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Vidya Sari
Faktor-faktor yang Berhubungan dengan Kadar Beta-2 Mikroglobulin pada Pasien HIV Koinfeksi dengan Hepatitis C dalam Terapi Anti Retroviral = Factors related to Beta-2 Microglobulin Levels in HIV Patients Coinfected with Hepatitis C on Antiretroviral Therapy
"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."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2019
T58884
UI - Tesis Membership  Universitas Indonesia Library
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Bertin Tanggap Tirtana
Tren peningkatan rerata berat badan dan faktor-faktor yang berpengaruh pada pasien HIV/AIDS yang mendapat inisiasi antiretroviral lini pertama pada tiga tahun awal pengobatan = Trend of increase in average body weight and factors affecting HIV/AIDS patients who received first-line antiretroviral initiation in the initial three years of treatment
"Latar Belakang. Studi-studi menunjukkan ditemukannya kekhawatiran baru komplikasi metabolik akibat Peningkatan rerata berat badan yang timbul selama pemberian terapi kombinasi ARV. Peningkatan rerata berat badan ini menyebabkan terjadinya overweight dan obesitas yang mengancam terjadinya peningkatan morbiditas dan mortalitas pada pasien HIV. Peningkatan rerata berat badan dan faktor determinannya pada berbagai penelitian masih menunjukkan hasil yang inkonklusif pada tiap populasi.
Tujuan. Penelitian ini bertujuan untuk mengetahui adanya Peningkatan rerata berat badan dan faktor-faktor yang berpengaruh pada pasien HIV/AIDS yang mendapat inisiasi antiretroviral lini pertama pada tiga tahun awal pengobatan.
Metode. Penelitian ini dilakukan dengan desain kohort retrospektif pada pasien HIV yang memulai inisiasi ARV di RSUPN Dr. Cipto Mangunkusumo tahun 2017-2020. Subjek dikumpulkan berdasarkan metode total sampling. Variabel bebas yang diteliti meliputi jenis kelamin, usia, jumlah CD4+awal, IMT awal, stadium klinis WHO, komorbid infeksi TB, regimen ARV inisiasi lini pertama, dan kepatuhan berobat. Variabel terikat yang diteliti adalah Peningkatan rerata berat badan. Analisis multivariat dilakukan dengan metode Linear Mixed Model terhadap variabel bebas dengan nilai p<0,25 pada uji bivariat. Kurva grafik rerata berat badan ditampilkan untuk menggambarkan Peningkatan rerata berat badan.
Hasil. Sebanyak 734 data subjek penelitian diolah dalam proses analisis data. Peningkatan rerata berat badan paling cepat terlihat pada 6 bulan pertama pemberian ARV, yaitu sebesar 3,66 kg ± 5,85. Rerata berat badan pasien HIV sebelum terapi ARV adalah 57,7 kg, rerata berat badan pasien HIV yang mendapat ARV pada bulan ke 6 adalah 62,1 kg, pada bulan ke 12 menjadi 63,5 kg. Pada bulan ke 24, rerata berat badan pasien HIV yang mendapat ARV adalah 66 kg dan menjadi 66,9 kg pada bulan ke 36. Faktor determinan yang berpengaruh terhadap peningkatan rerata berat badan adalah jenis kelamin laki-laki (Beta 7,79, IK 95% 6,598-8,961), usia< 50 tahun (Beta 1,55, IK 95% 0,046-3,049), jumlah CD4+≤200 sel/mm3 (Beta 2,15, IK 95% 0,98-3,32), kepatuhan berobat (Beta 1,98, IK 95% 0,40 - 3,55), IMT awal (Beta 2,54, IK 95% 2,406-2,685),stadium klinis WHO III (Beta 2,14, IK 95% 0,131-4,149) dan adanya komorbid infeksi TB (Beta -5,75, IK 95% -6,11 -(-5,39))
Simpulan. Pemberian ARV dalam 3 tahun pertama meningkatkan rerata berat badan pasien HIV/AIDS. Peningkatan rerata berat badan ini dipengaruhi oleh jenis kelamin, usia, jumlah CD4+ awal, kepatuhan berobat, IMT awal, stadium klinis WHO dan adanya komorbid infeksi TB.
