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"Disertasi ini membahas hubungan varian genotip alel G gen CD209 titik promoter -336 terhadap kejadian Infeksi oportunistik TB Paru Pada ODHA, dengan rancangan potong lintang. Data infeksi oportunistik TB Paru  diperoleh dari catatan rekam medik RSPI Sulianti Saroso, sedangkan adanya penentuan varian genotip alel A/G gen CD209 titik promoter-336 dari pemeriksaan PCR dan analisis sekuensing. Analisis data menggunakan regresi cox.Hasil penelitian menunjukkan ada hubungan alel G gen CD209 titik promoter-336 terhadap kejadian infeksi oportunistik TB Paru (PR 1,57 p=0,235, CI: 0,74-3,32). Alel G gen CD209 titik promoter -336 merupakan faktor risiko pada perempuan terhadap kejadian infeksi oportunistik TB Paru (PR 1,75 p=0,11, CI;0,97-3,14). Alel G gen CD209 titik promoter-336 pada malnutrisi terdapat hubungan terhadap kejadian infeksi oportunistik TB Paru (PR 2,1 p=0,22, Cl; 0,68-6,39). Alel G gen CD209 titik promoter-336 pada kelompok umur diatas 50 tahun  berisiko 3,5 kali mengalami kejadian infeksi oportunistik TB Paru (PR 3,5 p=0,07, Cl;1,09-11,3). Adanya riwayat kontak TB Paru serumah dengan alel G gen CD209 titik promoter-336 juga berisiko 1,5 kali dapat mencetuskan kejadian infeksi oportunistik TB Paru, walaupun tidak signifikan (PR 1,5 p=0,36, Cl 0,85-2,73).

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This dissertation discusses the association effect of genotype variant G allele promoter-336 CD209 gene in evidence pulmonary tuberculosa opportunistic infection in HIV/AIDS with cross sectional study. Pulmonary tuberculosa opportunistic infection data were obtained from the medical records of Sulianti Saroso hospital, while genotype variant G allele promoter-336 CD209 gene data were isolated from peripheral blood mononuclear cells and granulocytes obtained from the blood patients using salting out procedure-336 A/G (rs4804803). Genotyping of CD209 gene variants were studied using  PCR. The sequences of primers, restriction digestion enzymes used and restriction digestion pattern for different alleles. Data were analyzed using cox regression.The result of study showed association of G allele CD209 gene in evidence pulmonary tuberculosa opportunistic infection in HIV/AIDS (PR 1,57 p=0,235, CI: 0,74-3,32) G allele CD209 gene as risk factor for women in evidence pulmonary tuberculosa opportunistic infection in HIV/AIDS (PR 1,75 p=0,11, CI;0,97-3,14). Allele G in CD209 gene has also a strong association for malnutrition in evidence pulmonary tuberculosa opportunistic infection in HIV/AIDS (PR 2,1 p=0,22, Cl; 0,68-6,39). Risk factor of pulmonary tuberculosa opportunistic infection in HIV/AIDS has effects of G allele CD209 gene on ages group over 50 y about 3,5 (PR 3,5 p=0,07, Cl;1,09-11,3). and household pulmonary tuberculosa contact, about 1,5 (PR 1,5  p=0,36, Cl 0,85-2,73)."

