjadi dengan pesat. Saluran pencernaan merupakan target utama infeksi HIV. Enteropati terjadi pada 15-70% kasus anak. Enteropati dapat terjadi walaupun tanpa gejala gastrointestinal. Kondisi enteropati dapat menimbulkan perburukan gejala gastrointestinal, kegagalan pertumbuhan dan menyebabkan pasien mengarah pada wasting. Enteropati dideteksi dengan pemeriksaan alpha 1 antitripsin. Tujuan: (1) Mengetahui proporsi enteropati yang terjadi pada anak dengan AIDS stadium lanjut tanpa gejala gastrointestinal. (2) Mengetahui karakteristik enteropati yang terjadi pada anak dengan AIDS stadium lanjut tanpa gejala gastrointestinal. (3) Mengetahui hubungan antara enteropati dengan usia, status gizi, status imunodefisiensi, jenis dan lama terapi ARV serta lama sakit anak dengan AIDS stadium lanjut tanpa gejala gastrointestinal. Metode: Penelitian potong lintang deskriptif dan analitik yang dilakukan di Poliklinik Alergi Imunologi Departemen Ilmu Kesehatan Anak FKUI- RSCM antara bulan Agustus sampai dengan November 2015 terhadap anak dengan AIDS stadium lanjut berusia 0 - 18 tahun tanpa gejala gastrointestinal. Faktor risiko 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 anak perempuan, usia >60 bulan, mengalami malnutrisi, tidak ada imunodefisiensi, obat antiretroviral lini kedua dan ketiga, lama pengobatan 0-59 bulan dan lama sakit 059 bulan. 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 terjadinya enteropati pada anak dengan AIDS stadium lanjut tanpa gejala gastrointestinal. Simpulan : Proporsi enteropati pada anak dengan AIDS stadium lanjut tanpa gejala gastrointestinal sebanyak 31 dari 70 subjek. Faktor risiko yang berperan adalah lama sakit 0-59 bulan. ABSTRACT
Background: HIV/AIDS is a global pandemic. Digestive tract is a major target for HIV infection. The digestive-absorptive functions are impaired, occurring in 1570% of children. Enteropathy contributes to gastrointestinal manifestation, growth failure and further immune derangement, leading to wasting. The diagnostic approach includes alpha 1 antitrypsin fecal level. Objective: (1) to describe frequency of enteropathy in advanced stages of AIDS children without gastrointestinal manifestation, (2) to describe characteristic of children with advanced stages of AIDS without gastrointestinal manifestation who develop enteropathy, (3) to investigate the role of age, nutritional status, immunodeficiency status, type and duration of antiretroviral therapy, and duration of illness as risk for enteropathy in advanced stages of AIDS children without gastrointestinal manifestation. Methods: A descriptive and analytic cross-sectional study was conducted at Pediatric Allergy-Immunology Outpatient Clinic RSCM between August to November 2015. The inclusion criteria was advanced stages of AIDS children age 0-18 years old without gastrointestinal manifestation. Risk factors were analyzed 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 and third line antiretroviral regimen with duration 0-59 months and duration of illness 0-59 months. Bivariate analysis showed that no factor was significantly associated with enteropathy. Based on multivariate analysis, duration of illness 0-59 months is a significant risk factor with OR 3.451 (CI 1.026-11.610). Conclusions: The proportion enteropathy in advanced stages of AIDS children without gastrointestinal manifestation is 31/70. Patients who had been diagnosed as advanced stage of HIV/AIDS for 0-59 months are more likely to develop enteropathy.;Background: HIV/AIDS is a global pandemic. Digestive tract is a major target for HIV infection. The digestive-absorptive functions are impaired, occurring in 1570% of children. Enteropathy contributes to gastrointestinal manifestation, growth failure and further immune derangement, leading to wasting. The diagnostic approach includes alpha 1 antitrypsin fecal level. Objective: (1) to describe frequency of enteropathy in advanced stages of AIDS children without gastrointestinal manifestation, (2) to describe characteristic of children with advanced stages of AIDS without gastrointestinal manifestation who develop enteropathy, (3) to investigate the role of age, nutritional status, immunodeficiency status, type and duration of antiretroviral therapy, and duration of illness as risk for enteropathy in advanced stages of AIDS children without gastrointestinal manifestation. Methods: A descriptive and analytic cross-sectional study was conducted at Pediatric Allergy-Immunology Outpatient Clinic RSCM between August to November 2015. The inclusion criteria was advanced stages of AIDS children age 0-18 years old without gastrointestinal manifestation. Risk factors were analyzed 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 and third line antiretroviral regimen with duration 0-59 months and duration of illness 0-59 months. Bivariate analysis showed that no factor was significantly associated with enteropathy. Based on multivariate analysis, duration of illness 0-59 months is a significant risk factor with OR 3.451 (CI 1.026-11.610). Conclusions: The proportion enteropathy in advanced stages of AIDS children without gastrointestinal manifestation is 31/70. Patients who had been diagnosed as advanced stage of HIV/AIDS for 0-59 months are more likely to develop enteropathy.;Background: HIV/AIDS is a global pandemic. Digestive tract is a major target for HIV infection. The digestive-absorptive functions are impaired, occurring in 1570% of children. Enteropathy contributes to gastrointestinal manifestation, growth failure and further immune derangement, leading to wasting. The diagnostic approach includes alpha 1 antitrypsin fecal level. Objective: (1) to describe frequency of enteropathy in advanced stages of AIDS children without gastrointestinal manifestation, (2) to describe characteristic of children with advanced stages of AIDS without gastrointestinal manifestation who develop enteropathy, (3) to investigate the role of age, nutritional status, immunodeficiency status, type and duration of antiretroviral therapy, and duration of illness as risk for enteropathy in advanced stages of AIDS children without gastrointestinal manifestation. Methods: A descriptive and analytic cross-sectional study was conducted at Pediatric Allergy-Immunology Outpatient Clinic RSCM between August to November 2015. The inclusion criteria was advanced stages of AIDS children age 0-18 years old without gastrointestinal manifestation. Risk factors were analyzed 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 and third line antiretroviral regimen with duration 0-59 months and duration of illness 0-59 months. Bivariate analysis showed that no factor was significantly associated with enteropathy. Based on multivariate analysis, duration of illness 0-59 months is a significant risk factor with OR 3.451 (CI 1.026-11.610). Conclusions: The proportion enteropathy in advanced stages of AIDS children without gastrointestinal manifestation is 31/70. Patients who had been diagnosed as advanced stage of HIV/AIDS for 0-59 months are more likely to develop enteropathy.