Background. Studies have raised new concerns about metabolic complications due to the increase in mean body weight during combination ARV therapy. This increase in average body weight causes overweight and obesity, which threatens to increase morbidity and mortality in HIV patients. The increase in average body weight and its determinants in various studies still shows inconclusive results in each population.
Objective. This study aims to determine the average increase in body weight and the factors influencing HIV/AIDS patients who received first-line antiretroviral initiation in the first three years of treatment.
Method. This study was conducted with a retrospective cohort design in HIV patients who initiated ARV at Dr. Cipto Mangunkusumo in 2017-2020. Subjects were collected based on the total sampling method. The independent variables studied included gender, age, initial CD4+ count, initial BMI, WHO clinical stage, comorbid TB infection, first- line initiation of ARV regimen, and medication adherence. The dependent variable studied was the increase in the average body weight. Multivariate analysis was performed using the Linear Mixed Model method on the independent variables with a p-value of <0.25 in the bivariate test. The average body weight graph curve illustrates the increase in the average weight.
Results. A total of 734 research subject data was processed in the data analysis process. The fastest increase in average body weight was seen in the first six months of ARV administration, which was 3.66 kg ± 5.85. The average body weight of HIV patients before ARV therapy was 57.7 kg; the average weight of HIV patients who received ARVs at the 6th month was 62.1 kg; at the 12th month, it became 63.5 kg. At month 24, the mean weight of HIV patients receiving ARV was 66 kg and became 66.9 kg at month 36. The determinant factors that affect the increase in average body weight are male gender (Beta 7.79, 95% CI 6.598-8.961), age below 50 years (Beta 1.55, 95% CI 0.046-3.049), CD4+ count lower than 200 cells/mm3 (Beta 2.15, 95% CI 0.98-3.32), medication adherence (Beta 1.98, 95% CI 0.40 - 3.55), initial BMI (Beta 2.54, 95% CI 2.406-2.685), WHO III clinical stage (Beta 2.14, 95% CI 0.131-4.149) and presence of comorbid TB infection (Beta -5.75, 95% CI -6.11 -(-5.39) )).
Conclusion. Giving ARV in the first three years increases the average body weight of HIV/AIDS patients. The increase in average body weight was influenced by gender, age, initial CD4+ count, medication adherence, initial BMI, WHO clinical stage, and the presence of comorbid TB infection."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2022
SP-pdf
UI - Tugas Akhir  Universitas Indonesia Library
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Suzy Maria
Proporsi keberhasilan virologis dan faktor-faktor yang berhubungan pada reintroduksi terapi antiretroviral lini pertama pasca interupsi tidak terencana pada pasien HIV = Proportion of virological success and its associated factors in first line antiretroviral reintroduction after unplanned interruption in HIV patients
"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.
"
Fakultas Kedokteran Universitas Indonesia, 2015
SP-PDF
UI - Tugas Akhir  Universitas Indonesia Library
cover
Saragi, Indika Royani
Kanker pada Pasien HIV Selama 8 Tahun Terakhir di RSUPN Cipto Mangunkusumo, Jakarta = Malignancy in HIV Patients for the Last 8 Years at Cipto Mangunkusumo General Hospital, Jakarta
"Pendahuluan. Para penderita HIV diketahui memiliki risiko kanker yang lebih tinggi di banding populasi umum, dan kondisi itu mempengaruhi morbiditas dan mortalitas populasi tersebut. Tujuan dari penelitian ini adalah untuk mendapatkan gambaran prevalensi ADC dan NADC selama 8 tahun terakhir di RSUPN Cipto Mangunkusumo, Jakarta, Indonesia.
Metode. Penelitian ini menggunakan 149 sampel yang diambil secara konsekutif. Karakteristik demografis yang dinilai yaitu jenis kelamin, usia, faktor risiko, CD4+, terapi ARV, stadium kanker dan obat ARV yang diberikan.