"Human Immunodeficiency Virus (HIV) menjadi masalah utama kesehatan global yang sedang dihadapi oleh berbagai negara, termasuk Indonesia. Penderita HIV lebih rentan untuk terkena infeksi oportunistik, salah satunya tuberkulosis. Penelitian ini bertujuan untuk mengidentifikasi faktor-faktor yang berhubungan dengan infeksi oportunistik tuberkulosis pada pasien HIV di RSPI Prof. Dr. Sulianti Saroso tahun 2015-2019. Studi case control dilakukan dengan menggunakan data register pra-ART dan rekam medis. Jumlah sampel sebanyak 465 responden, yang terdiri dari 155 kasus dan 310 kontrol. Pengambilan sampel kasus menggunakan total sampling, sedangkan kontrol menggunakan simple random sampling. Analisis yang dilakukan adalah analisis univariat, bivariat menggunakan chi-square, dan multivariat menggunakan regresi logistik. Hasil uji regresi logistik menunjukkan ada hubungan yang bermakna secara statistik antara stadium HIV dengan infeksi oportunistik tuberkulosis (OR=33,03; 95% CI : 14,96 – 72,89) dengan nilai p <0,001, tetapi tidak ada hubungan yang bermakna secara statistik antara usia, jenis kelamin, jumlah CD4, jumlah viral load, pendidikan, status bekerja, perilaku seks berisiko, transfusi darah, dan penggunaan napza suntik dengan infeksi oportunistik tuberkulosis. Dibutuhkan perhatian khusus terhadap pasien HIV stadium lanjut (III-IV) untuk segera melakukan pemeriksaan tuberkulosis (TB).

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Human Immunodeficiency Virus (HIV) is a major global health problem currently being faced by countries, including Indonesia. People with HIV are more susceptible to opportunistic infections, including tuberculosis. This study aims to identify the factors associated with opportunistic tuberculosis infection in HIV patients in RSPI Prof. Dr. Sulianti Saroso in 2015-2019. Case control study was carried out using pre-ART register data and medical records. The total sample of 465 respondents consists of 155 cases and 310 controls. The case samples were collected using a total sampling technique, while the control ones were collected using a simple random sampling technique. The analysis conducted was univariate analysis, bivariate analysis using chi-square, and multivariate analysis using logistic regression. The logistic regression test results showed that there was a statistically significant relationship between the stage of HIV and opportunistic tuberculosis infection (OR=33,03; 95% CI: 14,96 – 72,89) with p value <0,001, but there was no significant relationship between age, sex, CD4 cell count, viral load, education, work status, sexual behavior, blood transfusion, and injection drug use with opportunistic tuberculosis infection. Special attention is needed for patients with advanced HIV stage (III-IV) to immediately conduct a tuberculosis (TB) examination.

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"[ABSTRAKLatar Belakang : Penggunaan efavirenz dan rifampisin secara bersamaan menjadi suatu tantangan dalam penanganan HIV/AIDS-Tuberkulosis. Rifampisin sebagai penginduksi enzim pemetabolisme efavirenz dapat menurunkan kadar plasma efavirenz, dan dapat menyebabkan gagal terapi HIV.Tujuan: Penelitian ini dilakukan untuk mengetahui pengaruh rifampisin terhadap kadar plasma efavirenz dan viral load viral load pasien HIV/AIDS-Tuberkulosis yang telah mendapat terapi antiretrovirus 3-6 bulan. Metode : Penelitian ini mengukur kadar efavirenz dan viral load pasien HIV/AIDS yang mendapat antiretroviral berbasis efavirenz dosis 600 mg/hari setelah 3-6 bulanterapi dan pasien HIV/AIDS-Tuberkulosis dengan terapi antiretroviral yang sama dan terapi antituberkulosis berbasis rifampisin di RSPI Prof. DR Sulianti Saroso, hasilnya akan dibandingkan. Hasil : Subjek penelitian berjumlah 45 pasien, terdiri dari 27 pasien kelompok HIV/AIDS dan 18 pasien kelompok HIV/AIDS-Tuberkulosis. Pada pemeriksaan kadar plasma efavirenz didapat median (min-maks) kelompok HIV/AIDS 0,680 mg/L (0,24-5,67 mg/L), median (min-maks) kadar plasma kelompok HIV/AIDS-Tuberkulosis 0,685 mg/L (0,12-2,23 mg/L), berarti tidak terdapat perbedaan kadar plasma efavirenz yang bermakna secara statistik antara kedua kelompok (MannWhitney, p=0,480). Proporsi pasien dengan viral load ≥ 40 kopi/ml pada kelompok HIV/AIDS sebesar 51,9%, sedangkan pada kelompok HIV/AIDS-Tuberkulosis sebesar 72,2% (ChiSquare, p=0,291), tidak terdapat perbedaan proporsi pasien yang viral load < 40 kopi/ml maupun ≥ 40 kopi/ml antar kelompok. Tidak terdapat perbedaan secara statistik (Chi Square, p=0,470) antara proporsi pasien yang mempunyai kadar subterapetik dalam kelompok, dengan hasil viral load < 40 kopi/ml (45,2%) maupun ≥ 40 kopi/ml (54,8%). Kesimpulan: Kadar plasma efavirenz maupun viral load pasien HIV/AIDS-Tuberkulosis yang mendapat antiretroviral bersama antituberkulosis berbasis rifampisin tidak berbeda bermakna dengan pasien HIV/AIDS setelah 3-6 bulan terapi antiretroviral.

