PREDICTOR OF ANEMIA AMONG PEOPLE LIVING WITH HIV TAKING TENOFOVIR+LAMIVUDINE+EFAVIRENZ THERAPY IN JAYAPURA, PAPUA

Background: The most common hematological abnormality among people infected with Human Immunodeficiency Virus (HIV) is anemia. This is also related to high mortality risk among patients receiving Antiretroviral Therapy (ART). Purpose: This study aimed to identify predictors of anemia among HIV patients taking ART using a regimen of the single-tablet drug contain tenofovir, lamivudine, and efavirenz in Jayapura, Papua. Methods: This was a cross-sectional study conducted at Jayapura regional hospital from June to September 2017. A total of 80 HIV patients were eligible for analysis. Data collection was conducted through an interview, medical record, measurement, and laboratory assay. The significance of differences among categorical variables was analyzed using Fisher’s exact test. The variables with p \u3c 0.25 were then analyzed using binary logistic regression to determine predictors associated with anemia. A threshold of p \u3c 0.05 indicates statistical significance. Results: This study showed that Body Mass Index (BMI) \u3c18.50 (p = 0.01; OR = 5.63; 95% CI = 1.43 \u3c OR \u3c 22.19), length on ART ≤12 months (p = 0.00; OR = 4.90; 95% CI = 1.65 \u3c OR \u3c 14.53), and Cluster of Differentiation 4 (CD4+) percentage out of normal (p = 0.02; OR = 0.19; 95% CI = 0.05 \u3c OR \u3c0.77) had a significant association with anemia. Conclusion: BMI, length on ART, and CD4+ percentage were predictors of anemia among HIV patients taking antiretroviral therapy containing tenofovir, lamivudine, and efavirenz regimen in Jayapura

Investigasi Kejadian Luar Biasa Pertama Demam Berdarah Dengue (DBD) di Kaimana, Papua Barat

The first case of DHF occurred in May-June in Kaimana district of West Papua. This investigation was aimed to identify the distribution of dengue cases related to the patient’s living environment. This was an observational research. An entomological survey was conducted to identify species, breeding habitats and vector confirmation through virus detection in mosquitoes. Interviews in patients with dengue positive as well as entomological surveys were conducted in June 2012. Mosquito samples were collected by resting habitat and human landing collection. Larvae were collected from water containers at 25 sampling sites consisting of patient's house hold, school and hospital. Larvae collection were rearranged in Entomology Laboratory. Dengue virus in mosquitoes was detected using RT-PCR method using Lanciotti primer. The results showed that the age of infected patients was predominantly 6-12 years (48.1%) and dominated by females (63%). The study showed one case died (3.7%) and 26 ill patients (96.3%). The entomological survey showed that Aedes aegypti was not found in Kaimana while the second vector of A. albopictus was found abundantly. Molecular detection of dengue virus with Lanciotti primer showed that positive dengue virus was detected in mosquito and also larvae sample collections.Kasus pertama DBD telah terjadi pada bulan Mei-Juni di Kabupaten Kaimana Papua Barat. Investigasi ini bertujuan mempelajari distribusi kasus DBD yang berkaitan dengan lingkungan tempat tinggal pasien. Jenis penelitian ini adalah observasional. Survei entomologi dilakukan untuk mengidentifikasi spesies, breeding habitat dan melakukan konfirmasi vektor melalui deteksi virus pada nyamuk.  Wawancara pada pasien yang positif menderita dengue serta survei entomologi dilakukan pada bulan Juni 2012. Sampel nyamuk dikoleksi pada resting habitat dan umpan orang. Larva dikoleksi dari kontainer yang berada pada 25 titik sampling yang terdiri dari lingkungan rumah tinggal pasien, sekolah dan rumah sakit. Koleksi larva selanjutnya direaring di Laboratorium Entomologi. Keberadaan virus DBD pada nyamuk dideteksi menggunakan metode RT PCR dengan primer Lanciotti. Laporan kasus menunjukkan bahwa usia pasien yang terinfeksi sebagian besar adalah 6-12 tahun (48,1%) dan didominasi oleh perempuan (63%). Penelitian menunjukkan satu kasus meninggal (3,7%) dan 26 pasien sakit (96,3%). Survei entomologi menunjukkan bahwa A. aegypti tidak ditemukan di Kaimana sementara vektor kedua A. albopictus ditemukan melimpah. Deteksi molekuler virus dengue dengan lancioti primer menunjukkan bahwa virus positif terdeteksi pada koleksi sampel nyamuk dan larva.</p

