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"Penelitian ini bertujuan untuk mengetahui pengaruh lokasi anatomi TB terhadap kesintasan (ketahanan hidup) 2 tahun pasien ko-infeksi TB-HIV setelah diagnosis.Penelitian ini menggunakan desain kohort restrospektifdinamik menggunakan 177 rekam medik pasien ko-infeksi TB-HIV di RSPI Prof. Dr Sulianti Saroso Jakarta yang terdaftar tahun 2010-2013, diambil secara simple random samplingKasintasan pasien ko-infeksi TB-HIV 2 tahun setelah diagnosa dengan lokasi anatomi TB di ekstraparu sebesar 86%, lebih rendah dibandingkan dengan lokasi anatomi TB di paru sebesar 98%. Lokasi anatomi TB di ekstraparu mempengaruhi kecepatan kematian pasien ko-infeksi TB-HIV (adjusted HR 1,48, 95% CI : 0,55-4,02), setelah dikontrol oleh faktor risiko penularan dan kadar CD4 awal. Infeksi HIV mengakibatkan kerusakan sistem imunitas tubuh yang luas sehingga infeksi dan penyebaran kuman TB juga akan meluas seperti ke kelenjar getah bening, pleura dan organ lainnya. TB ekstra paru memiliki beban bakteri TB yang lebih tinggi dan menunjukkan progresifitas perjalanan penyakit semakin parah yang mengakibatkan probabilitas ketahanan hidup (kesintasan) penderitanya semakin menurun.Perlu dilakukan screening lebih intensif terhadap pasien ko-infeksi TB-HIV untuk menemukan kemungkinan TB di ekstra paru sedini mungkinagar dapat diberikan penatalaksanaan yang tepat dalam rangka meningkatkan kualitas hidup penderitanya.......The objective of this study was to determine the influence of anatomical site to the survival of TB-HIV co-infection patient in 2 years after diagnosed. The design of this study was dynamic retrospective cohort with 177 medical records of TB-HIV co-infection patients in the Center of infection hospital Prof. Dr. SuliantiSaroso, Jakarta, from 2010 to 2013, taken by simple random sampling technique. The survival of TB-HIV co-infection for 2 years after it was diagnosed in patients with anatomical site of TB in the extrapulmonary was 86% and it was lower compared to patient with the anatomical site in the pulmonary which was 98%. Anatomical site of TB in the extrapulmonary were found to be an influencing factor to the rate of death in TB-HIV co-infection patients (adjusted HR 1,48, 95% CI : 0,55-4,02) after controlling with contagion factors and the level of CD4. HIV infection cause the widespreading damage in the immunity system therefor the infection of TB microbe also spreading to other organ such as lymph nodes and pleura. Extrapulmonary TB has much more TB microbe that worsen the progressivity of the disease and decrease the probability of the patient’s survival. Intensive screening are needed for TB/HIV co-infection patients to diagnosed the possibility of TB infection in the extrapulmonary as early as possible to increase the quality of life of its patients by finding the proper treatment."

"Telah dilakukan suatu penelitian eksperimental untuk menilai peran sel T regulator pada pasien dengan ko-infeksi HIV-TB. Terhadap 18 subyek HIV positif dilakukan penilaian IGRA, isolasi dan kultur PBMC dengan stimulasi antigen MTB, serta sorting dan deplesi Treg CD4 CD25highCD127low dengan metode FACS. Produksi sitokin IFN- dan IL-10 dinilai secara kuantitatif dengan multiplex Luminex 200. Diperoleh sebanyak 10 55,6 subyek TB negatif, 6 33,3 subyek TB laten, dan 2 11,1 subyekTB aktif. Persentase Treg dari CD4 pada subyek HIV dengan status TB menunjukkan kenaikan signifikan dibanding nilai referensi batas atas persentase Treg dalam CD4 subyek normal 11,006 2,840 ; p=0,008 . Rerata persentase Treg dari sel PBMC total antara kelompok TB aktif dan TB negatif menunjukkan perbedaan yang signifikan 1,3 vs 0,8 ; p=0,036 . Tidak terdapat perbedaan rasio sitokin proinflamasi INF- terhadap sitokin anti inflamasi IL-10 pada kelompok dengan ko infeksi HIV- TB aktif dan laten sebelum dan sesudah deplesi Treg.

