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Abstrak :
Cryptococcus adalah jamur penyebab tersering pada pasien imunokompromi. Pada penelitian ini, 200 isolat yang berasal dari cairan otak 20 pasien terinfeksi HIV ditetapkan spesies dan serotipenya, serta kepekaannya terhadap obat antifungal (amfoterisin B, flukonazol, vorikonazol, ketokonazol, flusitosin). Spesies dan serotipe Cryptococcus ditetapkan menggunakan medium canavanine glycine bromthymol blue (CGB) dan medium creatinine dextrose bromthymol thymine (CDBT), sementara kepekaan terhadap antifungal diuji dengan metode difusi cakram, NCCLS M-44A, approved guidelines. Spesies C. neoformans ditemukan pada 170 isolat (85%), dengan seluruhnya adalah serotipe A dan 30 isolat adalah C. gattii. Infeksi tunggal C. neoformans ditemukan pada 10 pasien, infeksi tunggal C. gattii pada satu pasien, dan infeksi campuran pada 9 pasien. Cryptococcus spp sensitif terhadap amfoterisin B (93,5%), flukonazol (88,5%), vorikonazol (100%) dan ketokonazol (98%). Resistensi primer terhadap flusitosin ditemukan pada semua isolat C. neoformans dan C. gattii (100%) sebelum dan sesudah terapi. Secara keseluruhan, C. gattii kurang peka dibandingkan C. neoformans terhadap seluruh obat antifungal. ......Cryptococcus are common causes of mycoses in imunocompromised patient. In this study, 200 clinical cerebrospinal fluid from 20 HIV patient?s isolates of Cryptococcus were determine their species and serotypes, and their susceptibilities to antifungal (amphotericin B, fluconazole, voriconazole, ketoconazole, flucytosine) were analyzed. Cryptococcus species and serotypes were determined by canavanine glycine bromthymol blue (CGB) medium and creatinine dextrose bromthymol thymine (CDBT) medium, meanwhile antifungal susceptibilities were determined by disk diffusion method, NCCLS M-44A, approved guidelines. Species C. neoformans was found in 170 (85%) isolate with all of them was serotipe A dan 30 isolates (15%) were C. gattii. Single infection of C. neoformans was found in 10 patients, single infection of C. gattii in one patient and mixed infection in nine patients. Cryptococcus spp susceptible to amphotericin B (93,5%), fluconazole (88,5%), voriconazole (100%) and ketoconazole (98%). Primary resistance to flucytosine was found in all isolates C. neoformans and C. gattii (100%) before and after therapy. In general, C.gattii was less susceptible than C. neoformans to all drug tested.

Abstrak :
Cryptococcus merupakan khamir bersimpai yang menyebabkan kriptokokosis dan pada era HIV/A1DS jumfah kasus meningkat tajam. Manifestasi klinik kriptokokosis berbeda sesuai dengan spesies dan serotipe, sehingga identifikasi menjadi sangat penting. Selain itu penerapan spesies pe;nting untuk studi epidemiologis kriptokokosis. Penelitian ini merupakan penelltian deskriptif untuk mengidentifikasi spesies dan serotipe serta virulensi jarnur. Seiai itu ingin diketahui penyebaran penyakit di Jabodetabek. Bahan yang diperiksa adalah 40 lsolat koleksi Departemen P.arasitologi FKUI dan 25 isolat dari cairan otak kulit dan darah. Metode pemeriksaan terdiri ata:s uji asimilasi (kit API 20C AUX), uji pembentukan germ tube, biakan pada medium CGB dan CDBT dan NSA. Penyebaran kasus kriptokokosis diadapatkan berdasarkan domisili pasien. Hasil uji asimilasi didapatkan Cr. neoformans (64 isolat), Cr. lat:rentii var. laurentfi (l isolat). Hasil uji pembentukan germ tube didapatkan bahwa jamur yang diteliti bukan golongan Candida. Penetapan spesies dengan medium CGB didapatkan seluruh isolat adaiah Cr. neoformans. Hasil penetapan serotipe dengan median CDBT didapatkan seluruh isoiat adalah Cr. neoformans serotipe A. Uji virulensi dengan medium NSA memperlihatkan pembentukan pigmen melanin pada semua isofat. Data demografis menunjukkan distribusi penderita kriptokokosis di Jim a wilayah DKI,.Bogor dan Bandung. ......Cryptococcus is encapsulated yeast that caused Cryptococcosis in human. In the era of HIV/AIDS there is an increased number of cryptococcosis. Its clinical manifestation varied according to the species, so species idcntif1calion is quite important. Furthermore species identification is also important in epidemiology study. This descriptive study aimed to identify species and stereotype of Cryptococcus and also its virulence. The study also aimed to know the distribution of Cryptococcosis in Jabodetabek. There wex 40 isolates from the collection of Department of Parasitology FKUl. and other 25 isolates were isolated from spinal fluid, blood and skin. The study Vas done using API 20C AUX, germ tube fonnation test, CGB for the differentiation of Cryptococcus. gattii and Cryptococcus neoformans. and, CDBT for serotyping and melanine production by plating the isolates on niger seed agar. The study on the distribution of the disease was based on patients residence. The results were, 64 isolates of Cr. neoformans and 1 Cr. laurentii. Germ tube formation test is negative. Identification of species with CGB agar showed all isolates were Cr. neoformans. Stereotype identification with CDBT were all stereotype A. All isolate were capable of forming melanin when growth on NSA. Demographic data of the patients shows a wide distribution including 5 areas of DKI, Bogor and Bandung.

