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Fitri Imelda
Korelasi antara interleukin-1b cairan sendi dan status fungsional pasien osteoartritis lutut
"Meningkatnya usia harapan hidup berdampak bertambahnya insideris penyakit muskuloskeletal. Diantara berbagai macam penyakit muskuloskeletal yang paling sering dijumpai yaitu osteoartritis (OA), artritis rematoid (RA), osteoporosis dan low back pani. Osteoartritis terjadi akibat kondrosit gagal mensintesis matriks yang berkualitas dan memelihara keseimbangan antara degradasi dan sintesis matriks ekstraselular. Kelainan utama pada osteoartritis adalah hilangnya rawan sendi secara progresif yang disertai perubahan reaktif pada tepi sendi dan tulang subkondral. sendi yang paling banyak terkena OA adalah lutut, panggul, lumbal dan servikal.
Insidens dan prevalensi OA bervariasi antar negara dan jumlahnya rneningkat sesuai bertambahnya usia. Menurut data WHO diperkirakan 10% penduduk dunia berusia lebih atau sama 60 tahun menderita OA. Insidens OA pada perempuan lebih tinggi yaitu 2,95 per 1000 populasi dibandingkan laki-laki yaitu 1,71 per 1000 populasi. Faktor gender pada OA diduga berkaitan dengan hormon estrogen.
Patogenesis OA pada awalnya dianggap hanya akibat proses degenerasi, tetapi kelainan yang ditemukan seperti efusi sendi, kekakuan sendi, dan nodes makin menguatkan adanya proses inflamasi. Proses biomekanik pada sendi penumpu berat badan seperti pada OA lutut tidak bisa menjelaskan kejadian OA pada sendi jari tangan yang bukan sendi penumpu barat badan. Berbagai tanda molekular baik serum maupun cairan sendi dapat digunakan untuk mendiagnosis, menilai progresivitas, dan prognosis penyakit OA."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2006
T21420
UI - Tesis Membership  Universitas Indonesia Library
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Hery Agung Samsu Alam
Profil pasien HIV periode 2004-2013 yang tetap berobat sampai akhir 2014 di Unit Pelayanan Terpadu HIV RS Cipto Mangunkusumo Jakarta = Profiles of HIV patients during the period of 2004 to 2013 who continued their medical treatment until the end of 2014 in HIV Integrated Service Unit Cipto Mangunkusumo Jakarta
"ABSTRAK
Latar Belakang: Kesinambungan berobat memiliki peran penting dalam
keberhasilan tatalaksana pasien HIV. Hingga saat ini, belum dilakukan penelitian
untuk melihat proporsi pasien yang masih tetap berobat di UPT HIV RSCM
maupun profil dari pasien-pasien tersebut.
Tujuan: Mengetahui proporsi dan profil pasien yang masih tetap berobat di UPT
HIV RSCM.
Metode: Studi dengan metode potong lintang pada pasien HIV yang baru
terdiagnosis dan berobat di UPT HIV RSUPNCM dalam periode Januari 2004 -
Desember 2013. Data diperoleh melalui ekstraksi data sekunder yang berasal dari
rekam medik. Penelitian dilakukan terhadap pasien HIV yang berusia diatas 18
tahun dan belum menjalani terapi ARV. Pasien yang tetap berobat sampai akhir
2014 didefinisikan sebagai pasien yang tetap kontrol ke poliklinik sejak awal pasien
datang ke UPT HIV hingga minimal tiga bulan sebelum akhir Desember 2014.
Hasil: Sebanyak 4949 subjek diikutkan dalam penelitian ini. Didapatkan proporsi
pasien yang tetap berobat sampai akhir 2014 adalah 23% (1136 subjek). Selain itu,
subjek dengan jenis kelamin wanita (26,6%), berusia ≥35 tahun (usia 35-44 tahun
sebesar 25,5% dan ≥45 tahun sebesar 35,5%), pendidikan terakhir diatas SMU
(26,8%), menikah/dengan pasangan (25%), beralamat di Bodetabek (26,1%),
stadium klinis IV (28,3%), memiliki angka CD4 awal 201-350 sel/mm3 (35%), dan
bukan penasun (28%) adalah subjek terbanyak yang tetap berobat sampai akhir
2014.
Simpulan: Proporsi pasien yang tetap berobat sampai akhir 2014 adalah 23% (1136
subjek). Selain itu, pasien dengan jenis kelamin wanita, berusia ≥35 tahun,
pendidikan terakhir diatas SMU, menikah/tinggal dengan pasangan, beralamat di
Bodetabek, stadium klinis IV, memiliki angka CD4 awal 201-350 sel/mm3, dan
bukan penasun merupakan kelompok subjek terbanyak yang tetap berobat sampai akhir 2014.ABSTRACT
Background: Continued medical treatment serves an important role in the
successful management of patients with HIV. Until this present day, there has never
been any research which seeks to examine the proportion of patients who continue
their medical treatment at HIV Integrated Service Unit of National Central General
Hospital Cipto Mangunkusumo (RSUPNCM) and the profiles of those patients.
Objectives: To discover the proportion and to generate the profiles of patients who
continued their medical treatment at HIV Integrated Service Unit, RSUPNCM.
Methods: This research was conducted by applying the cross-sectional method on
patients who were diagnosed with HIV and were subsequently undergoing medical
treatment at HIV Integrated Service Unit, RSUPNCM, during the period of January
2004 to December 2013. Data were obtained by extracting secondary data in the
form of medical records. The subjects of the research are HIV patients who are
more than 18 years of age and have not undergone anti-retroviral (ARV) treatments.