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ABSTRACTBackground: Concomitant use of efavirenz and rifampicin is a challenge in the treatment of HIV/AIDS-Tuberculosis infection. Rifampicin may decrease plasma concentration of efavirenz through induction of its metabolism, and could lead to HIV treatment failure Objective: To determine the effect of rifampicin-containing tuberculosis regimen on efavirenz plasma concentrations and viral load in HIV/AIDS-Tuberculosis infection patients who received efavirenz-based antiretroviral therapy. Methods: plasma efavirenz concentrations and HIV viral load were measured in HIV/AIDS patients treated with 600 mg efavirenz-based antiretroviral for 3 to 6 months and in HIV/AIDS-Tuberculosis infection patients treated with similar antiretroviral regimen plus rifampicin-containing antituberculosis in Prof. DR. Sulianti Saroso, Hospital Jakarta, Indonesia, The results were compared Results: Forty five patients (27 with HIV/AIDS and 18 with HIV/AIDSTuberculosis infections) were recruited during the period of March to May 2015. The median (min-max) efavirenz plasma concentration obtained from HIV/AIDS group [0,680 mg/L(0,24 to 5,67 mg/L] and that obtained from HIV/AIDSTuberculosis group[0.685 mg/L (0.12 -2.23 mg/L)] was not significantly different (Mann-Whitney U test, p = 0.480) .The proportion of patients with viral load ≥ 40 copies/ml after 3-6 months of ARV treatment in the HIV/AIDS group (51.9%), and the HIV/AIDS-Tuberculosis group (72.2%) was not significantly different (Chi Square test, p = 0.291). There was no significant difference (Chi Square, p=0,470) between the proportions of patients with subtherapeuticefavirenz plasma concentration in the groups with viral load < 40 copies/mL (45,2%) and ≥ 40 copies/mL (54,8%) Conclusions: Plasma efavirenz concentrations and viral load measurements in HIV/AIDS-Tuberculosis patients in antiretroviral and rifampicin-containing antituberculosis regimen were not significantly different with those in HIV/AIDS patients in 3 to 6 months antiretroviral therapy., Background: Concomitant use of efavirenz and rifampicin is a challenge in the treatment of HIV/AIDS-Tuberculosis infection. Rifampicin may decrease plasma concentration of efavirenz through induction of its metabolism, and could lead to HIV treatment failure Objective: To determine the effect of rifampicin-containing tuberculosis regimen on efavirenz plasma concentrations and viral load in HIV/AIDS-Tuberculosis infection patients who received efavirenz-based antiretroviral therapy. Methods: plasma efavirenz concentrations and HIV viral load were measured in HIV/AIDS patients treated with 600 mg efavirenz-based antiretroviral for 3 to 6 months and in HIV/AIDS-Tuberculosis infection patients treated with similar antiretroviral regimen plus rifampicin-containing antituberculosis in Prof. DR. Sulianti Saroso, Hospital Jakarta, Indonesia, The results were compared Results: Forty five patients (27 with HIV/AIDS and 18 with HIV/AIDSTuberculosis infections) were recruited during the period of March to May 2015. The median (min-max) efavirenz plasma concentration obtained from HIV/AIDS group [0,680 mg/L(0,24 to 5,67 mg/L] and that obtained from HIV/AIDSTuberculosis group[0.685 mg/L (0.12 -2.23 mg/L)] was not significantly different (Mann-Whitney U test, p = 0.480) .The proportion of patients with viral load ≥ 40 copies/ml after 3-6 months of ARV treatment in the HIV/AIDS group (51.9%), and the HIV/AIDS-Tuberculosis group (72.2%) was not significantly different (Chi Square test, p = 0.291). There was no significant difference (Chi Square, p=0,470) between the proportions of patients with subtherapeuticefavirenz plasma concentration in the groups with viral load < 40 copies/mL (45,2%) and ≥ 40 copies/mL (54,8%) Conclusions: Plasma efavirenz concentrations and viral load measurements in HIV/AIDS-Tuberculosis patients in antiretroviral and rifampicin-containing antituberculosis regimen were not significantly different with those in HIV/AIDS patients in 3 to 6 months antiretroviral therapy.]"

