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Abstrak :
Latar belakang: Terapi kombinasi antiretroviral (ARV) telah meningkatkan angka harapan hidup pasien HIV. Koinfeksi HCV kemudian menjadi penyebab utama morbiditas dan mortalitas terkait hati pada pasien HIV dalam terapi ARV. Aktivasi imun residual dipikirkan berperan penting dalam kondisi ini. Beta-2 mikroglobulin sebagai penanda aktivasi imun kronik dan hubungannya dengan CD4, derajat fibrosis, dan kadar RNA VHC masih harus dieksplorasi pada kelompok pasien HIV-VHC. Metode: Sebanyak 64 pasien yang telah mengalami supresi HIV diikutsertakan pada penelitian ini: 37 pasien koinfeksi HIV-VHC dan 27 pasien HIV. Seluruh pasien koinfeksi belum mendapat terapi VHC. Kadar β2M plasma dianalisis dengan teknik ELISA. Derajat fibrosis diperiksa menggunakan transient elastography. Kadar CD4 dan RNA VHC diperoleh dari rekam medis dalam enam bulan terakhir. Perbedaan rerata β2M dianalisis dengan uji t independen. Korelasi β2M dengan CD4, RNA VHC, dan derajat fibrosis dinilai dengan uji Pearson atau Spearman. Hasil: Kadar plasma β2M didapatkan lebih tinggi pada pasien koinfeksi HIV-VHC (2,75 ± 0,8 mg/L) dibandingkan dengan monoinfeksi HIV (1,93 ± 0,95 mg/L, p <0,001 dan IK95% 0, 37-1,25). Tidak ditemukan korelasi signifikan antara β2M dengan kadar CD4, derajat fibrosis, dan RNA VHC. Kesimpulan: Pasien koinfeksi HIV-VHC dalam terapi ARV menunjukkan derajat aktivasi imun residual yang lebih tinggi dibandingkan HIV monoinfeksi. ......Background: Introduction of combined antiretroviral therapy (cART) has improved life expectancy of HIV infected individuals. HCV coinfection then becomes the main cause of liver-related morbidity and mortality. Residual immune activation may play an important role. The level of beta-2 microglobulin as an immune activation marker and its associations with CD4, fibrosis stage, and HCV RNA remain to be explored in HIV/HCV coinfection. Methods: A total of 64 patients having supressed HIV viral load were included: 37 patients with HIV/HCV coinfection and 27 HIV patients. All coinfected patients were naïve to HCV treatment. Plasma levels of β2M were analyzed using ELISA. The fibrosis stage was determined using transient elastography. CD4, HCV RNA levels were obtained from medical records within the last six months. The mean difference of β2M was analyzed using independent t-test. β2M correlations with CD4, HCV RNA, and fibrosis degree were assessed by Pearson or Spearman test. Results: The levels of plasma β2M were higher in HIV/HCV coinfected patients (2.75 ± 0.8 mg/L) compared to HIV monoinfection (1.93 ± 0.95 mg/L, p < 0.001 and 95CI 0.37-1.25). There were no significant correlations of β2M with CD4 level, fibrosis stage, and HCV RNA. Conclusion: HIV/HCV coinfected patients on ART show a higher level of residual immune activation compared to HIV patients.