Patients who continued their medical treatment until the end of 2014 are defined as
patients who have undergone medical treatment at the polyclinic starting from their
first visit to HIV Integrated Service Unit until at least three months prior to the end
of December 2014.
Results: As many as 4949 subjects participated in this research. We found that the
proportion of patients who continued their medical treatment until the end of 2014
is 23% (1136 subjects). In addition to that, we also found that female subjects
(26.6%) who are ≥35 years of age (25.5% for those between 35 and 44 years of age
and 35.5% for those ≥45 years of age); whose education is higher than Senior High
School level (26.8%); who have married or live with their respective partners
(25%); who reside in Bogor, Depok, Tangerang, or Bekasi areas (26.1%); who have
reached clinical stage IV (28.3%); whose initial CD4 count is 201?350 cells/mm
3
(35%); and who are not injecting drug users (IDUs) (28%) constitute the largest
group of subjects who continued their medical treatment until the end of 2014.
Conclusion: The proportion of patients who continued their medical treatment until
the end of 2014 is 23% (1136 subjects). In addition to that, female patients who are
≥35 years of age; whose education is higher than Senior High School level; who
have married or live with their respective partners; who reside in Bogor, Depok,
Tangerang, or Bekasi areas; who have reached clinical stage IV (28.3%); whose
initial CD4 count is 201?350 cells/mm
3
, and who are not injecting drug users
(IDUs) constitute the largest group of subjects who continued their medical
treatment until the end of 2014.;Background: Continued medical treatment serves an important role in the
successful management of patients with HIV. Until this present day, there has never
been any research which seeks to examine the proportion of patients who continue
their medical treatment at HIV Integrated Service Unit of National Central General
Hospital Cipto Mangunkusumo (RSUPNCM) and the profiles of those patients.
Objectives: To discover the proportion and to generate the profiles of patients who
continued their medical treatment at HIV Integrated Service Unit, RSUPNCM.
Methods: This research was conducted by applying the cross-sectional method on
patients who were diagnosed with HIV and were subsequently undergoing medical
treatment at HIV Integrated Service Unit, RSUPNCM, during the period of January
2004 to December 2013. Data were obtained by extracting secondary data in the
form of medical records. The subjects of the research are HIV patients who are
more than 18 years of age and have not undergone anti-retroviral (ARV) treatments.
Patients who continued their medical treatment until the end of 2014 are defined as
patients who have undergone medical treatment at the polyclinic starting from their
first visit to HIV Integrated Service Unit until at least three months prior to the end
of December 2014.
Results: As many as 4949 subjects participated in this research. We found that the
proportion of patients who continued their medical treatment until the end of 2014
is 23% (1136 subjects). In addition to that, we also found that female subjects
(26.6%) who are ≥35 years of age (25.5% for those between 35 and 44 years of age
and 35.5% for those ≥45 years of age); whose education is higher than Senior High
School level (26.8%); who have married or live with their respective partners
(25%); who reside in Bogor, Depok, Tangerang, or Bekasi areas (26.1%); who have
reached clinical stage IV (28.3%); whose initial CD4 count is 201?350 cells/mm
3
(35%); and who are not injecting drug users (IDUs) (28%) constitute the largest
group of subjects who continued their medical treatment until the end of 2014.
Conclusion: The proportion of patients who continued their medical treatment until
the end of 2014 is 23% (1136 subjects). In addition to that, female patients who are
≥35 years of age; whose education is higher than Senior High School level; who
have married or live with their respective partners; who reside in Bogor, Depok,
Tangerang, or Bekasi areas; who have reached clinical stage IV (28.3%); whose
initial CD4 count is 201?350 cells/mm
3
, and who are not injecting drug users
(IDUs) constitute the largest group of subjects who continued their medical
treatment until the end of 2014.;Background: Continued medical treatment serves an important role in the
successful management of patients with HIV. Until this present day, there has never
been any research which seeks to examine the proportion of patients who continue
their medical treatment at HIV Integrated Service Unit of National Central General
Hospital Cipto Mangunkusumo (RSUPNCM) and the profiles of those patients.
Objectives: To discover the proportion and to generate the profiles of patients who
continued their medical treatment at HIV Integrated Service Unit, RSUPNCM.
Methods: This research was conducted by applying the cross-sectional method on
patients who were diagnosed with HIV and were subsequently undergoing medical
treatment at HIV Integrated Service Unit, RSUPNCM, during the period of January
2004 to December 2013. Data were obtained by extracting secondary data in the
form of medical records. The subjects of the research are HIV patients who are
more than 18 years of age and have not undergone anti-retroviral (ARV) treatments.
Patients who continued their medical treatment until the end of 2014 are defined as
patients who have undergone medical treatment at the polyclinic starting from their
first visit to HIV Integrated Service Unit until at least three months prior to the end
of December 2014.
Results: As many as 4949 subjects participated in this research. We found that the
proportion of patients who continued their medical treatment until the end of 2014
is 23% (1136 subjects). In addition to that, we also found that female subjects
(26.6%) who are ≥35 years of age (25.5% for those between 35 and 44 years of age
and 35.5% for those ≥45 years of age); whose education is higher than Senior High
School level (26.8%); who have married or live with their respective partners
(25%); who reside in Bogor, Depok, Tangerang, or Bekasi areas (26.1%); who have
reached clinical stage IV (28.3%); whose initial CD4 count is 201?350 cells/mm
3
(35%); and who are not injecting drug users (IDUs) (28%) constitute the largest
group of subjects who continued their medical treatment until the end of 2014.