"HIV/AIDS merupakan salah satu penyakit communicable disease yang merusak sistem kekebalan tubuh. Infeksi Oportunistik adalah infeksi yang timbul akibat penurunan sistem kekebalan tubuh. Penelitian ini bertujuan untuk mengetahui gambaran karakteristik individu dan faktor risiko terhadap terjadinya infeksi oportunistik pada penderita HIV/AIDS di Rumah Sakit Penyakit Infeksi Sulianti saroso tahun 2011. Desain penelitian ini adalah cross-sectional. Sampel dalam penelitian ini adalah seluruh penderita HIV/AIDS yang berkunjung ke klinik VCT yang memiliki kelengkapan data yang lengkap.Hasil penelitian menunjukkan bahwa proprsi infeksi oportunistik (84,4 %) dan ada hubungan antara jumlah CD4 dan stadium HIV/AIDS terhadap terjadinya infeksi oportunistik pada penderita HIV/AIDS (pvalue = 0,037). Diharapkan penelitian ini dapat berguna bagi perumusan program pencegahan dan tatalaksana HIV/AIDS di masa yang akan datang.

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HIV / AIDS is a disease communicable disease that damages the immune system. Opportunistic infections are infections caused by the decrease in the immune system. This study aims to know the description of individual characteristics and risk factors for the occurrence of opportunistic infections in people with HIV / AIDS at the Hospital for Infectious Diseases Sulianti Saroso in 2011. This study design is cross-sectional. The sample in this study were all patients with HIV / AIDS who visited the VCT clinic that has a complete data completeness.

The results showed that proprsi opportunistic infections (84.4%) and no relationship between CD4 count and stage of HIV / AIDS on the occurrence of opportunistic infections in people with HIV / AIDS (pvalue = 0.037). It is hoped this research can be useful for the formulation of programs of prevention and management of HIV / AIDS in the future."

"Penelitian ini bertujuan untuk mengetahui pengaruh lokasi anatomi TB terhadap kesintasan (ketahanan hidup) 2 tahun pasien ko-infeksi TB-HIV setelah diagnosis.Penelitian ini menggunakan desain kohort restrospektifdinamik menggunakan 177 rekam medik pasien ko-infeksi TB-HIV di RSPI Prof. Dr Sulianti Saroso Jakarta yang terdaftar tahun 2010-2013, diambil secara simple random samplingKasintasan pasien ko-infeksi TB-HIV 2 tahun setelah diagnosa dengan lokasi anatomi TB di ekstraparu sebesar 86%, lebih rendah dibandingkan dengan lokasi anatomi TB di paru sebesar 98%. Lokasi anatomi TB di ekstraparu mempengaruhi kecepatan kematian pasien ko-infeksi TB-HIV (adjusted HR 1,48, 95% CI : 0,55-4,02), setelah dikontrol oleh faktor risiko penularan dan kadar CD4 awal. Infeksi HIV mengakibatkan kerusakan sistem imunitas tubuh yang luas sehingga infeksi dan penyebaran kuman TB juga akan meluas seperti ke kelenjar getah bening, pleura dan organ lainnya. TB ekstra paru memiliki beban bakteri TB yang lebih tinggi dan menunjukkan progresifitas perjalanan penyakit semakin parah yang mengakibatkan probabilitas ketahanan hidup (kesintasan) penderitanya semakin menurun.Perlu dilakukan screening lebih intensif terhadap pasien ko-infeksi TB-HIV untuk menemukan kemungkinan TB di ekstra paru sedini mungkinagar dapat diberikan penatalaksanaan yang tepat dalam rangka meningkatkan kualitas hidup penderitanya.