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An experimental study has been conducted to assess the role of T regulatory cells in patients with HIV TB co infection. 18 HIV positive subjects undergo IGRA assessment, PBMC isolation and culture with ESAT 6 CFP 10 mycobacterial antigen stimulation, and Treg CD4 CD25highCD127low sorting and depletion by FACS method. The production of cytokines IFN and IL 10 were quantitatively assessed with Luminex 200 multiplex assay. Respectively, 10 55.6 were negative TB subjects, 6 33.3 were latent TB subjects, and 2 11.1 subjects were TB active. The percentage of Treg from CD4 cells in HIV subjects with TB status showed a significant increase over the reference value in normal subjects 11.006 2.840 p 0.008 . The mean percentage of Treg from total PBMC cells between active and negative TB groups showed a significant difference 1.3 vs. 0.8 p 0.036 . There was no difference in the ratio of proinflammatory cytokines INF to the anti inflammatory cytokine IL 10 in the group with active and latent HIV TB infection coinfection before and after Treg depletion. "

"ABSTRAKProgram penanggulangan TB nasional menggunakan strategi DOTS (DirectlyObserved Treatment Shortcourse) telah dilaksanakan sejak tahun 1995. Secaranasional strategi DOTS telah memberikan perubahan meskipun belum secarakomprehensif. Kondisi diatas diperparah dengan munculnya masalah baru,diantaranya adalah kejadian TB-HIV. Tipe penderita dan ko-infeksi TB-HIVmenjadi faktor risiko terjadinya putus berobat OAT pada penderita TB Paru BTAPositif. Tujuan penelitian ini untuk mengetahui hubungan tipe penderita dan koinfeksiTB-HIV dengan kejadian putus berobat penderita TB Paru BTA positif diKota Jakarta Timur.Desain penelitian kasus kontrol, dilakukan pengamatan pada penderita TB ParuBTA positif di Kota Jakarta Timur. Analisis multivariat dengan regresi logistic.Hasil penelitian didapatkan hubungan yang signifikan antara ko-infeksi TB-HIVdengan kejadian putus berobat pada penderita TB Paru BTA positif di KotaJakarta Timur dengan aOR 19,27 setelah dikontrol jenis kelamin dan status PMO(p value=0,006; 95% CI: 2,36-157,21). Keberadaan infeksi HIV secara bersamaandengan infeksi TB semakin mengancam kelangsungan hidup sehingga diperlukanterapi yang adekuat untuk mengendalikan virus dan membunuh kumanmycobacterium tuberculosis. Skrining HIV pada penderita TB harus dilakukansecara intensif untuk tata laksana pengobatan yang adekuat melalui programkolaborasi TB-HIV sehingga penderita bisa sembuh dari infeksi TB.

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ABSTRACTA national TB control program using the DOTS strategy (Directly ObservedTreatment Shortcourse) has been implemented since 1995. Nationally, the DOTSstrategy has provided changes although not yet comprehensively. The aboveconditions are exacerbated by the emergence of new problem, such as theincidence of TB-HIV. Type of patient and TB-HIV co-infection is a risk factor todefault of anti tuberculosis drugs on positive smear pulmonary tuberculosispatient. The purpose research is to know relation between patient type and TBHIVco-infection default of treatment for positive smear pulmonary tuberculosis patients in East Jakarta.The design of case control research, conducted observation on the patient of smearpositive pulmonary tuberculosis in East Jakarta. Multivariate analysis with logisticregression.The result of anti tuberculosis drugs of the research showed significant correlationbetween TB-HIV co-infection with default with smear positive pulmonarytuberculosis patient with aOR 19,27 after controlled sex and drug administersuperviser statue (p value = 0,006; 95% CI: 2,36-157.21). The presence of HIVinfection simultaneously with TB infection is increasingly threatening survival sothat adequate therapy is needed to control the virus and kill the bacteriamycobacterium tuberculosis. HIV screening of tuberculosis patients should beintensified for an adequate treatment regimen through a TB-HIV collaborationprogram so that people can recover from TB infection."

"AbstrakDespite asthma being the most common chronic childhood ailment, there is still much to learn about the disease. Early childhood infections with well-known or emerging viruses can lay the pathophysiologic framework for asthma development and exacerbation later in life, which may be due partly to alteration of the airway microbiome. Once asthma is established, acute exacerbations are usually associated with infections with respiratory viruses, such as rhinoviruses (RVs). Once again, there are bidirectional interactions between viruses and airway bacteria that appear to influence the severity of illness and the likelihood of exacerbation. Studies employing recent advances in viral and bacterial identification analytic techniques will clarify these new concepts and may provide the basis for new treatments or prevention or respiratory infection-associated exacerbation. This paper is a review of the associations among respiratory viruses, bacteria, inflammatory mechanisms, and asthma exacerbation."