Abstrak :
ABSTRAK
Latar belakang : Cytomegalovirus (CMV) merupakan salah satu infeksi oportunistik pada pasien dengan sindrom immunodefisiensi (AIDS). Gejala klinis dan CT scan tidak dapat menegakkan diagnosa definitif ensefalitis CMV. Oleh karena itu diperlukan uji alternatif untuk menegakkan diagnosis infeksi CMV pada pasien HIV dengan infeksi otak. Salah satu uji yang sensitif dan spesifik adalah Real Time Polymerase Chain Reaction (rPCR). Tujuan : Mendapatkan uji deteksi molekular CMV pada pasien HIV dengan tersangka infeksi otak. Metode : Penelitian dilakukan dalam 3 tahap. Tahap 1 adalah optimasi konsentrasi primer, probe, suhu annealing, volume elusi ekstraksi DNA, dan volume cetakan. Tahap 2 adalah uji spesifisitas (reaksi silang) dan uji sensitivitas (ambang batas deteksi DNA) rPCR dan tahap 3 adalah penerapan uji rPCR yang sudah dioptimasi terhadap sampel plasma, urin, dan LCS. Hasil : Kondisi optimal uji rPCR telah diperoleh dengan konsentrasi primer dan probe 0,1 μM, dengan kondisi suhu reaksi rPCR: aktivasi enzim pada 950C selama 3 menit; 45 siklus pada 950C selama 15 detik (denaturasi) dan 560C selama 1 menit (annealing dan ekstensi). Volume elusi ekstraksi DNA yang optimal untuk ketiga jenis sampel (LCS, plasma dan urin) adalah 40 μL, dan volume cetakan rPCR untuk LCS, plasma, dan urin, masing-masing adalah 5, 4, dan 3 μL. Uji rPCR mampu mendeteksi DNA pada 50.000 jumlah kopi/mL dan tidak bereaksi silang dengan Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus saprophyticus, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Mycobacterium tuberculosis, Candida spp, Toxoplasma gondii, EBV,HSV,dan VZV. Penerapan uji rPCR 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 DNA CMV 50.000 jumlah kopi/mL dan tidak bereaksi silang dengan mikroorganisme yang berpotensi menyebabkan positif palsu (false positive).ABSTRACT
Background: Cytomegalovirus (CMV) is one of opportunistic infections in patients with Aquired Immunodeficiency Syndrome (AIDS). Clinical manifestations are not typical, and CT scans can not define encephalitis CMV specifically. Therefore, it is important to apply an alternative assay for sensitive and specific detection of CMV infection 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 with suspect CNS infections. Methods: This study was conducted in three phases. The first is optimization of concentrations of primers, probe, annealing temperature, final elution of DNA extraction, 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, and liquor cerebrospinal (LCS). Results: The rPCR reaction showed optimal concentrations of primers and probe at 0.1 μM, with thermal cycler: 950C for 3 min (enzyme activation), followed by 45 cycles of 950C for 15 sec (denaturation) and 560C for 1 min (annealing and extension). Final elution of DNA extraction was 40 μL and volume of PCR templates for urine, plasma, and LCS was 3, 4, and 5 μL, respectively. The rPCR had minimal detection of DNA at 50,000 copies/mL and was not cross-reacted with Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus saprophyticus, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Mycobacterium tuberculosis, Candida spp, Toxoplasma gondii, Epstein-Bar Virus (EBV), Herpes Simplex Virus (HSV) and Varicella Zoster Virus (VZV). Application of rPCR for clinical 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 detection at 50,000 copies/mL and was not cross-reacted with other microorganisms that are potential to cause false positive results.;Background: Cytomegalovirus (CMV) is one of opportunistic infections in patients with Aquired Immunodeficiency Syndrome (AIDS). Clinical manifestations are not typical, and CT scans can not define encephalitis CMV specifically. Therefore, it is important to apply an alternative assay for sensitive and specific detection of CMV infection 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 with suspect CNS infections. Methods: This study was conducted in three phases. The first is optimization of concentrations of primers, probe, annealing temperature, final elution of DNA extraction, 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, and liquor cerebrospinal (LCS). Results: The rPCR reaction showed optimal concentrations of primers and probe at 0.1 μM, with thermal cycler: 950C for 3 min (enzyme activation), followed by 45 cycles of 950C for 15 sec (denaturation) and 560C for 1 min (annealing and extension). Final elution of DNA extraction was 40 μL and volume of PCR templates for urine, plasma, and LCS was 3, 4, and 5 μL, respectively. The rPCR had minimal detection of DNA at 50,000 copies/mL and was not cross-reacted with Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus saprophyticus, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Mycobacterium tuberculosis, Candida spp, Toxoplasma gondii, Epstein-Bar Virus (EBV), Herpes