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The objective of this study was to determine the influence of anatomical site to the survival of TB-HIV co-infection patient in 2 years after diagnosed. The design of this study was dynamic retrospective cohort with 177 medical records of TB-HIV co-infection patients in the Center of infection hospital Prof. Dr. SuliantiSaroso, Jakarta, from 2010 to 2013, taken by simple random sampling technique. The survival of TB-HIV co-infection for 2 years after it was diagnosed in patients with anatomical site of TB in the extrapulmonary was 86% and it was lower compared to patient with the anatomical site in the pulmonary which was 98%. Anatomical site of TB in the extrapulmonary were found to be an influencing factor to the rate of death in TB-HIV co-infection patients (adjusted HR 1,48, 95% CI : 0,55-4,02) after controlling with contagion factors and the level of CD4. HIV infection cause the widespreading damage in the immunity system therefor the infection of TB microbe also spreading to other organ such as lymph nodes and pleura. Extrapulmonary TB has much more TB microbe that worsen the progressivity of the disease and decrease the probability of the patient’s survival. Intensive screening are needed for TB/HIV co-infection patients to diagnosed the possibility of TB infection in the extrapulmonary as early as possible to increase the quality of life of its patients by finding the proper treatment."

"Pada kondisi dengan keterbatasan sumber daya untuk mengakses pemantauan viral load, pemantauan imunologis menjadi bagian dari standar perawatan terapi pasien dengan pengobatan antiretroviral yang dapat digunakan untuk menilai respon terapi. Studi ini dilakukan untuk melihat hubungan antara ketidakpatuhan pengobatan terhadap kegagalan imunologis pada pasien HIV/AIDS di RSPI Prof. Dr. Sulianti Saroso. Studi kohort retrospektif dilakukan di RSPI Prof. Dr. Sulianti Saroso pada 284 pasien HIV/AIDS dewasa yang inisiasi antiretroviral lini pertama pada periode Januari 2014-April 2018, yang diikuti selama 12 bulan waktu pengamatan. Analisis menggunakan Kaplan Meier digunakan untuk mengestimasi probabilitas kegagalan imunologis berdasarkan ketidakpatuhan pengobatan (ambil obat dan minum obat), yang signifikansinya dilihat dengan Log-Rank Test. Analisis Cox Proportional Hazard dilakukan untuk menghitung Hazard Ratio dengan 95% confidence interval. Sebanyak 29 (10,2%) pasien mengalami kegagalan imunologis dengan 4,8 per 10.000 orang hari. Kepatuhan ambil obat (aHR 1,72, 95%CI: 0,67-4,44) dan kepatuhan minum obat (aHR 1,14, 95%CI: 0,41-3,19) berasosiasi terhadap kejadian gagal imunologis, meskipun tidak signifikan. Asosiasi yang tidak signifikan ini dimungkinkan karena pemantauan imunologis bukanlah gold standard dalam menilai respon pengobatan. Perhitungan sensitivitas dan spesifisitas kegagalan imunologis terhadap kegagalan virologis pada penelitian ini yaitu 50% dan 82,66%. Monitoring kepatuhan secara berkala dan pemeriksaan CD4/viral load yang lebih tepat waktu diperlukan untuk mencegah kegagalan pengobatan lebih dini.