Conclusion: The proportion of patients who continued their medical treatment until
the end of 2014 is 23% (1136 subjects). In addition to that, female patients who are
≥35 years of age; whose education is higher than Senior High School level; who
have married or live with their respective partners; who reside in Bogor, Depok,
Tangerang, or Bekasi areas; who have reached clinical stage IV (28.3%); whose
initial CD4 count is 201?350 cells/mm
3
, and who are not injecting drug users
(IDUs) constitute the largest group of subjects who continued their medical
treatment until the end of 2014.;Background: Continued medical treatment serves an important role in the
successful management of patients with HIV. Until this present day, there has never
been any research which seeks to examine the proportion of patients who continue
their medical treatment at HIV Integrated Service Unit of National Central General
Hospital Cipto Mangunkusumo (RSUPNCM) and the profiles of those patients.
Objectives: To discover the proportion and to generate the profiles of patients who
continued their medical treatment at HIV Integrated Service Unit, RSUPNCM.
Methods: This research was conducted by applying the cross-sectional method on
patients who were diagnosed with HIV and were subsequently undergoing medical
treatment at HIV Integrated Service Unit, RSUPNCM, during the period of January
2004 to December 2013. Data were obtained by extracting secondary data in the
form of medical records. The subjects of the research are HIV patients who are
more than 18 years of age and have not undergone anti-retroviral (ARV) treatments.
Patients who continued their medical treatment until the end of 2014 are defined as
patients who have undergone medical treatment at the polyclinic starting from their
first visit to HIV Integrated Service Unit until at least three months prior to the end
of December 2014.
Results: As many as 4949 subjects participated in this research. We found that the
proportion of patients who continued their medical treatment until the end of 2014
is 23% (1136 subjects). In addition to that, we also found that female subjects
(26.6%) who are ≥35 years of age (25.5% for those between 35 and 44 years of age
and 35.5% for those ≥45 years of age); whose education is higher than Senior High
School level (26.8%); who have married or live with their respective partners
(25%); who reside in Bogor, Depok, Tangerang, or Bekasi areas (26.1%); who have
reached clinical stage IV (28.3%); whose initial CD4 count is 201?350 cells/mm
3
(35%); and who are not injecting drug users (IDUs) (28%) constitute the largest
group of subjects who continued their medical treatment until the end of 2014.
Conclusion: The proportion of patients who continued their medical treatment until
the end of 2014 is 23% (1136 subjects). In addition to that, female patients who are
≥35 years of age; whose education is higher than Senior High School level; who
have married or live with their respective partners; who reside in Bogor, Depok,
Tangerang, or Bekasi areas; who have reached clinical stage IV (28.3%); whose
initial CD4 count is 201?350 cells/mm
3
, and who are not injecting drug users
(IDUs) constitute the largest group of subjects who continued their medical
treatment until the end of 2014.;Background: Continued medical treatment serves an important role in the
successful management of patients with HIV. Until this present day, there has never
been any research which seeks to examine the proportion of patients who continue
their medical treatment at HIV Integrated Service Unit of National Central General
Hospital Cipto Mangunkusumo (RSUPNCM) and the profiles of those patients.
Objectives: To discover the proportion and to generate the profiles of patients who
continued their medical treatment at HIV Integrated Service Unit, RSUPNCM.
Methods: This research was conducted by applying the cross-sectional method on
patients who were diagnosed with HIV and were subsequently undergoing medical
treatment at HIV Integrated Service Unit, RSUPNCM, during the period of January
2004 to December 2013. Data were obtained by extracting secondary data in the
form of medical records. The subjects of the research are HIV patients who are
more than 18 years of age and have not undergone anti-retroviral (ARV) treatments.
Patients who continued their medical treatment until the end of 2014 are defined as
patients who have undergone medical treatment at the polyclinic starting from their
first visit to HIV Integrated Service Unit until at least three months prior to the end
of December 2014.
Results: As many as 4949 subjects participated in this research. We found that the
proportion of patients who continued their medical treatment until the end of 2014
is 23% (1136 subjects). In addition to that, we also found that female subjects
(26.6%) who are ≥35 years of age (25.5% for those between 35 and 44 years of age
and 35.5% for those ≥45 years of age); whose education is higher than Senior High
School level (26.8%); who have married or live with their respective partners
(25%); who reside in Bogor, Depok, Tangerang, or Bekasi areas (26.1%); who have
reached clinical stage IV (28.3%); whose initial CD4 count is 201?350 cells/mm
3
(35%); and who are not injecting drug users (IDUs) (28%) constitute the largest
group of subjects who continued their medical treatment until the end of 2014.
Conclusion: The proportion of patients who continued their medical treatment until
the end of 2014 is 23% (1136 subjects). In addition to that, female patients who are
≥35 years of age; whose education is higher than Senior High School level; who
have married or live with their respective partners; who reside in Bogor, Depok,
Tangerang, or Bekasi areas; who have reached clinical stage IV (28.3%); whose
initial CD4 count is 201?350 cells/mm
3
, and who are not injecting drug users
(IDUs) constitute the largest group of subjects who continued their medical
treatment until the end of 2014."