Abstrak :
Cryptococcosis is an infection caused by encapsulated yeast Crypococcus neofonnans, Before AIDS pandemic it was rarely reported, but nowadays its prevalence increasing sharply. The most common clinical manifestation in AIDS is meningitis. Mycology investigation for the diagnosis of cryptococcosis is obscure by the limitation of sensitivity and time consuming. It is necessary to use another method as the alternative. GXM antigen is distributed in body fluids such as spinal fluid, serum and urine. The detection of GXM in those body fluids can be used to support the diagnosis of Cryptococcus. The dilution that can be used for the diagnosis of cryptococcosis meningitis in Jakarta is not yet known. The method used fur GXM detection is latex agglutination test. For the purpose of this study neat, 100, 300 and 500 dilution of spinal fluid were tested. The gold standard of this study is mycology test i.e. india ink examination and culture. The result of Prevalens Ratio (PR) showed male are more prone to infection (RP; 1,1), while the range of the age is 25 30 value. Sensitivity) specificity, negative predictive value and positive predictive value it can be concluded that 300 dilution of spinal fluid is cut off value fur the diagnosis of cryptoocccal meningitis in AIDS.

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Kriptokokosis adalah infeksi yang disebabkan oleh jamur Cryptococcus sp. terutama Crypococcus neoformans. Sebelum pandemi AIDS kriptokokosis hanya berupa kasus sporadis, namun meningkat tajam setelah era AIDS, dengan manifestasi klinis terbanyak meningitis. Pemeriksaan mikofogi untuk diagnosis krlptokokosis memiliki keterbatasan sensitivitas dan waktu, sehingga dipertukan met

Abstrak :
Infeksi Human Immunodeficiency Virus tipe I (HIV-1) sebagai penyebab AIDS (Acquired Immunodeficiency Syndrome) merupakan salah satu masalah utama kesehatan dunia yang barns segem diatasi. Sejak ditemukannya penyakit tersebut, vaksin yang dihampkan tidak kanjung tersedia karena berbagai usaha I pengembangan vaksia HIV-1 mengalami hambatan besar oleh karena keanekar&gaman HIV·I yang tinggi. Strategi mutakhir untuk mengatasi hambatan tersebut adalah pengembangan vaksin HIV-I yang spesifik pada subtipe dan populasi di regional tertentu. menggunakan isolat identik dengan sekuen konsensus yang telah ditentukan, sebagai kandidat vaksin. Tujuan pcnelitian ini adalah menentukan sekuen konsensus HlV-1 di Indonesia dengan menggunakan sekuen - sekuen gen protease dan gen reverse transcriptase HN - 1 subtipe paling dominan isola!Indonesia dati isolat damb plasma omng terinfeksi HIV akibat penggunaan narkoba dengan jarum suntik (penasnn). Berdasarkan analisis dalam penelitian ini diketahui bahwa CRFO I_AE merupakan subtipe paling dominan di Indonesia dan telah berhasH diperoleh sekuen konsensus protease dan reverse transcriptase HIV-1 CRFOl_AE Indonesia Sekuen konsensus protease Indonesia tersebut. memiliki perbedaan dengan sekuen konsensus dari database Los Alomos National Laboratory (LANL) sebesar 2,7% untuk sekuen nukleotida (p = 0,030); 5,1% untuk sekuen asam amino (p = 0,000). Sedangkan sekuen konsensus reverse trancriptase Indonesia merniliki perbedaan dengan sekuen konsensus dari LANL sebesar 2,0% nntuk nuklootida (p = 0,208) dan 3,0% untuk asam amiao (p = 0,015).