Abstrak :
Infeksi Trichomonas vaginalis merupakan salah penyakit Infeksi Menular Seksual IMS yang disebabkan oleh T. vaginalis. Parasit ini menyebabkan mikrotrauma pada saluran kelamin perempuan. Hal ini membuat koinfeksi dengan mikroba lainnya dapat terjadi sehingga bisa menyebabkan kondiloma yang umumnya terdapat pada Human Papillomavirus HPV. Penelitian ini dilakukan di Departemen Parasitologi Fakultas Kedokteran Universitas Indonesia yang datanya berasal dari Indramayu, Jawa Barat. Metode penelitian ini adalah cross sectional pada 214 Pekerja Seks Komersial PSK dengan menganalisis perbedaan proporsi kondiloma antara kelompok T. vaginalis positif dan negatif serta mengetahui faktor yang berhubungan. Berdasarkan analisis chi square menunjukkan perbedaan proporsi infeksi kondiloma yang tidak bermakna p=0,356;p>0,05. Jenis kontrasepsi, asal daerah, dan tingkat pendidikan memiliki hubungan bermakna denga koinfeksi tetapi tidak memiliki hubungan bermakna pada faktor status perkawinan. Kesimpulan dari penelitian ini adalah tidak ada hubungan yang bermakna antara koinfeksi T. vaginalis dan kondiloma pada PSK di Daerah Indramayu, Jawa Barat dan faktor yang memiliki hubungan bermakna adalah jenis kontrasepsi, asal daerah, dan tingkat pendidikan. ......Trichomonas vaginalis infections is a disease Sexually Transmitted Infections STI caused by T. vaginalis. This parasite causes mikrotrauma in the female genital tract. This makes co infection with other microbes may occur that could cause condyloma are generally present in the Human papillomavirus HPV. This research was held in the Department of Parasitology, Faculty of Medicine, University of Indonesia whose data comes from Indramayu, West Java. This research method is cross sectional at 214 Commercial Sex Workers CSWs with analyze proportion differences of condyloma between group T. vaginalis positive and negative and to identify factors associated to the co infection. Based on the analysis of chi square is known revealed a significant association between T. vaginalis and condyloma p 0.356 p 0,05. Type contraception, national origin, and level of education have a significant relationship premises coinfection but do not have a significant relationship to the marital status factor. The conclusion from this study is there is no significant association between co infection with T. vaginalis and condyloma at the CSW in the Region Indramayu, West Java and the factors that have a significant relationship was kind of contraception, region of origin, and education level.

Abstrak :
Penyakit TB lebih berkembang pada masyarakat dengan status sosial ekonomi yang rendah, kelompok terpinggirkan dan populasi rentan lainnya. Salah satu yang termasuk populasi rentan adalah komunitas penderita kusta. Penyakit TB dan kusta banyak ditemukan di daerah beriklim tropis dengan kelembapan udara tinggi, tingkat sosial ekonomi penduduk yang rendah serta status gizi dan higienitas yang buruk. Infeksi kedua penyakit ini dapat terjadi bersamaan pada satu individu dan biasanya terjadi pada pasien imunokompromais. Koinfeksi TB paru pada penderita kusta dapat meningkatkan mortalitas. Penelitian ini bertujuan untuk mengetahui proporsi TB Paru pada penderita kusta yang berobat di Poliklinik Kulit dan Kelamin RSUPN Dr. Cipto Mangunkusumo serta mengetahui faktor risiko yang dapat memengaruhi. Desain penelitian adalah cross sectional dengan jenis penelitian deskriptif analitik berdasarkan hasil pemeriksaan laboratorium, foto toraks dan kuesioner. Penelitian dilakukan di Poliklinik Kulit dan Kelamin serta Poliklinik Penyakit Dalam – Pulmonologi RSUPN Dr. Cipto Mangunkusumo pada tahun 2022. Sampel penelitian ini adalah pasien kusta baik sedang dalam pengobatan multi drugs therapy (MDT) maupun telah dinyatakan release from treatment (RFT) yang memenuhi kriteria penelitian dan bersedia untuk berpartisipasi dalam penelitian. Besar sampel yang diperlukan untuk penelitian ini adalah 105 orang. Data yang diperoleh diolah dan dianalisis secara univariat, bivariat dan multivariat dengan perangkat lunak SPSS. Dari total 109 subjek, terdapat 3 orang (2,75%) yang didiagnosis TB paru yang mencakup 1 orang TB paru bakteriologis terkonfirmasi TCM dan 2 orang TB paru klinis. Mayoritas subjek dengan TB paru berusia kurang dari 40 tahun (66,7%), didominasi laki-laki (66,7%) dan seluruhnya berpendidikan rendah. Dari subjek yang memberikan informasi, sebanyak 50% memiliki pendapatan kurang dari 3,5 juta per bulan. Seluruh subjek dengan TB paru mengaku tidak pernah mendapat vaksinasi BCG dan mayoritas mengaku memiliki riwayat merokok (66,7%). Sebanyak 66,7% mengaku tidak ada riwayat kontak fisis, tidak pernah menggunakan barang dan berbincang dengan