Fakultas Kedokteran Universitas Indonesia, 2015
SP-PDF
UI - Tugas Akhir  Universitas Indonesia Library
cover
Jerry Nasarudin
Prevalensi kejadian resistensi rifampisin pada pasien TB HIV dan faktor faktor yang mempengaruhi = Prevalence of rifampicin resistance in TB HIV patients and its contributing factors
"ABSTRAK
Latar belakang : Pasien HIV berisiko 20-37 kali lipat terinfeksi TB, dan TB
merupakan penyebab kematian tertinggi pada HIV. Resistensi OAT menjadi
masalah utama dalam pengobatan TB terutama pada pasien HIV, hal ini berujung
pada peningkatan mortalitas dan biaya. Rifampisin merupakan OAT utama,
dibuktikan dengan kesembuhan yang rendah pada regimen tanpa rifampisin,
sehingga perlu diketahui prevalensi resistensi rifampisin dan faktor-faktor yang
mempengaruhi pada pasien TB-HIV.
Tujuan : Mengetahui prevalensi resistensi rifampisin pada pasien TB-HIV dan
faktor-faktor yang mempengaruhi.
Metode : Studi potong lintang terhadap 196 pasien TB-HIV yang menjalani
pemeriksaan Xpert MTB-RIF di poli pelayanan terpadu HIV RSUPN Cipto
Mangunkusumo selama tahun 2012-2015. Analisa bivariat untuk mengetahui
hubungan faktor-faktor dengan kejadian resistensi rifampisin. Analisa multivariat
menggunakan uji regresi logistik.
Hasil dan Pembahasan : Pada 196 pasien yang menjadi subjek penelitian,
didapatkan prevalensi resistensi rifampisin sebesar 13,8%. Usia, jenis kelamin,
riwayat penggunaan ARV, dan TB ekstra paru tidak berhubungan dengan
kejadian resistensi rifampisin pada TB-HIV. CD4 < 100 mempengaruhi kejadian
resistensi rifampisin (OR 2,57; 95% IK 0,99-6,69), Riwayat pengobatan TB
mempengaruhi kejadian resistensi rifampisn (OR 3,98; 95% IK 1,68-9,44).
Kesimpulan : Prevalensi resistensi rifampisin TB-HIV di RSUPN Cipto
Mangunkusumo sebesar 13,8%. Riwayat TB mempengaruhi kejadian resistensi rifampisin pada pasien TB-HIV. ABSTRACT
Background: HIV patients have 20-37 fold risk of getting TB infection and TB is
the leading cause of death among them. Anti tuberculosis drug resistance is a
major problem in the treatment of tuberculosis with rifampicin as one of the main
drug. We need more information about prevalence of rifampicin resistance and its
contributing factors in TB-HIV patients.
Aim: To determine the prevalence of rifampicin resistance in TB-HIV patients
and its contributing factors.
Method : A cross sectional study of 196 TB-HIV patients who underwent Xpert
MTB/RIF examination at Cipto Mangunkusumo Hospital during the year 20122105.
Correlation
between
prevalence
of
rifampicin
resistance
and
its
contributing
factors
was done using bivariate analysis. Multivariate analysis was done using
logistic regression test.
Result and Discussion : From 196 patients, we found prevalence of 13,8%
rifampicin resistance. CD4 < 100 affects the incidence of rifampicin resistance
(OR2.5;95% CI 0.99-6.69). Hiistory of TB treatment affects the incidence of
rifampicin resistance (OR3.98;95%CI 1.68-9.44).
Conclusion : Prevalence of rifampicin resistance in TB-HIV patients in Cipto
Mangunkusumo Hospital is 13.8%. History of TB treatment affects the incidence
of rifampicin resistance in TB-HIV patients. ;Background: HIV patients have 20-37 fold risk of getting TB infection and TB is
the leading cause of death among them. Anti tuberculosis drug resistance is a
major problem in the treatment of tuberculosis with rifampicin as one of the main
drug. We need more information about prevalence of rifampicin resistance and its
contributing factors in TB-HIV patients.
Aim: To determine the prevalence of rifampicin resistance in TB-HIV patients
and its contributing factors.
Method : A cross sectional study of 196 TB-HIV patients who underwent Xpert
MTB/RIF examination at Cipto Mangunkusumo Hospital during the year 20122105.
Correlation
between
prevalence
of
rifampicin
resistance
and
its
contributing
factors
was done using bivariate analysis. Multivariate analysis was done using
logistic regression test.
Result and Discussion : From 196 patients, we found prevalence of 13,8%
rifampicin resistance. CD4 < 100 affects the incidence of rifampicin resistance
(OR2.5;95% CI 0.99-6.69). Hiistory of TB treatment affects the incidence of
rifampicin resistance (OR3.98;95%CI 1.68-9.44).
Conclusion : Prevalence of rifampicin resistance in TB-HIV patients in Cipto
Mangunkusumo Hospital is 13.8%. History of TB treatment affects the incidence
of rifampicin resistance in TB-HIV patients. ;Background: HIV patients have 20-37 fold risk of getting TB infection and TB is
the leading cause of death among them. Anti tuberculosis drug resistance is a
major problem in the treatment of tuberculosis with rifampicin as one of the main
drug. We need more information about prevalence of rifampicin resistance and its
contributing factors in TB-HIV patients.
Aim: To determine the prevalence of rifampicin resistance in TB-HIV patients
and its contributing factors.