Investigasi Kejadian Luar Biasa Pertama Demam Berdarah Dengue (DBD) di Kaimana, Papua Barat

The first case of DHF occurred in May-June in Kaimana district of West Papua. This investigation was aimed to identify the distribution of dengue cases related to the patient’s living environment. This was an observational research. An entomological survey was conducted to identify species, breeding habitats and vector confirmation through virus detection in mosquitoes. Interviews in patients with dengue positive as well as entomological surveys were conducted in June 2012. Mosquito samples were collected by resting habitat and human landing collection. Larvae were collected from water containers at 25 sampling sites consisting of patient's house hold, school and hospital. Larvae collection were rearranged in Entomology Laboratory. Dengue virus in mosquitoes was detected using RT-PCR method using Lanciotti primer. The results showed that the age of infected patients was predominantly 6-12 years (48.1%) and dominated by females (63%). The study showed one case died (3.7%) and 26 ill patients (96.3%). The entomological survey showed that Aedes aegypti was not found in Kaimana while the second vector of A. albopictus was found abundantly. Molecular detection of dengue virus with Lanciotti primer showed that positive dengue virus was detected in mosquito and also larvae sample collections.Kasus pertama DBD telah terjadi pada bulan Mei-Juni di Kabupaten Kaimana Papua Barat. Investigasi ini bertujuan mempelajari distribusi kasus DBD yang berkaitan dengan lingkungan tempat tinggal pasien. Jenis penelitian ini adalah observasional. Survei entomologi dilakukan untuk mengidentifikasi spesies, breeding habitat dan melakukan konfirmasi vektor melalui deteksi virus pada nyamuk.  Wawancara pada pasien yang positif menderita dengue serta survei entomologi dilakukan pada bulan Juni 2012. Sampel nyamuk dikoleksi pada resting habitat dan umpan orang. Larva dikoleksi dari kontainer yang berada pada 25 titik sampling yang terdiri dari lingkungan rumah tinggal pasien, sekolah dan rumah sakit. Koleksi larva selanjutnya direaring di Laboratorium Entomologi. Keberadaan virus DBD pada nyamuk dideteksi menggunakan metode RT PCR dengan primer Lanciotti. Laporan kasus menunjukkan bahwa usia pasien yang terinfeksi sebagian besar adalah 6-12 tahun (48,1%) dan didominasi oleh perempuan (63%). Penelitian menunjukkan satu kasus meninggal (3,7%) dan 26 pasien sakit (96,3%). Survei entomologi menunjukkan bahwa A. aegypti tidak ditemukan di Kaimana sementara vektor kedua A. albopictus ditemukan melimpah. Deteksi molekuler virus dengue dengan lancioti primer menunjukkan bahwa virus positif terdeteksi pada koleksi sampel nyamuk dan larva

Viral load as a risk factor of reverse transcriptase inhibitor drug resistance mutation in antiretroviral-treated people living with HIV/AIDS

BACKGROUND The human immunodeficiency virus type 1 (HIV-1) is a major contagion faced by the population of Indonesia. The success of antiretroviral treatment (ART) is threatened by the emergence of drug resistance mutations (DRM). The aim of this study was to determine the association between CD4 count, CD4 count changes, viral load, adherence to therapy, and therapy history in the presence of DRM in people living with HIV/AIDS (PLWHA). METHODS This was a cross-sectional study involving 269 adults who underwent antiretroviral (ARV) therapy for at least 6 months. The frequencies of DRM and polymorphisms were measured by partial amplification of the reverse transcriptase (RT) gene using RT-nested PCR on samples with viral loads of >1000 copies/mL. Sequencing was performed using the Sanger method, and edited by BioEdit. The edited sequences were submitted to http://hivdb.stanford.edu for DRM determination. Respondents' medical data, CD4 count, viral load, and DRM were analyzed by simple and multiple logistic regression. RESULTS The multiple logistic regression analysis showed a significant association of CD4 count (aOR=12.47; 95% CI: 1.45 -107.39; p=0.023) andviral load at the time of study (aOR=29.56; 95% CI: 3.47-251.52; p=0.002) with the presence of DRM in respondents. ARV substitution history was not associated with the presence of DRM. There were 17 respondents (6.3%) carrying HIV-1 DRM, with M184V/I (11 sequences) as the most frequent pattern of NRTI resistance, and K103 (9 sequences) as that of NNRTI resistance. CONCLUSION This study demonstrated that viral load at the time of the study was the most influential determinant factor for the presence of DRM in PLWHA