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Immunological monitoring becomes standard care of antiretroviral treatment due to the inaccessibility of viral load in a resource-limited setting. The aim of this study was to estimate association between antiretroviral therapy adherence and immunological failure among HIV/AIDS patient in Prof. Dr. Sulianti Saroso Infectious Disease Hospital. Retrospective cohort study was conducted at Prof. Dr. Sulianti Saroso Infectious Disease Hospital on 284 adults who started first-line antiretroviral during period between January 2014 and April 2018, then followed for about 12 months. Kaplan Meier was used to estimate probability of immunological failure based on pharmacy refill adherence and self report adherence, and their significance assessed using Log Rank Test. Cox Proportional Hazard model was fitted to measured Hazard Ratio with their 95% confidence interval. 29 (10,2%) patient has developed immunological failure with hazard rate of 4,8 per 10.000 person-day of follow up. Pharmacy refill adherence (aHR 1,72, 95%CI: 0,67-4,44) and self report adherence (aHR 1,14, 95%CI: 0,41-3,19) were associated with immunological failure. The association was not significant may because of immunological failure is not the gold standard to evaluate therapy response. Calculation of the sensitivity and specificity between immunological failure and virological failure for about 50% and 83%. Routine adherence monitoring and CD4 or viral load laboratorium measuring on schedule need to early prevent therapy failure."

"Infeksi HIV/AIDS akan menimbulkan infeksi berkepanjangan dan gangguan pada semua sistem tubuh serta masalah psikologis seperti depresi dan akhirnya menimbulkan fatigue. Intervensi untuk mengatasi fatigue salah satunya dengan self care practice. Tujuan penelitian adalah mengidentifikasi hubungan depresi dan self care practice dengan tingkat fatigue pada penderita HIV/AIDS. Metode penelitian menggunakan analitik korelasi dengan cross sectional, dan jumlah sempel 98 responden. Pengambilan sampel dengan tehnik purposive sampling. Hasil penelitian menunjukan rata-rata usia 33,2 tahun, berjenis kelamin laki-laki 85,7%, berpendidikan tinggi 91,8%, berpenghasilan > UMR 73,5%, Telah mengkonsumsi ARV selama 36,96 bulan, rata-rata kadar CD4 310 cell/mm3, ratarata Hb 13 gr%. Analisis hubungan menunjukan ada hubungan yang bermakna antara depresi, self care practice dengan tingkat fatigue (p<0,05). Analisis selanjutnya menunjukan responden yang mengalami depresi dan mempunyai self care practice yang kurang beresiko terjadi fatigue berat setelah dikontrol oleh kadar haemoglobin. Diketahui bahwa depresi merupakan faktor yang dominan yang berhubungan dengan fatigue. Rekomendasi peneliti adalah peningkatan peran perawat sebagai konselor terhadap gejala depresi dan fatigue pada pasien HIV dan dikembangkan strategi self care practice.

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HIV/ AIDS infection will cause prolonged infection and disturbance to all body system and also psychological such as depression and eventually fatigueness. One of the interventions to deal with fatigue is by self care practice. The research?s goal is to identify the relation between depression and self care practice on fatigue level of HIV/AIDS patient. The method of the research applied correlation analysis with cross sectional. There were 98 respondents. Sample was taken by purposive sampling technique. The research showed that 85,7 % male respondents with 33,2 years of age in average, 91,8 % highly educated, 73,5 % earns higher than Regional Minimum Wage, has consumed ARV for 36 months, CD4 rate average of 310 cell/mm3, Hb rate 13 gr% in average.

The analysis showed that there was a significant relation between depression, self care practice with fatigue level of (p0,05). Further analysis showed that respondents that underwent depression and had lower self care practice will risk heavy fatigue after controlled by hemoglobin rate. It was found that depression is the dominant factor related to fatigue. The researcher recommends that there should be an increase of nurse?s role as counselor to depression symptom and fatigue of HIV patient. There should also efforts to develop self care practice."