Method : A cross sectional study of 196 TB-HIV patients who underwent Xpert
MTB/RIF examination at Cipto Mangunkusumo Hospital during the year 20122105.
Correlation
between
prevalence
of
rifampicin
resistance
and
its
contributing
factors
was done using bivariate analysis. Multivariate analysis was done using
logistic regression test.
Result and Discussion : From 196 patients, we found prevalence of 13,8%
rifampicin resistance. CD4 < 100 affects the incidence of rifampicin resistance
(OR2.5;95% CI 0.99-6.69). Hiistory of TB treatment affects the incidence of
rifampicin resistance (OR3.98;95%CI 1.68-9.44).
Conclusion : Prevalence of rifampicin resistance in TB-HIV patients in Cipto
Mangunkusumo Hospital is 13.8%. History of TB treatment affects the incidence
of rifampicin resistance in TB-HIV patients. "
Fakultas Kedokteran Universitas Indonesia, 2016
SP-PDF
UI - Tugas Akhir  Universitas Indonesia Library
cover
Birry Karim
Korelasi perubahan kadar CD4, kadar viral load dan indeks massa tubuh terhadap perubahan ketebalan tunika intima media arteri karotis pada pasien HIV na ve yang mendapat terapi antiretroviral = Correlation of changes in cd4 levels, viral load levels and body mass index on changes in thickness of intima tunica in carotid artery media in hiv-na ve patients receiving antiretroviral therapy
"Latar Belakang: Human immuno deficiency virus/ Acquired Immune Deficiency Syndrome HIV/AIDS merupakan masalah global yang menunjukkan adanya keterkaitan antara kasus HIV/AIDS dengan adanya kejadian aterosklerosis sebagai pemicu terjadinya kasus Penyakit Jantung Koroner PJK . Pemberian Antiretroviral ARV tersebut juga berisiko untuk kejadian PJK melalui mekanisme dislipidemia, lipodistrofi, resistensi insulin dan gangguan hati, yang juga bisa menyebabkan penebalan tunika intima media.Tujuan: Mendapatkan korelasi perubahan kadar CD 4, kadar viral load dan Indeks Massa Tubuh terhadap perubahan ketebalan tunika intima media arteri karotis pada pasien HIV yang mendapat ARV lini pertama selama 12 bulanMetode: Penelitian ini merupakan studi uji korelasi terhadap 54 pasien HIV yang menggunakan data sekunder penelitian JACCANDO PROJECT. Data yang digunakan adalah data USG doppler arteri karotis, hasil CD 4, hasil viral load dan hasil Indeks Massa Tubuh IMT .Hasil: Median CD 4 sebelum pemberian ARV ialah 68 sel/ l, sedangkan median CD 4 sesudah pemberian ARV 286,5 sel/ l. Median kadar viral load sebelum ARV sebesar 1.79 log10 copy/ml, sedangkan median viral load sesudah ARV yaitu 0 log10 copy/ml. Median IMT sebelum ARV 19.6, sedangkan median sesudah 12 bulan ARV 19.72. Rerata tunika intima media arteri karotis kiri sebelum dan sesudah pemberian ARV selama 12 bulan ialah 0.58 dan 0.63 dengan p-value 0.031. Korelasi perubahan kadar CD 4 dengan ketebalan tunika intima media arteri karotis kanan r= 0.08, p=0,58 , dan kiri r= 0.01, p=0,965 . Korelasi perubahan kadar viral load dengan ketebalan tunika intima media arteri karotis kanan r= 0.09, p=0,54 dan arteri karotis kiri r= 0.06, p=0,66 . Korelasi perubahan kadar IMT dengan perubahan ketebalan tunika intima kanan r= - 0.11, p=0,37 dan kiri r= -0.18, p=0,19 .Simpulan: Ketebalan tunika intima mengalami peningkatan antara sebelum dan sesudah pengobatan antiretroviral, namun tidak didapatkan korelasi antara kadar CD4, Viral load dan indeks massa tubuh dengan ketebalan tunika intima arteri karotis.
Background Human immuno deficiency virus Acquired Immune Deficiency Syndrome HIV AIDS is currently a global issue related with coronary artery disease. The effects of antiretroviral ARV is accompanied with some negative features such as dyslipidemia, lipodystrophy, insulin resistance and liver dysfunction which all contribute to increasing tunima intima thickness.Objective To acquire correlation between level of CD4, viral load, and Body Mass Index BMI with changes in tunica intima of carotid artery thickness in HIV patients receiving first line ARV for 12 monthsMethods This study is a correlation study involving 54 HIV patients using secondary data from the JACCANDO PROJECT research data such as Doppler ultrasound of the carotid artery, CD4 values, viral load as well as BMI.Results Median CD before antiretroviral treatment was 68 cells l, median CD 4 after ARV 286.5 cell l. The median viral load rate before ARV was 1.79 log10 copy ml, while median viral load after ARV was 0 log10 copy ml. The median BMI before ARV was 19.6, while median after 12 months of ARV was 19.72. The mean of the left artery carotid artery intima media before and after ARV administration for 12 months was 0.58 and 0.63 with p value 0.031. Correlation of changes in CD4 levels with the thickness of tunica intima medium of right carotid artery r 0.08, p 0,58 , and left r 0.01, p 0,965 . Correlation of changes in viral load levels with the tunica thickness of the right carotid artery medium r 0.09, p 0,54 and left carotid artery r 0.06, p 0.66 . Correlation of changes in BMI levels with changes in thickness of the right tunica intima r 0.11, p 0.37 and left carotid artery r 0.18, p 0.19 .Conclusion The thickness of intima tunica increased after antiretroviral treatment, but no correlation found between CD4, viral load and BMI level with the thickness of the intima tunica carotid artery."