Hasil. Dari seluruh pasien didapatkan Limfoma Non Hodgkin (LNH) sebagai kanker terbanyak, yaitu 45 pasien (30%) dari seluruh kanker dan diikuti kanker serviks sebanyak 30 (20%) pasien. Kanker tipe NADC terbanyak meliputi kanker tipe sarkoma dan kanker hati sebanyak masing masing 10 (6%) dari seluruh kasus. Sebanyak 119 (79,9%) pasien memiliki usia kurang dari 50 tahun dan 82 (55,03%) dalam terapi ARV. CD4+ pada 102 (68,46%) pasien berada dibawah 200 sel/uL dan CD4+ > 350 sel/uL dimiliki oleh 16 (17,45%) pasien.
Simpulan. Pada penelitian kami, didapatkan ADC lebih banyak dari NADC (87 vs 62). Peningkatan terapi ARV, skrining kanker dini dan tatalaksana komorbiditas akan membantu peningkatan kualitas hidup dan kesintasan terkait kanker pada pasien HIV.
Introduction. Patients with HIV are known to possess a higher risk of malignancy compared to the general population. The purpose of this study was to get an overwiew of the prevalence of ADC and NADC over the last 8 years at Cipto Mangunkusumo General Hospital, Jakarta, Indonesia.
Methods. This study used 149 samples consecutively. Demographic characteristics assessed were sex, age,risk factors, CD4+, ARV therapy, malignancy stadium and ARV consumed.
Results. Of all patients, Non-Hodgkin’s Lymphoma (LNH) was the most common malignancy with 45 patients (30%) of all cancers, followed by cervical cancer with 30 patients (20%). Most common NADC included sarcoma type cancer and liver cancer each with 10 patients (6%) of all cases. One-hundred and nineteen patients (79.9%) were younger than 50 years old and 82 patients (55.03%) were taking ARV therapy. Serum CD4+ count in 102 patients (68.46%) were <200 cells/uL and 16 patients (17.45%) had CD4+ count >350 cells/uL.
Conclusion. In our study, the number for ADC was larger than NADC (87 vs 62). Increasing ARV therapy, early cancer screening and management of comorbidities will help improve the quality of life and cancer-related survival in HIV patients."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2022
T-pdf
UI - Tesis Membership  Universitas Indonesia Library
cover
Rahmi Salsabila
Evaluasi Penyebab Kematian Pasien HIV di Rumah Sakit Ciptomangunkusumo (RSCM) Periode 2020-2023 = Evaluation of Mortality Causes in HIV Hospitalized Patient at Rumah Sakit Ciptomangunkusumo during 2020-2023 Period
"Latar Belakang Human immunodeficiency virus (HIV) merupakan virus yang menyerang sistem imun dengan tahap akhir berupa AIDS (acquired immunodeficiency syndrome). Penyebab kematian pada penderita HIV dapat dikelompokkan menjadi terkait AIDS dan tidak terkait AIDS. Sejak digencarkannya pemberian ARV, beberapa penelitian menunjukkan penurunan tren mortalitas serta perubahan tren penyebab mortalitas menjadi penyakit yang tidak terkait dengan AIDS. Penelitian terbaru diperlukan untuk mengevaluasi penyebab kematian pada pasien HIV rawat inap di RSCM selama periode 2020-2023. Metode Penelitian deskriptif observasional dengan metode kohort retrospektif ini menggunakan data rekam medis rawat inap RSCM periode Juli 2020-Juni 2023. Variabel yang diamati diantaranya adalah luaran, status terapi ARV, dan penyebab kematian. Hasil Dari total 497 pasien yang dianalisis dalam penelitian ini, proporsi mortalitas pasien sebesar 21,1% dengan proporsi tertinggi pada tahun 2020 (25,9%) dan mengalami penurunan hingga tahun 2023. Penyebab mortalitas didominasi oleh penyebab terkait AIDS (76,2%), dengan penyebab terbanyak berupa syok sepsis (20%). Sebanyak 81,6% pasien yang tidak pernah/putus terapi ARV mengalami kematian akibat penyebab terkait AIDS. Kesimpulan Proporsi mortalitas pasien HIV rawat inap RSCM mengalami penurunan dari tahun 2020 hingga 2023. Penyebab mortalitas masih didominasi oleh penyebab terkait AIDS, khususnya pada kelompok tidak pernah/putus terapi.