"IntroduksiHuman Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS), sejak dikenalnya sindrom penyakit ini lebih dari 2 (dua) dekade, terus menerus menyebar diseluruh dunia tanpa ada tanda-tanda pengurangan. Tuberkulosis (TB) merupakan penyebab utama kesakitan dan kematian pada orang dengan HIV/AIDS sekitar 40%-50%. Tujuan penelitian yaitu mengetahui kesintasan tiga tahun pasien HIV/AIDS dan pengaruh ko-infeksi TB terhadap kesintasan 3 tahun pasien HIV yang mendapat terapi ARV.MetodePenelitian ini adalah dengan pendekatan cohort retrospective di RSPI prof.dr. Sulianti Saroso Tahun 2009-2011.HasilProbabilitas kesintasan kumulatif pasien HIV/AIDS yang mendapat ART pada tahun pertama adalah 84,2%, 2 tahun adalah 81,4%, dan 3 tahun adalah 79,26%. Hasil analisis multivariate dengan uji regresi Cox Time Dependent Covariate menemukan koinfeksi TB mempengaruhi kecepatan kematian pasien HIV/AIDS (adjusted HR 1,60; 95% CI: 0,96-2,67) setelah dikontrol oleh faktor risiko penularan dan hitung CD4 sebelum terapi ARV. IDU memiliki pengaruh terhadap kesintasan tiga tahun pasien HIV/AIDS (aHR 1,71; 95% CI: 1,04-2,95). Apabila pajanan Koinfeksi TB dapat dieliminasi, maka sebesar 40% kematian pasien HIV/AIDS dapat dicegah di Rumah Sakit Prof. Sulianti Saroso.DiskusiPengaruh TB terhadap HIV, selain mempercepat progresivitas HIV juga berakibat pada mortalitas HIV. Koinfeksi TB menambah laju hazard terhadap ketahanan hidup pasein. Tingkat mortalitas pengidap HIV yang sekaligus mengidap TB 2 kali lebih tinggi dibandingkan dengan pengidap HIV tanpa TB.SaranMeningkatkan kualitas conselling kepada ODHA yang mendapat ART khususnya pada pasien dengan koinfeksi TB. Meningkatkan pogram kolaborasi TB-HIV di rumah sakit untuk menunjang efektifitas program dan pelayanan kesehatan kepada pasien HIV/AIDS.......IntroductionHuman Immunodeficiency Virus / Acquired Immunodeficiency Syndrome (HIV / AIDS), since this disease syndrome known more than two (2) decades, continuously spread throughout the world with no signs of abatement. Tuberculosis (TB) is a major cause of morbidity and mortality in people with HIV/AIDS around 40%-50%. The purpose of research is to determine the three-year survival rate of patients with HIV / AIDS and TB co-infection influences the 3-year survival of patients with HIV who receive antiretroviral therapy.Methods:This study is a retrospective cohort approach in RSPI Prof. Sulianti Saroso Year 2009-2011.Results:The cumulative probability of survival of patients with HIV / AIDS who receive antiretroviral treatment in the first year was 84.2%, 2 years was 81.4%, and 3 years was 79.26%. Results of multivariate analysis with the Cox regression Time Dependent covariate find TB affects the speed of death in HIV / AIDS (adjusted HR 1,60; 95% CI: 0,96-2,67)) after controlled by transmission risk factors and CD4 counts before ART. IDU patients had 2 times the risk of a hazard than patients with non-IDU group (adjusted HR 1.95, 95% CI: 1.17 to 3.24). If TB Co-infection can be eliminated from th e susceptible population, then the death of 40% of patients with HIV/AIDS can be prevented in the Infectious Disease Hospital Prof. dr. Sulianti Saroso.Discussions:Effect of TB to HIV, besides accelerating the progression of HIV also result in mortality of HIV. TB adds to the hazard rate of survival pasein. The mortality rate of people with HIV who also have tuberculosis 2 times higher compared to HIV without TB.Recommendations:Counselling to improve the quality of people living with HIV who received antiretroviral therapy, especially in patients co-infected with TB. Increase pogram TB-HIV collaboration at the hospital to support effective programs and health services to patients with HIV / AIDS."