Depok: Fakultas Kedokteran Universitas Indonesia, 2018
T-Pdf
UI - Tesis Membership  Universitas Indonesia Library
cover
Indria Yogani
Faktor-faktor yang berhubungan dengan kenaikan CD4 pada pasien HIV yang mendapat highly active antiretoviral therapy dalam 6 bulan pertama = Factors associated with increase in CD4 count in HIV patient who received highly active antiretroviral therapy in the first six months
"Latar Belakang: HIV adalah infeksi yang menyerang sistem kekebalan tubuh, dengan CD4 sebagai sel targetnya. Dengan ditemukannya Highly Active Antiretroviral Therapy (HAART) diharapkan mampu menurunkan angka morbiditas dan mortalitasnya dengan cara mengurangi replikasi virus HIV dan meningkatkan jumlah CD4. Namun kenaikan CD4 tidak sama untuk setiap pasien. Terdapat faktor lain yang berhubungan dengan kenaikan CD4 pada pasien HIV.
Tujuan: Mengetahui hubungan antara usia, jenis kelamin, indeks massa tubuh, faktor risiko infeksi HIV, jumlah CD4 awal, jumlah infeksi opportunistik, stadium klinis HIV, jenis HAART yang diberikan, kepatuhan minum obat, infeksi tuberkulosis, hepatitis C, infeksi HSV, infeksi CMV, dan obat herbal dengan kenaikan CD4 dalam 6 bulan pertama setelah pemberian HAART.
Metode: Studi kohort retrospektif dilakukan pada pasien HIV rawat jalan di Unit Pelayanan Terpadu HIV RSUPN Cipto Mangunkusumo dalam kurun waktu Januari 2004-Desember 2013. Data penelitian didapatkan dari rekam medis. Hubungan antara usia, indeks massa tubuh, dan jumlah CD4 awal dengan kenaikan CD4 dianalisis dengan uji beda dua rerata menggunakan Uji Mann Whitney. Sedangkan hubungan antara jenis kelamin, faktor risiko infeksi HIV, jumlah infeksi opportunistik, stadium klinis HIV, jenis HAART yang digunakan, kepatuhan minum obat, infeksi tuberkulosis, hepatitis C, infeksi HSV, CMV, dan obat herbal dengan kenaikan CD4 dianalisis dengan uji perbedaan dua kelompok kategorik (Uji Chi Square atau Fisher) serta analisis multivariat dengan teknik regresi logistik.
Hasil: Sebanyak 818 subjek diikutsertakan pada penelitian ini. Sebanyak 368 (45%) subjek tidak mengalami kenaikan CD4 seperti yang diharapkan. Median CD4 awal sebelum terapi 56 sel/mm3 dan setelah 6 bulan terapi 130 sel/mm3. Terdapat hubungan yang bermakna antara jumlah CD4 awal (p<0,001), infeksi tuberkulosis (p=0,010) dan tingkat kepatuhan (p<0,001) dengan kenaikan CD4. Hasil analisis multivariat didapatkan bahwa jumlah CD4 awal (p<0,001; OR: 0,996; IK 95% 0,995-0,998), tidak patuh minum obat (p<0,001; OR:2,907; IK 95%: 2,162-3,909), dan infeksi tuberkulosis (p=0,021; OR: 1,527; IK 95%: 1,065-2,190) berhubungan dengan kenaikan CD4 pada pasien HIV yang mendapat HAART.
Simpulan: Jumlah CD4 awal, kepatuhan minum obat, dan infeksi tuberkulosis mempengaruhi kenaikan CD4 pada pasien HIV yang mendapat Highly Active Antiretroviral Therapy setelah 6 bulan pertama.
Background: HIV infection attacked immune system causing immunodeficiency with CD4 as a targel cell. Highly Active Antiretroviral Therapy given to reduce HIV replications and increased CD4 counts. The increasing of CD4 count is different among each patient. There were several factors associated with the increased of CD4 count after first six months therapy.
Objectives: To prove that age, gender, body mass index, risk factor of HIV infection, CD4 pre HAART, number of opportunistic infections, HIV stadium, type of HAART, adherence, Tuberculosis infection, co-infection Hepatitis C, HSV infection, CMV infection, use of herb associated with the increased of CD4 count.
Methods: Retrospective cohort study conducted in this study, among out patient in Integrated HIV Clinic In Cipto Mangunkusumo General Refferal Hospital between January 2004-December 2013. The data of this study were taken from medical records. For age, body mass index, and CD4 pre HAART associated with the increased of CD4 were analyze using Mann Whitney Test. For variable gender, risk factor for HIV infection, number of opportunistic infections, HIV stadium, type of HAART, adherence, Tuberculosis infection, co-infection of Hepatitis C, HCV infection, CMV infection, and use of herb associated with the increased of CD4 analyze using Chi Square test of Fisher test and for multivariate analysis the logistic regression test.
