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"HIV merupakan penyakit yang sering terjadi bersamaan dengan penyakit lain. Keberadaan penyakit penyerta memerlukan terapi bersama dengan obat ARV. Hal ini memungkinkan terjadinya interaksi antar obat yang berpotensi menyebabkan penurunan atau peningkatan kadar obat dalam darah, yang bisa menimbulkan kegagalan terapi atau efek samping berupa toksisitas. Penelitian ini bertujuan melihat potensi interaksi yang penting secara klinis dari terapi ARV dengan obat komorbidnya. Penelitian ini adalah penelitian non eksperimental, pengambilan data dilakukan secara potong lintang pada pasien HIV dengan komorbid yang dirawat di rumah sakit Cipto Mangunkusumo dalam periode Januari 2016 sampai dengan Juli 2017. Data diambil dari electronic health record dan pusat rekam medis RSCM. Dari 224 pasien HIV yang masuk kedalam kriteria inklusi, terdapat 121 pasien yang memenuhi persyaratan dan diambil menjadi subjek penelitian. Potensi interaksi yang penting secara klinis didefinisikan sama dengan potensi interaksi mayor memerlukan modifikasi dosis, jangan diberikan bersamaan, kontraindikasi atau hindari . Hasil penelitian menunjukkan dari 121 pasien, potensi interaksi mayor terjadi pada 18 pasien 14,99 dengan potensi interaksi yang menurunkan kadar ARV pada 14 pasien 11,57 . Kejadian potensi interaksi mayor yang paling banyak terjadi yaitu antara nevirapin dan rifampisin 3,53 . Komorbid terbanyak adalah Tuberkulosis Paru 12,92 . Diperlukan penelitian prospektif pengukuran kadar obat dan efek terapi akibat interaksi obat ARV dengan obat komorbidnya.

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HIV is a disease commonly presents with other comorbidities which need concomitant treatments with ARV. Drug-drug interaction is an unavoidable consequence which may potentially lead to an increase or a decrease of affected drug and ultimately resulted in therapeutic failure or otherwise, toxicity.This study was aimed to look at the potential of clinically significant drug-drug interactions between ARV and other treatments. This was a non experimental cross sectional study conducted on HIV patients with comorbids treated at the Cipto Mangunkusumo hospital from January 2016 to Juli 2017. Data were taken from the electronic health record and Cipto Mangunkusumo hospital medical record. From 224 HIV patients who meet the criteria of inclusion, there are 121 patients that rsquo;s fulfilled the conditions and was taken to be the subjects of research. The potential of clinically significant drug-drug interactions are definitioned as potential for major interaction requiring dose modification, do not coadminister, contraindicated or avoid . The results showed that potential for mayor interactions occurred in 18 out of 121 patients 14.99 . Potential decrease of blood ARV level was found in 14 patients 11.57 . The occurance of potential for major interaction mostly happened between nevirapin and rifampisin 3,35 . The most comorbid is pneumonia tuberculosis 12.92 . Prospective study is required to measure drugs level and the effect of therapy consequence ARV drugs interaction with comorbid drugs"

"Agen antiretroviral adalah obat yang digunakan untuk pasien HIV dan diminum rutin oleh pasien HIV seumur hidup. Berdasarkan data Kementrian Kesehatan, setidaknya sebanyak 83,4% pasien HIV mendapatkan terapi antiretroviral untuk mengurangi perkembangan virus tersebut. Penggunaan obat antiretroviral harus dipantau dan dievaluasi penggunaannya apakah sesuai dengan tatalaksana yang berlaku. Selain itu, evaluasi diperlukan untuk mengurangi risiko kejadian yang tidak diinginkan oleh pasien HIV yang menggunakan antiretroviral. Oleh karena itu, diperlukan evaluasi penggunaan obat antiretroviral terhadap pasien HIV di RSUP Fatmawati secara berkala. Metode penelitian yang digunakan dalam pembuatan tugas khusus ini adalah penelitian observasional dengan design cross sectional. Data diambil secara retrospektif terhadap data sekunder yaitu data penggunaan obat yang diperoleh dari depo farmasi Instalasi Rawat Jalan Lantai 3 RSUP Fatmawati periode Juli-September 2022. Pengambilan data dilakukan dengan metode total sampling. Berdasarkan hasil pengambilan data, terdapat 2346 pasien HIV yang menjalani pengobatan rawat jalan di RSUP Fatmawati. Dari 2346 pasien tersebut, sebanyak 71% pasien HIV yang menjalani pengobatan rawat jalan di RSUP Fatmawati adalah laki-laki dan usia 35 - ≤45 tahun menjadi populasi terbanyak dengan persentase sebesar 46,76%. Dalam penelitian ini, didapatkan bahwa penggunaan kombinasi Tenolam E (Tenofovir – Lamivudin – Efavirenz) merupakan kombinasi yang paling sering diresepkan di RSUP Fatmawati dengen persentase sebesar 24%. Kemudian, penggunaan obat non-ARV yang sering diresepkan adalah cotrimoxazol yang merupakan antibiotik untuk mencegah infeksi oportunistik pada ODHA.