Introduction Human Immunodeficiency Virus (HIV) is a virus that attacks the immune system, with the final stage being Acquired Immunodeficiency Syndrome (AIDS). The causes of death in HIV patients can be categorized as AIDS-related and non-AIDS-related. Since the intensification of ARV administration, several studies have indicated a shift in the trend of mortality causes towards non-AIDS related cause of death. New research is needed to evaluate the causes of death in HIV inpatients at RSCM during the period 2020-2023. Method This observational descriptive study with a retrospective cohort design utilizes medical records data of hospitalized patient at RSCM from July 2020 to June 2023. Observed variables include outcomes, ARV therapy status, and causes of death. Results Of the total 495 patients analyzed in this study, the patient mortality rate was 21.1%, with the highest mortality rate in 2020 (25,9%) and continue to decrease until 2023. Mortality causes were predominantly AIDS-related (76,2%), with the most common cause being septic shock (20%). A total of 81,6% of patients who never/discontinued ARV therapy experienced death due to AIDS-related causes. Conclusion The proportion of mortality in HIV inpatients at RSCM has decreased from 2020 to 2023. The causes of mortality are still predominantly AIDS-related, especially in the group with no/interrupted therapy."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2024
S-pdf
UI - Skripsi Membership  Universitas Indonesia Library
cover
Sri Wahdini
Deteksi cryptosporidium sp pada feses pasien terinfeksi HIVI AIDS dengan diare kronis = Detection of cryptosporidium sp in human immunodeficiency virus/acquired immunodeficiency syndrome patient with chronic diarrhea
"Cryprosporidium sp adalah parasit yang merupakan protozoa penyebab diare pada individu lmunodefisiensi seperti penderita HlV/AIDS, Diagnosis criptosporidiosis dengan menemukan ookista pada tinja menggunakan metode pulasan tahan asam dinilai kurang sensitif. Deteksi koproantigen Crypto:,poridium sp menggunakan ELISA diketahui lebih sensitif dan spesifik. Penelitian ini bertujuan untuk deteksi koproantigen Cryptosporidlum sp pada pasien HIV/AJDS dengan diare kronik menggunakan ELISA dan MTA serta melihat korelasi antara nilai absorbansi dengan hitung ookista. Sebanyak 95 sampel tinja dari pasien HIV/AIDS dengan diare kronik diperiksa menggunakan pulasan tahan asam yang merupakan gold standort dan deteksi koproantigen. Frekuensi kriptosporidiosis menggunakan deteksi koproantigen sebesar 36,8% dan dengan metode MTA 11,6%. Nilai sensitivitas dan spesifisitas koproantigen dibandingkan dengan pulasan tahan asam sebesar 100% dan 71A%. Tidak terdapat korelasi antara nilai absorbansi dengan hitung ookista.