"Penelitian ini bertujuan mengetahui pengaruh lama pemberian antiretroviral (ARV) setelah Obat Anti Tuberkulosis (OAT) dimulai terhadap kegagalan perbaikan CD4 pasien ko-infeksi TB-HIV. Penelitian dilakukan pada mei-juni 2016 di Rumah Sakit Penyakit Infeksi (RSPI) Prof. Dr. Sulianti Saroso. Design penelitian yang digunakan adalah kohort restrospektif dengan follow-up selama satu setengah tahun. Populasi studi adalah pasien Ko-infeksi TB-HIV yang naive ART dan tercatat pada rekam medis periode Januari 2010 - November 2014. Kriteria inklusi sampel adalah pasien usia ≥15 tahun, mendapat OAT minimal 2 minggu sebelum ART dimulai, dan memiliki data hasil pemeriksaan CD4 sebanyak dua kali dengan total sampel adalah 164 orang. Probabilias kumulatif kegagalan perbaikan CD4 pasien ko-infeksi TB-HIV sebesar 14,43%. Hazard rate kegagalan perbaikan CD4 pada pasien yang memulai terapi ARV 2-8 minggu setelah OAT dibandingkan dengan yang menunda terapi ARV 8 minggu setelah OAT masing-masing 767 per 10.000 orang tahun dan 447 per 10.000 orang tahun (p=0,266). Analisis multivariat dengan menggunakan uji cox regresi time independen menunujukkan rate kegagalan perbaikan CD4 pada pasien yang memulai ART >8 minggu setelah OAT lebih rendah dibandingkan pasien yang memulai ART pada 2-8 minggu setelah OAT (Adjusted HR=0,502 ; 0,196-1,287 ; p value=0,151) setelah dikontrol oleh jenis regimen ARV dan klasifikasi pengobatan TB.

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This study was aim to assess the effect of time to Antiretroviral Treatment (ART) on CD4 response failure in TB-HIV coinfection patients. This study was conducted from May to June 2016 at Infectious Disease Hospital Sulianti Saroso. This study used cohort restrospective design with one and half year time to follow up. Study population were TB-HIV coinfected patients, noted as a naive ART patient in medical records from january 2010-november 2014. A total 164 patients ≥ 15 years old, had Anti Tuberculosis Treatment (ATT) 2 weeks before ART and had minimum 2 CD4 sell count laboratorium test results. The cumulative probability of CD4 response failure among TB-HIV co-infected patients was 14,43%. Hazard rate of CD4 response failure was 767 per 10.000 person year in early ART (2-8 weeks after ATT) versus 474 per 10.000 person year in delayed ART (8 weeks after ATT) arm (p=0,266). In multivariate analysis using time independent cox regression test, rate of CD4 responses failure was lower in patients with delayed ART until 8 weeks after ATT than early ART 2-8 weeks after ATT. (Adjusted HR=0,502 ; 0,196-1,287 ; P value=0,151) controlled by types of ARV regiments and classification of TB cure."

"Keluarga inti merupakan sistem pendukung utama dalam perawatan kesehatan terhadap anggotanya. Dukungan keluarga sangat berpengaruh terhadap kepatuhan minum obat pada pasien pengidap HIV/AIDS yang memiliki durasi pengobatan seumur hidup. Tujuan penelitian ini adalah mengidentifikasi hubungan dukungan keluarga inti dengan kepatuhan minum obat ARV pada pasien HIV/AIDS di RS Penyakit Infeksi Sulianti Saroso. Penelitian ini menggunakan studi kuantitatif, dan pendekatan cross sectional. Teknik pengambilan sampel menggunakan total sampling dengan jumlah sampel 337 responden. Variabel independen menggunakan kuesioner dukungan keluarga yang meliputi 4 aspek yaitu dukungan emosional, dukungan instrumen, dukungan informasi, dukungan penghargaan. Variabel dependen menggunakan instrumen Morisky Scale. Uji data menggunakan Chi Square. Hasil penelitian terdapat hubungan yang signifikan pada dukungan emosional (p=0,032; OR=3,427) dan dukungan informasi (p=0,048; OR=3,365) dengan kepatuhan minum obat ARV. Responden yang mendapatkan dukungan emosional memiliki peluang 3,427 kali lebih besar untuk patuh mengkonsumsi ARV dibandingkan responden yang tidak mendapatkan dukungan emosional keluarga inti. Dukungan penghargaan (p=0,227) dan dukungan instrumental (p=0,243) tidak menunjukkan hubungan dengan kepatuhan minum obat ARV.