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Human Immunodeficiency Virus type I (HIV-I) infection as the etiology of AIDS (Acquired Immunodeficiency Syndrome) is a major health problem which need to be urgently solved. Since the discovery of the desease, the effective vaccine is still not available. It is caused by widely the diversity of HIV-I. Novel strategy to overcome this problem is to develop country-specific HIV-1 vaccine, which use the most identical isolate with consensus sequences that had been determined, as vaccine candidate. This study aims to determine consensus sequences (CS) of HIV-1 in Indonesia by using sequences of protease gene and reverse transcriptase l gene of the most predominant subtype HIV-1 sequences from HIV-infected intravenous drog users' blood plasma. This study concluded that CRFOl_AE is I the most predominant subtype HIV-1 in Indonesia Nucleotide and amino acid of Iprotease which determine as CS has 2.7% (p = 0,030) and 5.1% (p = 0,000) differences with CS of CRFOI AE respectively. While nucleotide and amino acid of reverse trancriptase of the CS has 2,0% (p = 0,208) and 3,0".4 (p = 0,015) differences with CS of CRFOI_AE of the LANL, respectively.

Abstrak :
Kasus HIV/AIDS dan kematian akibat infeksi oportunistiknya di Indonesia terus bertambah, sehingga merupakan suatu masalah kesehatan. Penelitian ini bertujuan mengetahui prevalensi penyakit infeksi otak pada pasien HIV/AIDS di RSCM. Desain penelitian ini cross sectional dan terdapat 108 sampel yang diambil secara acak. Data dari Rekam Medik RSCM diolah menggunakan SPSS dan diuji dengan chi-square, Kolmogorov-Smirnov, dan Mann Whitney. Dari hasil penelitian ini ditemukan 35 orang (32,4%) pengidap HIV/AIDS dengan infeksi otak komorbid. Pasien dengan infeksi otak ini terbanyak laki-laki (27 orang, 77,1%), dengan rentang usia terbanyak 25-49 tahun (32 orang, 91,4%), dan faktor risiko penularan terbanyak melalui jarum suntik (15 orang, 42,9%). Indeks Massa Tubuh sebagian besar pasien tergolong kurang (median 17,6) dan hitung CD4+ absolut rendah (median 29). Tidak terdapat perbedaan bermakna antara infeksi otak pada pasien dengan jenis kelamin, rentang usia, faktor risiko penularan, Indeks Massa Tubuh, dan hitung CD4+ absolut. Disimpulkan prevalensi infeksi otak komorbid terjadi pada 32,4% pasien HIV/AIDS dan tidak berhubungan dengan karakteristik pasien. ......HIV/AIDS cases and deaths caused by opportunistic infections in Indonesia are increasing and make it as health problem. This study aims at knowing the prevalence of co-morbid brain infection in HIV/AIDS patients in RSCM. The method of this study is cross sectional and there are 108 samples taken randomly. Data from RSCM Medical Record was processed using SPSS and was tested by chi-square, Kolmogorov-Smirnov, and Mann Whitney test. The results showed there was 35 patients (32,4%) of the HIV/AIDS patients had brain infection. Most of them were men (27 patients, 77,1%), in a range of 25-49 years old (32 patients, 91,4%), and the majority of transmission risk factors is using needles (15 patients, 42,9%). The Body Mass Index in nearly all of them is low (median 17,6) and absolute CD4+ count in most of them also low (median 29). There is no significant difference between the patient?s brain infection with gender, range of age, transmission risk factors, Body Mass Index, and absolute CD4+ count. In conclusion, co-morbid brain infection found in 32,4% of HIV/AIDS patients and has no relation with patients' characteristics.

Abstrak :
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.