Cryptosporidium sp is a protozoan parasite, causes severe diarrhea in immunodeficient hosts like the HIV/AIDS patients. Diagnosis of cryptosporidiosis by finding the oocyst from stool by modified acid fast staining, is insensitive. Coproantigen detection offers more sensitive and specific technique to detect Cryptosporidium infection. The objective of this study is to determine cryptosporidiosis proportion among HIVIAIDS patients by Cryptosporidial antigen detection in stool compare it to modified acid fast staining and determine its correlation with oocyts count. A number of 95 stool specimens from the HIV/AIDS patients with chronic diarrhea were subjected to coproantigen ELISA test and modified acid-fast staining (gold standard). The frequency of Criptosporidial infection was 36,8% and 11,6% respectively by coproantigen detection and AF staining with 100% sensitivity and 71.4% specificity. There is no correlation between optical density and oocyst count."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2009
T32063
UI - Tesis Open  Universitas Indonesia Library
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Sri Wahdini
Deteksi Cryptosporidium sp pada feses pasien terinfeksi HIV/AIDS dengan diare kronis = Detection of Cryptosporidium sp in Human Immunodeficiency Virus/Acquired Immunodeficiency syndrome patient with chronic diarrhea
"Cryptosporidium sp adalah parasit yang merupakan protozoa penyebab diare pada individu imunodefisiensi seperti penderita HIV/AIDS. Diagnosis criptosporidiosis dengan menemukan ookista pada tinja menggunakan metode pulasan tahan asam dinilai kurang sensitif. Deteksi koproantigen Cryprosporidfum sp mengunakan ELISA diketahui lebih sensitif dan spesifik. Penelitian ini bertujuan untuk deteksi koproantigen Cryptosporidium sp pada pasien HIV/AIDS dengan diare kronik menggunakan ELISA dan MTA serta melihat korelasi antara nilai absorbansi dengan hitung ookista. Sebanyak 95 sampel tinja dari pasien HIV/AIDS dengan diare kronik diperiksa rnenggunakan pulasan tahan asam yang merupakan gold standorr dan deteksi koproantigen. Frekuensi kriptosporidiosis menggunakan deteksi koproantigen sebesar 36,8% dan dengan metode MTA lI,6%. Nilai sensitivitas dan spesifisitas koproantigen dibandingkan dengan pulasan tahan asam sebesar 100% dan '71,4%. Tidak terdapat korlasi antara nilai absorbansi dengan hitung ookista.
Cryptosporidium sp is a protozoan parasite, causes severe diarrhea in imrnunodeticient hosts like the HIV/AIDS patients. Diagnosis of cryptosporidiosis by finding the oocyst from stool by modified acid fast staining, is insensitive. Coproantigen detection offers more sensitive and specific technique to detect Cqptosporidium infection. The objective of this study is to determine eryptosporidiosis proportion among HTV/AIDS patients by Cryptosporidial antigen detection in stool compare it to modified acid fast staining and determine its correlation with ooeyts count. A number of 95 stool specimens from the HIV/AIDS patients with chronic diarrhea were subjected to coproantigen ELISA test and modified acid-fast staining (gold standard). The frequency of Criptosporidial infection was 36,8% and 11,6% respectively by coproantigen detection and AF staining with 100% sensitivity and 71,4% specificity. There is no correlation between optical density and oocyst count."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2009
T32882
UI - Tesis Open  Universitas Indonesia Library
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Fahriyani
Karakteristik gambaran radiografi toraks pada pasien HIV dengan TB paru berdasarkan diagnosis mikrobiologis dan klinis di RSUPN Cipto Mangunkusumo = Characteristic of chest radiograph findings in HIV patients with lung tuberculosis based on microbiologic and clinical diagnosis in Cipto Mangunkusumo Hospital
"Latar belakang : penegakkan diagnosis TB paru pada pasien HIV dapat dilakukan berdasarkan pemeriksaan mikrobiologis dan klinis. Rekomendasi WHO 2007, memperbolehkan penegakan diagnosis berdasarkan hasil pemeriksaan klinis dengan dan tanpa melalui pemeriksaan mikrobiologis. Penelitian ini bertujuan mendapatkan perbedaan karakteristik gambaran radiografi toraks pasien HIV dengan TB paru yang didiagnosis berdasarkan pemeriksaan mikrobiologis dan klinis.
Metode : Penelitian ini adalah comparative cross sectional study. Subyek penelitian diambil secara consecutive dan dipilih berdasarkan catatan hasil pemeriksaan BTA sputum, kultur, Genexpert®, CD4+, dan radiografi toraks. Subyek penelitian dikelompokkan menjadi mikrobiologis dan klinis. Dilakukan pembacaan ulang radiografi toraks.