"ABSTRACTInfeksi Trichomonas vaginalis seringkali terjadi pada pekerja seks komersial PSK , menyebabkan mikrotrauma pada epitel saluran genital perempuan, dan menjadi portal masuk infeksi herpes genitalis; sehingga koinfeksi T. vaginalis dan herpes genitalis dapat terjadi. Penelitian ini merupakan penelitian potong lintang pada 212 PSK yang bertujuan untuk mengetahui apakah terdapat perbedaan proporsi infeksi herpes genitalis antara kelompok T. vaginalis positif dengan kelompok T. vaginalis negatif serta mengetahui faktor-faktor yang berhubungan. Analisis uji Chi-square menunjukkan perbedaan proporsi infeksi herpes genitalis yang bermakna p=0,027.

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ABSTRACTTrichomonas vaginalis infections are commonly found among female sex workers FSWs , causing microtrauma on the female genital epithelium, and predispose the entry of genital herpes infection thus co infection of T. vaginalis and genital herpes may occur. A cross sectional study was applied among 212 FSWs to analyze proportion differences of genital herpes infection between FSWs with T. vaginalis infection and FSWs without T. vaginalis infection, and to identify factors associated to the co infection. Analysis using Chi square revealed a significant association between T. vaginalis infection and genital herpes p 0,027."

"Background: Narcotics and psychoactive substances abuse, particularly by intravenous route, currently is a major health problem affecting young Indonesian people. Consequently, there is an increasing incidence of blood-borne viral diseases, including hepatitis C virus (HCV) and human immunodeficiency virus (HIV) infections. This study was aimed to investigate the prevalence of HCV and HIV co-infection among narcotics abusers in Pondok Indah Hospital, Jakarta.Method: This was a cross-sectional study in Pondok Indah Hospital, Jakarta using patients' medical records. Data from patients with the diagnosis of mental and behavioral disorders due to various psychoactive substances and HIV-related diseases were retrieved to obtain demographic characteristics, history of drug abuse and sewlogical testing. Patients were excluded if there were another organic mental disorders found or a history of blood transfusion prior to infection.Results: There were 157 cases of drug abuse collected between January 2000 and May 2005, 85.4% were men and their median age was 24 years old. The peak age group was 21-25 years old. Injection drug users (IDUs) were found in 72% of cases. Anti-HCV total antibody was found in 45.2% cases, including 2 non-IDUs, while anti-HIV antibody and combined anti-HCV/anti HIV antibodies were found in 13.4% and 7.6% cases, respectively. Anti-HCV positive patient are significantly younger than anti-HCV negative patients (27.9 ± 8.2 vs. 23.7 ± 4.4 years, p < 0.001), while the duration of use was not significantly correlated with HCV infection. Neither age nor duration of use was statistically significant with the presence of anti-HIV antibody. However, there is a significant correlation between the duration of drug abuse with HCV and HIV co-infection (6.0 ± 3.0 vs. 4.1 ± 2.8 years, p = 0.027).Conclusion: The prevalence of HCV and HIV co-infection among narcotics abusers in Pondok Indah Hospital was 7.6%. The emerging cases of hepatitis C and HIV infections during the last several years was significantly related to the increasing numbers of narcotics abusers."

"Penelitian ini bertujuan mengetahui pengaruh lama pemberian antiretroviral (ARV) setelah Obat Anti Tuberkulosis (OAT) dimulai terhadap kegagalan perbaikan CD4 pasien ko-infeksi TB-HIV. Penelitian dilakukan pada mei-juni 2016 di Rumah Sakit Penyakit Infeksi (RSPI) Prof. Dr. Sulianti Saroso. Design penelitian yang digunakan adalah kohort restrospektif dengan follow-up selama satu setengah tahun. Populasi studi adalah pasien Ko-infeksi TB-HIV yang naive ART dan tercatat pada rekam medis periode Januari 2010 - November 2014. Kriteria inklusi sampel adalah pasien usia ≥15 tahun, mendapat OAT minimal 2 minggu sebelum ART dimulai, dan memiliki data hasil pemeriksaan CD4 sebanyak dua kali dengan total sampel adalah 164 orang. Probabilias kumulatif kegagalan perbaikan CD4 pasien ko-infeksi TB-HIV sebesar 14,43%. Hazard rate kegagalan perbaikan CD4 pada pasien yang memulai terapi ARV 2-8 minggu setelah OAT dibandingkan dengan yang menunda terapi ARV 8 minggu setelah OAT masing-masing 767 per 10.000 orang tahun dan 447 per 10.000 orang tahun (p=0,266). Analisis multivariat dengan menggunakan uji cox regresi time independen menunujukkan rate kegagalan perbaikan CD4 pada pasien yang memulai ART >8 minggu setelah OAT lebih rendah dibandingkan pasien yang memulai ART pada 2-8 minggu setelah OAT (Adjusted HR=0,502 ; 0,196-1,287 ; p value=0,151) setelah dikontrol oleh jenis regimen ARV dan klasifikasi pengobatan TB.......This study was aim to assess the effect of time to Antiretroviral Treatment (ART) on CD4 response failure in TB-HIV coinfection patients. This study was conducted from May to June 2016 at Infectious Disease Hospital Sulianti Saroso. This study used cohort restrospective design with one and half year time to follow up. Study population were TB-HIV coinfected patients, noted as a naive ART patient in medical records from january 2010-november 2014. A total 164 patients ≥ 15 years old, had Anti Tuberculosis Treatment (ATT) 2 weeks before ART and had minimum 2 CD4 sell count laboratorium test results. The cumulative probability of CD4 response failure among TB-HIV co-infected patients was 14,43%. Hazard rate of CD4 response failure was 767 per 10.000 person year in early ART (2-8 weeks after ATT) versus 474 per 10.000 person year in delayed ART (8 weeks after ATT) arm (p=0,266). In multivariate analysis using time independent cox regression test, rate of CD4 responses failure was lower in patients with delayed ART until 8 weeks after ATT than early ART 2-8 weeks after ATT. (Adjusted HR=0,502 ; 0,196-1,287 ; P value=0,151) controlled by types of ARV regiments and classification of TB cure."