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Nuclear Family is one of the esssential support in health caring for family member. Family support influence the level of adherence to antiretroviral (ARV) medication consumption in people living with HIV/AIDS who have a duration treatment for a lifetime. The aim of this research was to identify the relationship between family support and adherence to ARV people living with HIV/AIDS at Sulianti Saroso Hospital.

This study used the quantitative study, and cross sectional design. The sampling was 337 total respondents. The independent variable uses a questionnaire support family that includes four aspects: emotional support, information support, award support, and instrumental support. The Morisky Scale instrument was used to assess level of adherence. The data test used Chi Square.

There is a significant results in the emotional support (p=0,032; OR=3,427) and information support (p=0,048; OR=3,365) with the adherence in taking to ARV. The respondents who received the support of emotional were 3,427 more likely to adherence than those who did not receive emotional support from nuclear family. The awards support (p=0,227) and instrumental support (p=0,243) did not show significant relationship with adherence in taking to ARV."

"Terapi antiretroviral mampu menekan replikasi HIV, mencegah morbilitas dan mortalitas. Kepatuhan pengobatan dibutuhkan untuk mencapai kesuksesan terapi, mencegah resistensi obat antiretroviral dan risiko penularan HIVDR ditengah masyarakat. Efek samping obat antiretroviral umumnya terjadi pada 3 bulan pertama setelah inisiasi yang dapat mempengaruhi kepatuhan pengobatan pasien di tahun pertama pengobatan antiretroviral. Penelitian ini bertujuan untuk mengetahui pengaruh efek samping obat antiretroviral lini pertama terhadap kepatuhan pengobatan pasien HIV/AIDS di RSPI Prof. Dr. Sulianti Saroso tahun 2010-2015. Penelitian ini merupakan studi kohort retrospektif berbasis rumah sakit dimana sebanyak 376 naïve-patient HIV/AIDS dipilih sebagai sampel dan diamati selama 12 bulan setelah inisiasi ART. Kepatuhan pengobatan diukur dengan dua metode yaitu berdasarkan self report dan ketepatan waktu ambil obat. Data dianalisa dengan menggunakan cox proportional hazard regression dengan perangkat lunak STATA12. Hasil penelitian menunjukkan bahwa efek samping obat ARV lini pertama berpengaruh terhadap kepatuhan minum obat (RR12=1,45, 95% CI 1,009?2,021 dan RR34=0,85, 95% CI 0,564-1,273) namun tidak berpengaruh terhadap kepatuhan ambil obat (RR12=1,23, 95% CI 0,851-1,839 dan RR34=0,70, 95% CI 0,437-1,108).

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Antiretroviral therapy suppresses HIV replication, preventing morbidity and mortality. Adherence to antiretroviral therapy is needed to achieve successful treatment, prevent resistance to antiretroviral drugs and the risk of transmission of HIVDR in the community. The side effects of antiretroviral drugs generally occur in the first 3 months after initiation that could affect adherence in the first year of antiretroviral treatment. The aim of this study analyzed the effect of first-line antiretroviral side effect and adherence of HIV/AIDS patients in RSPI Prof. Dr. Sulianti Saroso period 2010 until 2015.

This study is hospital based retrospective cohort. A total of 376 HIV/AIDS naïve-patient had been selected as samples. Adherence was measured by two methods, based on self report and drug pick-up. Data was analyzed using cox proportional hazard regression with STATA12 software. Based on self report, HIV/AIDS patients who experience first-line ARV drugs side effect significantly associated with non-adherent (RR12=1.45, 95% CI 1.009 to 2.021 and RR34=0.85, 95% CI 0.564 to 1.273). Based on drug pick up, patients who experience first-line ARV drugs side effect not significantly associated with non-adherent (RR12=1.25, 95% CI 0.851 to 1.839 and RR34=0.70, 95% CI 0.437 to 1.108)."