Hasil : gambaran radiografi toraks dengan frekuensi terbanyak pada kelompok diagnosis mikrobiologis adalah infiltrat/konsolidasi, fibroinfiltrat, limfadenopati, kavitas dan kalsifikasi. Sisanya efusi pleura, milier, fibrosis, bronkiektasis, pneumotoraks dan normal. Pada kelompok diagnosis klinis, gambaran radiografi toraks dengan frekuensi terbanyak adalah infiltrat/konsolidasi, kavitas, limfadenopati, fibroinfiltrat dan sisanya kalsifikasi, efusi pleura, milier, fibrosis, bronkiektasis, dan normal. Terdapat perbedaan bermakna karakteristik gambaran radiografi toraks fibroinfiltrat pada kelompok diagnosis mikrobiologis dan klinis. Frekuensi fibroinfiltrat terbanyak adalah di kelompok mikrobiologis dengan sebaran lokasi tersering di lapangan atas paru.
Kesimpulan : Terdapat perbedaan bermakna karakteristik gambaran radiografi toraks fibroinfiltrat pada kelompok diagnosis mikrobiologis dan klinis dengan lokasi tersering di lapangan atas paru.
Background : To diagnose Pulmonary Tuberculosis in HIV patient can be done based on microbiology examination and clinically. WHO 2007 recommendation, allowing diagnosis based on clinical examination with and without microbiological examination. This study aims to obtain the different characteristics of chest radiographs of HIV patients with pulmonary TB were diagnosed based on clinical and microbiological examination.
Methods : This study is a comparative cross-sectional study. Subjects were taken consecutively and selected based on the results of sputum smear examination, culture, Genexpert®, CD4+, and chest x-ray. The study subjects were grouped into microbiological and clinical. Then we do expertise review.
Results : The most chest x-ray finding in the microbiological group is infiltrates/ consolidation. Following by fibroinfiltrat, lymphadenopathy, cavities and calcification. The rest are pleural effusion, miliary, fibrosis, bronchiectasis, pneumothorax and normal . In the group of clinical diagnosis, the highest frequency chest x-ray finding is infiltrates/ consolidation. Following by cavities, lymphadenopathy, fibroinfiltrat and the rest are calcification, pleural effusion, miliary, fibrosis, bronchiectasis and normal. There is significant differences of fibroinfiltrat on microbiological and clinical diagnosis groups. The highest frequency of fibroinfiltrat is in the microbiological group with the most common sites in the upper of the lung field.
Conclusions : There is significant differences of fibroinfiltrat on microbiological and clinical diagnosis groups with the most common sites in the upper lung field."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2014
T-Pdf
UI - Tesis Membership  Universitas Indonesia Library
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Ratna Komalasari
Perubahan gambaran radiografi toraks pasien HIV dengan tuberkulosis paru selama pemberian OAT di Rumah Sakit Cipto Mangunkusumo = Changes finding of chest radiography in HIV patients with tuberculosis during administration of anti tuberculous therapy at Ciptomangunkusumo Hospital
"Koinfeksi HIV dan tuberkulosis masih merupakan ancaman kesehatan global saat ini. Diperkirakan sebanyak 1.4 juta kasus tuberculosis pada pasien HIV (+) dilaporkan pada tahun 2007. HIV merupakan risiko terbesar untuk tuberculosis, risiko berkembang menjdai TB laten 20 kali lipat. Tuberkulosis penyebab utama kematian pada pasien HIV.Pengobatan tuberculosis paru pada pasien HIV harus dimulai sesegera mungkin saat diagnosis ditegakkan, inisiasi dari pengobatan berkorelasi dengan menurunnya mortalitas dan risiko penularan infeksi tuberculosis.
Tujuan dari penelitian ini adalah menilai perubahan radiografi toraks pada pasien HIV dengan tuberculosis selama pemberian obat anti tuberkulosis (OAT) di rumah sakit Cipto Mangunkusumo. Semua pasien yang menjalani pemeriksaan radiografi toraks proyeksi AP atau PA sebelum pengobatan, setelah 2 bulan dan 6 bulan setelah pengobatan diberikan dan juga bulan ke 9 dan 12 apabila pengobatan dilanjutkan. Kemudian perubahan scoring lesi radiografi toraks diamati dan dievaluasi.