"Tuberkulosis (TB) menjadi salah satu penyebab kematian tertinggi di dunia, dimana Indonesia pada tahun 2019 menjadi negara penyumbang kasus Tuberkulosis terbanyak kedua di dunia. Pengaruh pandemi COVID-19 dikhawatirkan akan mempersulit penanggulangan TB yang dapat dievaluasi melalui tingkat keberhasilan pengobatan. Studi potong lintang ini dilakukan untuk menganalisis pengaruh pandemi COVID-19 terhadap keberhasilan pengobatan TB di Puskesmas. Sejumlah 418 pasien TB yang menerima OAT KDT Kategori 1 sebelum dan selama pandemi COVID-19 di tiga Puskesmas Wilayah Kota Depok diikutsertakan dengan metode total sampling. Observasi dilakukan terhadap data sekunder dari sistem informasi TB, kartu pengobatan pasien, rekam medis, dan catatan pasien lainnya. Keberhasilan pengobatan ditentukan melalui kategori hasil pengobatan pasien berdasarkan Kementerian Kesehatan RI. Hasil pengobatan sembuh atau pengobatan lengkap dikategorikan sebagai berhasil, sedangkan hasil pengobatan lainnya dimasukkan dalam kategori tidak berhasil. Angka keberhasilan pengobatan selama pandemi meningkat sebesar 10,3% dibandingkan pada periode sebelum COVID-19, dengan nilai berturut-turut sebesar 90,3% dan 80%. Pandemi COVID-19 ditemukan berpengaruh signifikan (p = 0,005) secara statistik terhadap keberhasilan pengobatan pasien TB di tiga puskesmas. Hanya ditemukan 5 pasien TB (1,8%) yang mengalami koinfeksi COVID-19. Faktor yang mempengaruhi keberhasilan pengobatan meliputi usia dan komorbid selama pandemi COVID-19 serta lama pengobatan pasien pada kedua periode.......Tuberculosis (TB) is one of the highest causes of death in the world, where Indonesia in 2019 became country that contributed second most Tuberculosis cases in the world. The impact of the COVID-19 pandemic feared to complicate TB management which can be evaluated through success rate of treatment. This cross-sectional study was conducted to analyze the effect of COVID-19 pandemic on TB success treatment in public health centers. A total of 418 TB patients who received anti-TB FDC Category I before and during COVID-19 pandemic in three Puskesmas Depok city region were included with total sampling method. Observations were made on secondary data from TB information systems, patient treatment cards, medical records, and other patient records. Success treatment are determined through category of patient treatment outcomes based on the Health Ministry of the Republic of Indonesia. The results of cured treatment or complete treatment are categorized as successful, while other treatment results are included in the category of unsuccessful. The success rate of treatment during the pandemic increased by 10.3% compared to the period before COVID-19, with successive values of 90.3% and 80%. The COVID19 pandemic was found to have a significant effect (p = 0.005) statistically on the successful treatment of TB patients in three health centers. Only 5 TB patients (1.8%) were found to have COVID-19 co-infection. Factors influencing treatment success include age and comorbidities during the COVID-19 pandemic as well as the length of treatment of patients in both periods."