penderita TB paru. Hanya 33,3% penderita koinfeksi TB paru pada kusta yang memiliki status gizi kurang. Seluruh penderita TB paru pada kusta didiagnosis kusta tipe multibasiler. Dari hasil analisis bivariat, faktor pendidikan memiliki hubungan yang bermakna dengan luaran TB paru. Namun pada analisis multivariat tidak dapat mengeluarkan hasil. ......TB disease develops more in communities with low socio-economic status, marginalized groups, and other vulnerable populations. One of the vulnerable populations is the leprae community. TB and leprosy are often found in tropical climates with high air humidity, low socio-economic levels of the population, and poor nutritional and hygiene status. Infection with these two diseases can occur simultaneously in one individual and usually occurs in immunocompromised patients. Pulmonary TB coinfection in leprosy sufferers can increase mortality.This study aims to determine the proportion of pulmonary TB in leprosy sufferers who seek treatment at the Skin and Venereology Polyclinic, RSUPN Dr. Cipto Mangunkusumo, and the risk factors that can influence it. The research design was cross-sectional with a descriptive analytical research type based on the results of laboratory examinations, chest x-rays, and questionnaires. The research was conducted at the Skin and Venereology Polyclinic and the Internal Medicine- Pulmonology Polyclinic, RSUPN Dr. Cipto Mangunkusumo, in 2022. The sample for this study was leprosy patients who were either undergoing multidrug therapy (MDT) or had been declared released from treatment (RFT) and who met the research criteria and were willing to participate in the research. The sample size required for this research is 105 people. The data obtained was processed and analyzed univariately, bivariately, and multivariately with SPSS software.Of the total 109 subjects, there were 3 people (2.75%) who were diagnosed with pulmonary TB, including 1 person with bacteriological pulmonary TB confirmed by TCM and 2 people with clinical pulmonary TB. The majority of subjects with pulmonary TB were less than 40 years old (66.7%), dominated by men (66.7%), and all had low education. Of the subjects who provided information, 50% had an income of less than 3.5 million per month. All subjects with pulmonary TB admitted that they had never received BCG vaccination, and the majority admitted to having a history of smoking (66.7%). As many as 66.7% admitted that they had no history of physical contact, had never used items, or talked to pulmonary TB sufferers. Only 33.3% of people with pulmonary TB co-infection with leprosy have poor nutritional status. All patients with pulmonary TB in leprosy were diagnosed with multibacillary-type leprosy. According to the results of the bivariate analysis, educational factors have a significant relationship with pulmonary TB outcomes. However, multivariate analysis could not produce results.

Abstrak :
Background: HIV infection in HCV-infected patients accelerates disease progression and reduces the success rate of Peg-IFN/RBV treatment. HCV mutation in NS5A-ISDR/PKR-BD region improved the outcome in HCV monoinfection treated with Peg-IFN/RBV. SNP-IL28B polymorphism is predicted to have an effect on HCV quasispecies evolution. However, the role of NS5A mutation and SNP IL-28B in HIV-HCV coinfection is still unclear. The aim of the study is to determine the role of HCV NS5A-ISDR/PKR-BD mutation and SNP IL-28 polymorphism on the successfulness of Peg-IFN/RBV therapy in HCV-HIV coinfection. Methods: prospective cohort was performed in this study. Plasma sample were obtained from 30 and 8 patients with HCV-HIV coinfection and HCV monoinfection, respectively. PCR nucleotide sequencing was performed after RNA virus extraction and cDNA synthesis. Protein secondary structure and prediction of mutation function were analyzed using PredictProtein (PP) program. Results: sixteen HCV-HIV coinfected patients and none from eight HCV patients achieved sustained virological response (SVR). ≥1 non-neutral mutation was found in 24/30 HCV-HIV coinfection and more frequent in SVR group (14 patients). ≥1 non-neutral mutation were found statistically significant for overall SVR achievement (p<0.05) in all patients regardless of coinfection or monoinfection status. Of the 27 HCV-HIV coinfected patients with CC-gene, 21 subjects had non-neutral mutation. The structure which was expected as NS5A binding site structure was different from consensus (wild type) in SVR group, while the structure was similar to consensus in non-SVR group. Conclusion: having ≥1 non-neutral mutation was associated with SVR achievement in Peg-IFN/RBV therapy, regardless of monoinfection and coinfection status.