Hasil penelitian adalah statistic deskriptif menggambarkan perubahan scoring lesi radiogafi toraks sebelum dan 2 bulan serta setelah pengobatan 2 bulan dan 6 bulan setelah terapi diberikan. Perubahn yang terlihat pada radiografi toraks membaik 33 pasien (60%), menetap 9 pasien (16.4%) dan memburuk 13 pasien (23.6%). Perubahan lain pada bulan ke-2 dan ke-6 adalah; membaik 43 pasien (78.2%), menetap 6 pasien (10.9%) dan memburuk 6 pasien (10.9%). Kemungkinan kecurigaan kasus imune reconstitution inflammatory syndrome (IRIS) terdapat pada 3 pasien (5.45%). Perubahan skoring lesi pada bulan ke-2 dan ke-6 dianalisa dengan menggunakan Friedman Rank test dengan nilai confidence interval CI 95% ( p = 0.000).
Kesimpulan : Perubahan skoring lesi pada radiografi toraks pasien HIV dengan tuberkulosis paru lebih terlihat membaik setelah 6 bulan sejak diberikan obat anti tuberkulosis. Radiografi toraks masih merupakan modalitas bermakna dalam mengevaluasi perubahan lesi pada pasien HIV dan tuberculosis paru.
HIV and tuberculosis coinfection are major global health threats recently. It was estimated1.4 milionnew tuberculosis cases in patient with HIV- positive were reported in 2007. HIVconfers the greatest risk for tuberculosis, increasing the risk of latentTB reactivation 20-fold.Tuberculosis is a leading cause of death among patients with HIV.The initiation treatment of lung tuberculosis in HIV patients beginsmust be started as early as possible at the time when diagnose is made, the initiation treatment of tuberculosis correlated with decreasing mortality and risk of transmission tuberculosis infection.
The aim of this research is to observe changes of chest radiography in HIV patients with tuberculosis during administration of anti tuberculous therapy at CiptoMangunkusumo hospital. All of patients have taken chest radiography with PA or AP projection before the treatment begin and after 2 and 6 months therapy was given and also after 9 and 12 months if therapy continued, than the changes scoring lesion of chest radiography finding is observed and examined.
Descriptive statistic is provided as scoring lesion changes of chest radiography devided into changes chest radiography before and 2 month after anti tuberculous therapy was given and changes at 2 months to 6 months therapy was given. In group before and 2 months therapy, the changes was seen in chest radiography; better in 33 patients (60%), stationary condition in 9 patients (16.4%) and worse 13 patients (23.6%). Another changes in 2 and 6 months therapy was seen; better in 43 patients (78.2%), stationary condition in 6 patients (10.9%) and worse 6 patients (10.9%). Imune reconstitution inflammatory syndrome was suspected in 3 patients (5.45%).
The changes of scoring lesion in 2 and 6 months therapy was examined used Friedman Rank test with confidence interval CI 95% ( p = 0.000)."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2014
T-pdf
UI - Tesis Membership  Universitas Indonesia Library
cover
Estie Puspitasari
Faktor-faktor prediktor mortalitas pasien HIV/AIDS rawat inap = Predictors of mortality among hospitalized patients with HIV/AIDS
"Latar Belakang: Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) adalah masalah besar yang mengancam Indonesia dan banyak negara di seluruh dunia. Pengetahuan tentang karakteristik dan prediktor mortalitas dapat membantu dalam penatalaksanaan pasien. Penelitian terdahulu mengenai faktor-faktor prediktor mortalitas di Indonesia belum ada.
Tujuan: Mengetahui faktor-faktor prediktor mortalitas pasien HIV/AIDS dewasa yang dirawat inap di Rumah Sakit Cipto Mangunkusumo (RSCM).