Results: 818 subjects met the inclusion criteria. 368 subject did not meet the expected CD4 count. The median of CD4 pre HAART was 56 cell/mm3, and after six months therapy was 130 cell/mm3. There was significant correlation between CD4 pre HAART (p<0,001), tuberculosis infection (p=0,010), and adherence with the increasing of CD4 count (p<0,001). From the multivariate analysis, shown that CD4 pre HAART (p<0,001; OR: 0,996; IK 95% 0,995-0,998), not adherence (p<0,001; OR:2,907; IK 95%: 2,162-3,909), and tuberculosis infection (p=0,021; OR: 1,527; IK 95%: 1,065-2,190) associated with the increased of CD4 count after six months therapy.
Conclusion: Adherence, CD4 pre HAART, and Tuberculosis infection were associated with the increasing of CD4 count in HIV patient who received HAART in the first six months therapy."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2014
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Dwi Rahayu Nur Laila Praptiwi
Faktor-faktor yang berhubungan dengan tertundanya inisiasi terapi antiretroviral pada pasien dengan infeksi human immunodeficiency virus = Factors associated with delayed initiation of antiretroviral therapy in human immunodeficiency virus infected patients
"Latar Belakang: Cakupan pemberian obat antiretroviral (ARV) yang semakin luas berdampak positif dengan menurunnya angka kematian dan kesakitan pasien HIV/AIDS. Waktu inisiasi pemberian terapi ARV pada pasien HIV juga berhubungan erat dengan penurunan angka kematian dan kesakitan. Tertundanya inisiasi terapi ARV pada pasien HIV menyebabkan angka kematian yang lebih tinggi yaitu 10% dibanding yang tidak tertunda. Faktor-faktor yang berhubungan dengan tertundanya inisiasi terapi ARV penting untuk diketahui sehingga dapat dilakukan upaya pengendalian terhadap faktor-faktor tersebut sehingga dapat menurunkan angka kesakitan dan kematian pada pasien HIV.
Tujuan: Mengetahui faktor-faktor yang berhubungan dengan tertundanya inisiasi terapi ARV pada pasien HIV.
Metode: Penelitian ini merupakan studi potong lintang pada pasien HIV rawat jalan dewasa di UPT/HIV RSUPNCM yang memulai ARV pertama kali selama periode Januari 2013-Desember 2014. Data klinis dan laboratorium didapatkan dari rekam medis pasien. Tertundanya inisiasi terapi ARV dinyatakan bila pasien belum memulai terapi ARV 10 minggu setelah diagnosis HIV. Faktor-faktor yang diteliti adalah jenis kelamin, status pernikahan, tingkat pendidikan, pekerjaan, Indeks Massa Tubuh (IMT), status fungsional, stadium klinis HIV, dan infeksi oportunistik. Uji regresi logistik digunakan untuk mengetahui hubungan faktor-faktor tersebut dengan tertundanya inisiasi terapi ARV.
Hasil: Terdapat 444 pasien yang memulai terapi ARV pertama kali, 107 pasien (24,1%) yang tertunda inisiasi terapi ARV dan 337 pasien (75,9%) tidak tertunda. Berdasarkan hasil analisis bivariat didapatkan 3 variabel yang memiliki kemaknaan statistik yaitu stadium klinis lanjut (p<0,001), status fungsional rendah (p<0,001) dan adanya infeksi oportunistik (p<0,001). Pada analisis multivariat lebih lanjut terdapat dua variabel yang berhubungan dengan tertundanya inisiasi terapi ARV pada pasien HIV yaitu stadium klinis lanjut (OR: 2,92, IK95% 1,53-7,40, p=0,02) dan adanya infeksi oportunistik (OR 1,99, IK95% 1,21-3,29, p=0,01).
Simpulan: Stadium klinis lanjut menurut WHO dan adanya infeksi oportunistik merupakan faktor-faktor yang berhubungan dengan tertundanya inisiasi terapi ARV pada pasien HIV.
Background: Increase access towards antiretroviral therapy (ART) contribute to global decrease of HIV/AIDS-associated morbidity and mortality. Time to initiation of ART in eligible HIV-infected patients is associated with reduction of mortality and morbidity. Delayed initiation of antiretroviral therapy can lead to increase of mortality rate more than 10% compared to early initiation. It is important to identify factors associated with delayed initiation ART among HIV patient in order to control these factors and thus lower the mortality and morbidity in HIV patients.
Objectives: To identify factors associated with delayed initiation of ART in HIV patients.
Methods: This study was a cross sectional study among adult HIV patients in Out-patient Clinic of HIV Integrated Clinic Cipto Mangunkusumo General Hospital who started ARV therapy for the first time (ART-naïve patients) enrolled from January 2013 to December 2014. Clinical and laboratory data were extracted from medical records. Delayed initiation ART was defined as eligible patients didn?t initiate ART within 10 weeks after the diagnosis of HIV infection. Factors identified were gender, education level, employment, marital status, WHO clinical stage, BMI, functional status, and the presence of opportunistic infection. Logistic regression test was used to find factors associated with delayed initiation of ART.
Results: There were 444 subjects in this study, which consisted of 107 patients (24.1%) who delayed initiation of ART and 337 patients (75.9%) who didn?t delayed initiation of ART. Based on the bivariate analysis, there were three variables statistically significance, which were advanced WHO clinical stage (p<0.001), lower functional status (p<0.001) and the presence of opportunistic infection (p<0.001). Further multivariate analysis showed that there were two variables associated with delayed initiation of ART, which were advanced WHO clinical stage (OR: 2.92, 95%CI 1.53-7.40, p=0.02) and the presence of opportunistic infection (OR 1.99, 95%CI 1.21-3.29, p=0.01).