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Antiretroviral agents are drugs that are used for HIV patients and are taken regularly by HIV patients for life. Based on data from the Ministry of Health, at least 83.4% of HIV patients receive antiretroviral therapy to reduce the spread of the virus. The use of antiretroviral drugs must be monitored and evaluated for their use whether they are in accordance with the applicable management. In addition, evaluation is needed to reduce the risk of adverse events in HIV patients taking antiretrovirals. Therefore, it is necessary to periodically evaluate the use of antiretroviral drugs in HIV patients at Fatmawati General Hospital. The research method used in making this special assignment is an observational study with a cross-sectional design. Data were collected retrospectively from secondary data, namely drug use data obtained from the pharmacy depot on the 3rd floor of the Outpatient Installation at Fatmawati Hospital for the period July-September 2022. Data was collected using the total sampling method. Based on the results of data collection, there were 2346 HIV patients undergoing outpatient treatment at Fatmawati General Hospital. Of the 2346 patients, 71% of HIV patients undergoing outpatient treatment at Fatmawati General Hospital were male and aged 35 - ≤45 years being the largest population with a percentage of 46.76%. In this study, it was found that the use of the combination Tenolam E (Tenofovir – Lamivudin – Efavirenz) was the most frequently prescribed combination at Fatmawati General Hospital with a percentage of 24%. Then, the use of non-ARV drugs that are often prescribed is cotrimoxazol which is an antibiotic to prevent opportunistic infections in PLWHA."

"ABSTRACTBackground: antiretroviral drug-related liver injury (ARLI) is a drug-induced hepatotoxicity due to antiretroviral medication (ARV). It commonly disrupts compliance to treatment and causes treatment discontinuation in HIV-infected patients. Several studies have been conducted on predisposing factors for ARLI including studies on body mass index (BMI) and cluster of differentiation 4 (CD4). The association of BMI and CD4 with ARLI remains controversial as previous studies have demonstrated different outcomes. Our study was conducted to identify the association of low baseline BMI and CD4 cell count as risk factors for ARLI in HIV-infected patients. Methods: this is a cross-sectional study. Subjects were 75 patients with HIV-AIDS who received ARV therapy using fixed-dose combination (tenofovir, lamivudine, efavirenz) at the Teratai HIV outpatient clinic of Hasan Sadikin Hospital in Bandung city. Alanine aminotransferase (ALT) test was performed prior to starting ARV treatment and the test was repeated on the sixth month of therapy. Results: there was no significant difference on the proportion of low baseline CD4 count between ARLI and non-ARLI group (p=0.155). Bivariate analysis demonstrated that regarding the proportion of low baseline BMI, there was a significant difference between ARLI and non-ARLI group (p= 0.001). Multivariate analysis using logistic regression showed that BMI of < 18.5 kg/m2 increased the risk for developing ARLI by 5.53 fold; while CD4 cell count of < 200 cells/µL did not the risk. Conclusion: our study indicates that low baseline BMI may increase the risk for developing ARLI; while low baseline CD4 cell count does not; therefore, we suggest that ALT test should be performed on a routine basis among HIV-AIDS patients for early detection of ARLI, particularly in patients with low BMI."