Metode: Penelitian ini merupakan studi kohort retrospektif pada pasien rawat inap dewasa RSCM yang didiagnosis HIV/AIDS selama tahun 2011-2013. Data klinis dan laboratorium beserta status luaran (meninggal atau hidup) dan penyebab mortalitas selama perawatan diperoleh dari rekam medis. Analisis bivariat menggunakan uji Chi-Square dilakukan pada tujuh variabel prognostik, yaitu jenis kelamin laki-laki, tidak dari rumah sakit rujukan, tidak pernah/putus terapi antiretroviral (ARV), stadium klinis WHO IV, kadar hemoglobin <10 g/dL, kadar eGFR <60 mL/min/1,73 m2 dan kadar CD4+ ≤200 sel/µL. Variabel yang memenuhi syarat akan disertakan pada analisis multivariat dengan regresi logistik.
Hasil: Dari 606 pasien HIV/AIDS dewasa yang dirawat inap (median usia 32 tahun; laki-laki 64,2%), sebanyak 122 (20,1%) baru terdiagnosis HIV selama rawat dan 251 (41,5%) dalam terapi ARV. Median lama rawat adalah 11 (rentang 2 sampai 75) hari. Sebanyak 425 (70,1%) pasien dirawat karena infeksi oportunistik. Mortalitas selama perawatan sebesar 23,4% dengan mayoritas (92,3%) penyebabnya terkait AIDS. Prediktor independen mortalitas yang bermakna adalah stadium klinis WHO IV (OR=6,440; IK 95% 3,701 sampai 11,203), kadar hemoglobin <10 g/dL (OR=1,542; IK 95% 1,015 sampai 2,343) dan kadar eGFR <60 mL/min/1,73 m2 (OR=3,414; IK 95% 1,821 sampai 6,402).
Simpulan: Proporsi mortalitas selama perawatan sebesar 23,4%. Stadium klinis WHO IV, kadar hemoglobin <10 g/dL dan kadar eGFR <60 mL/min/1,73 m2 merupakan prediktor independen mortalitas pasien HIV/AIDS dewasa saat rawat inap.
Background: Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) is a big problem that threatening in Indonesia and many countries in the world. The knowledge on the characteristics and prediction of outcome were important for patients management. There are no studies on the predictors of mortality in Indonesia.
Objective: To determine the predictors of mortality in hospitalized adult patients with HIV/AIDS in Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
Methods: We performed a retrospective cohort study among hospitalized adult patients with HIV/AIDS in Cipto Mangunkusumo Hospital between 2011-2013. Data on clinical, laboratory, outcome (mortality) and causes of death during hospitalization were gathered from medical records. Bivariate analysis using Chi- Square test were used on the seven prognostic factors (male sex, not came from referral hospital, never/ever received antiretroviral therapy (ART), WHO clinical stage IV, hemoglobin level <10 g/dL, eGFR level <60 mL/min/1.73 m2 and CD4+ count ≤200 cell/µL). Multivariate logistic regression analysis was performed to identify independent predictors of mortality.
Results: Among 606 hospitalized HIV/AIDS patients (median age 32 years; 64.2% males), 122 (20.1%) were newly diagnosed with HIV infection during the hospitalization and 251 (41.5%) on ART. Median length of stay was 11 (range 2 to 75) days. There were 425 (70.1%) patients being hospitalized due to opportunistic infection. In-hospital mortality rate was 23.4% with majority (92.3%) due to AIDS-related illnesses. The independent predictors of mortality in multivariate analysis were WHO clinical stage IV (OR=6.440; 95% CI 3.701 to 11.203), hemoglobin level <10 g/dL (OR=1.542; 95% CI 1.015 to 2.343) and eGFR level <60 mL/min/1.73 m2 (OR=3.414; 95% CI 1.821 to 6.402).
Conclusions: In-hospital mortality rate was 23.4%. WHO clinical stage IV, hemoglobin level <10 g/dL and eGFR level <60 mL/min/1.73 m2 were the independent predictors of in-hospital mortality among hospitalized patients with HIV/AIDS."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2015
SP-PDF
UI - Tugas Akhir  Universitas Indonesia Library
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