Conclusion: Advanced WHO clinical stage and the presence of opportunistic infections are factors associated with delayed initiation of ART among HIV patients."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2015
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Maryatun
Faktor-faktor prediktor terjadinya reaksi hipersensitivitas obat nevirapin dan efavirenz pada pasien HIV/AIDS di Rumah Sakit Cipto Mangunkusumo = Predictors of hypersentivity reaction of nevirapine and evafirenz among HIV/AIDS patients in RSCM
"Latar Belakang: Penggunaan terapi antiretroviral (ARV) dapat menurunkan morbiditas dan mortalitas penderita HIV/AIDS. Namun penggunaan ARV juga sering menimbulkan reaksi hipersensitivitas dalam berbagai manifestasi dan gradasi, mulai dari yang ringan sampai potensial mengancam nyawa. Pemahaman tentang prediktor kejadian reaksi hipersensitivitas dapat membantu klinisi dalam menatalaksana pasien HIV/AIDS sehingga memberikan luaran klinis yang lebih baik.
Tujuan: Mengetahui faktor-faktor prediktor terjadinya reaksi hipersensitivitas pada penggunaan obat nevirapin dan efavirenz pada penderita HIV/AIDS di Rumah Sakit Cipto Mangunkusumo.
Metode: Penelitian ini merupakan studi kohort retrospektif pada pasien HIV/AIDS rawat jalan di UPT HIV RSCM selama Januari 2004 sampai Desember 2013. Status demografik, data klinis dan laboratorium diperoleh dari rekam medis. Analisis bivariat menggunakan uji Chi-Square dilakukan pada prediktor dengan data nominal dan Uji Mann Whitney pada prediktor dengan data numerik. Adanya data yang tidak lengkap diatasi dengan teknik multiple imputation. Semua variabel yang memenuhi syarat akan dilanjutkan dengan analisis multivariat menggunakan regresi logistik.
Hasil: Total subjek yang mendapat terapi ARV baik sebagai terapi pertama kali (naïve patient) atau substitusi pada kelompok nevirapin berjumlah 2.071 subjek dan efavirenz 1.212 subjek. Insiden terjadinya reaksi hipersensitivitas terkait penggunaan nevirapin dan efavirenz adalah sebesar 14%, dan 4,5%. Insiden kejadian reaksi hipersensitivitas silang adalah 5%. Prediktor reaksi hipersensitivitas yang bermakna pada analisis multivariat adalah prediktor terkait penggunaan nevirapin, yaitu jenis kelamin perempuan (OR=1,622; IK95% 1,196-2,199; p=0,002), CD4+ awal >200 sel/mm3 (OR=1,387; IK95% 1,041-1,847; p=0,025), koinfeksi dengan hepatitis C (OR=1,507; IK95% 1,138-1,995; p=0,004), dan kadar SGPT awal >1,25 kali batas atas nilai normal (OR=1,508; IK95% 0,998-2,278; p=0,051). Sedangkan prediktor reaksi hipersensitivitas terkait penggunaan efavirenz tidak ada yang memiliki kemaknaaan secara statistik.
Simpulan: Jenis kelamin perempuan, jumlah CD4+ awal >200 sel/mm3, koinfeksi dengan hepatitis C dan kadar SGPT awal yang abnormal merupakan prediktor independen terjadinya reaksi hipersensitivitas terkait penggunaan nevirapin pada pasien HIV/AIDS.
Background: ARV therapy decreases morbidity and mortality in AIDS/HIV patients. Beside its benefits, ARV therapy induces hypersensitivity reactions manifesting in various level of severity from mild to life threatening symptoms. Understanding the predictors of hypersensitivity reaction will help clinicians to manage HIV/AIDS patients particularly in anticipating the risks that will give better clinical outcomes.
Objectives: To determine the predictors of hypersensitivity reactions in nevirapine and efavirenz administration among HIV/AIDS patients in RSCM .
Methods: This is a cohort retrospective study in patients with HIV/AIDS in UPT HIV RSCM during January 2004 to December 2013. Demographic status, clinical and laboratory data are obtained from medical records. Bivariate analysis using Chi-Square test performed on nominal data and Mann Whitney test on numeric data. Incomplete data is resolved by multiple imputation techniques. All eligible variables analyzed with multivariate analysis using logistic regression.
Results: There are 2.071 naïve patients or substitution regiment in nevirapine group and 1.212 subjects in efavirenz group. Hypersensitivity reaction incidence in nevirapine and evafirenz group are 14% and 4.5% consecutively. Cross hypersensitivity reaction incidence between these drugs is 5%. Hypersentivity reaction predictors associated with nevirapine administration are female gender (OR=1,622; 95%CI 1,196-2,199; p=0,002), baseline CD4+ absolute count >200 cells/mm3 (OR=1,387; 95%CI 1,041-1,847; p=0,025), hepatitis C coinfection (OR=1,507; 95%CI 1,138-1,995; p=0,004), and baseline ALT level > 1.25 x ULN (OR=1,508; 95%CI 0,998-2,278; p=0,051), but there is no predictors associated statistically significant with efavirenz hypersensitivity reaction.
Conclusion: Female gender, baseline CD4 absolute count >200 cells/mm3, hepatitis C coinfection and baseline ALT level > 1.25 x ULN are independent predictors for hypersensitivity reaction due to nevirapine usage in HIV/AIDS."
Depok: Universitas Indonesia, 2015
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UI - Tesis Membership  Universitas Indonesia Library