Simplex Virus (HSV) and Varicella Zoster Virus (VZV). Application of rPCR for clinical 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 detection at 50,000 copies/mL and was not cross-reacted with other microorganisms that are potential to cause false positive results.;Background: Cytomegalovirus (CMV) is one of opportunistic infections in patients with Aquired Immunodeficiency Syndrome (AIDS). Clinical manifestations are not typical, and CT scans can not define encephalitis CMV specifically. Therefore, it is important to apply an alternative assay for sensitive and specific detection of CMV infection 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 with suspect CNS infections. Methods: This study was conducted in three phases. The first is optimization of concentrations of primers, probe, annealing temperature, final elution of DNA extraction, 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, and liquor cerebrospinal (LCS). Results: The rPCR reaction showed optimal concentrations of primers and probe at 0.1 μM, with thermal cycler: 950C for 3 min (enzyme activation), followed by 45 cycles of 950C for 15 sec (denaturation) and 560C for 1 min (annealing and extension). Final elution of DNA extraction was 40 μL and volume of PCR templates for urine, plasma, and LCS was 3, 4, and 5 μL, respectively. The rPCR had minimal detection of DNA at 50,000 copies/mL and was not cross-reacted with Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus saprophyticus, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Mycobacterium tuberculosis, Candida spp, Toxoplasma gondii, Epstein-Bar Virus (EBV), Herpes Simplex Virus (HSV) and Varicella Zoster Virus (VZV). Application of rPCR for clinical 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 detection at 50,000 copies/mL and was not cross-reacted with other microorganisms that are potential to cause false positive results.;Background: Cytomegalovirus (CMV) is one of opportunistic infections in patients with Aquired Immunodeficiency Syndrome (AIDS). Clinical manifestations are not typical, and CT scans can not define encephalitis CMV specifically. Therefore, it is important to apply an alternative assay for sensitive and specific detection of CMV infection 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 with suspect CNS infections. Methods: This study was conducted in three phases. The first is optimization of concentrations of primers, probe, annealing temperature, final elution of DNA extraction, 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, and liquor cerebrospinal (LCS). Results: The rPCR reaction showed optimal concentrations of primers and probe at 0.1 μM, with thermal cycler: 950C for 3 min (enzyme activation), followed by 45 cycles of 950C for 15 sec (denaturation) and 560C for 1 min (annealing and extension). Final elution of DNA extraction was 40 μL and volume of PCR templates for urine, plasma, and LCS was 3, 4, and 5 μL, respectively. The rPCR had minimal detection of DNA at 50,000 copies/mL and was not cross-reacted with Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus saprophyticus, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Mycobacterium tuberculosis, Candida spp, Toxoplasma gondii, Epstein-Bar Virus (EBV), Herpes Simplex Virus (HSV) and Varicella Zoster Virus (VZV). Application of rPCR for clinical 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 detection at 50,000 copies/mL and was not cross-reacted with other microorganisms that are potential to cause false positive results.

Abstrak :
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)

Abstrak :
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)

Abstrak :
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 :
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. ......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.

Abstrak :
HIV/AIDS has become a growing epidemic in Indonesia. The potential of infected partners from high-risk groups infecting their sexual partners from low-risk groups has become a major concern. This qualitative, applied study aims to see the counseling process for married, HIV – positive men who have not disclosed their statues to their wives. Counseling was designed to follow the basic principles of reality, a form of cognitive therapy that emphasizes on the freedom of choice to make rational decisions. Analysis is done on the issues that arise during conseling, as well as the process of counseling itself, based on the WDEP model developed for reality therapy. Results show that two of the three subjects have concern on how to disclose their HIV status to their wives, and are willing to make plans to disclose their HIV Status. Another major concern for the clients is the issue of dependence on methadone, whichh they claim to be on the biggest hindrance in their everyday lives.