Progress in the Treatment of HIV-Associated Lymphoma When Combined With the Antiretroviral Therapies

With the wide use of combination antiretroviral therapy (cART), the life expectancy of HIV-infected individuals drastically improved. However, HIV infection and HIV-associated cancers were the most common causes of death in the HIV-infected populations. The HIV-associated cancers are divided into acquired immune deficiency syndrome (AIDS)-defining and non-AIDS-defining cancers based on the incidence among the HIV-infected patients. Among HIV-associated cancers, acquired immune deficiency syndrome-related lymphoma (ARL) is still the most common condition and the leading cause of HIV/AIDS-related deaths. Diffuse large B-cell lymphoma (DLBCL) and Burkitt’s lymphoma (BL) are the most common subtypes of the ARL. Although Hodgkin’s lymphoma (HL) is not considered as an AIDS-defining cancer, incidence of HL in HIV-infected individuals is higher than the general population. The review summarizes the new progress in the treatment of HIV-associated lymphoma.

A case of Pneumocystis jirovecii pneumonia in a patient with acquired immune deficiency syndrome who showed eosinophilia and an increased serum TARC/CCL17 level

Pneumocystis jirovecii pneumonia (PCP) in patients with acquired immune deficiency syndrome (AIDS) shows eosinophilic pneumonia like condition. The detailed mechanisms how AIDS-associated PCP causes eosinophilic pneumonia has not been elucidated, but it has been suggested that beta-D-glucan, a major component of Pneumocystis jirovecii, and T helper type 2 immunity may be involved in the mechanism of eosinophilia in the lung. We experienced the case who developed an eosinophilic pneumonia-like condition in a patient with AIDS-associated PCP, whose clinical course indicated the importance of TARC/CCL17 but not IL-4 and IL-5 as involved in eosinophilia caused by HIV and Pneumocystis jirovecii infection.

Pengaruh Pemberian Konseling Apoteker pada Pasien HIV-AIDS Di Poliklinik Rawat Jalan RS Bhayangkara TK I R. Said Sukanto

HIV-AIDS (Human Immunodeficiency Virus-Acquired Immune Deficiency Syndrome) merupakan suatu penyakit yang terus berkembang dan menjadi masalah global yang melanda dunia. HIV (Human Immunodeficiency Virus) adalah sejenis virus yang menyerang/menginfeksi limfosit yang menyebabkan turunnya kekebalan tubuh manusia. AIDS (Acquired Immune Deficiency Syndrome) adalah sekumpulan gejala penyakit yang timbul karena turunnya kekebalan yang disebabkan infeksi oleh HIV. Pengidap HIV memerlukan pengobatan dengan ARV (Antiretrovirus) untuk menurunkan jumlah virus HIV di dalam tubuh agar tidak masuk ke dalam stadium AIDS dan untuk mencegah terjadinya infeksi oportunistik dengan berbagai komplikasinya, dalam terapi pengobatan pasien. Tujuan penelitian ini yaitu untuk memperoleh gambaran karakterisitik (umur, jenis kelamin, pekerjaan, pendidikan, stadium penyakit) menganalisis pengaruh pemberian konseling Apoteker terhadap aspek pengetahuan, kepatuhan, kualitas hidup pasien dan efektivitas terapi ARV pada mengetahui pengaruh kepatuhan pasien dalam ART terhadap peningkatan kualitas hidup pasien HIV-AIDS di RS. Bhayangkara TK I R. Said Sukanto. Penelitian ini menggunakan metode quasi-eksperimental yang dilakukan secara prospektif. Penelitian ini dilakukan pada pasien HIV yang berobat di klinik rawat jalan RS Bhayangkara Tk I R. Said Sukanto. Pembagian kelompok kontrol dan kelompok intervensi menggunakan rumus sampling sederhana. Pengambilan data dan observasi dilakukan selama 6 (enam bulan) dari bulan Oktober 2019-Maret 2020. Aspek pengetahuan dan kualitas hidup diambil dengan menggunakan kuesioner, aspek kepatuhan diambil melalui obervasi data kunjungan pasien dan sisa obat sedangkan efektifitas terapi ARV diambil berdasarkan pemeriksaan CD4 pasien. Aspek pengetahuan diambil pada kunjungan pertama dan kedua, aspek kepatuhan diambil data tiap bulan, sedangkan aspek kualitas hidup dan efektifitas terapi diambil awal kunjungan dan 6 bulan kemudian. Hasil dari penelitian ini berdasarkan demografi kategori jenis kelamin yang paling dominan yaitu laki-laki sebanyak 46 responden (76,76%). Kategori usia yang paling dominan yaitu dengan rentang usia 30 tahun – 39 tahun sebanyak 29 responden (48,33%). Kategori Pendidikan yang paling dominan yaitu kategori SMA sebanyak 31 (51,67%). Status merital yang paling dominan yaitu kelompok menikah dengan total 34 (56,67%). Kepatuhan dalam terapi ODHA mempunyai pengaruh terhadap kualitas hidup pasien HIV-AIDS dengan nilai korelasi hasil uji Chi Sqaure 0,933 sebesar 0.373 > p value 0.01.

A trend analysis of people living with human immunodeficiency virus attending an anti-retroviral therapy centre in urban Bangalore

Background: HIV infection in India is a major public health problem. The anti-retroviral therapy (ART) centre is the backbone of the national acquired immune deficiency syndrome (AIDS) control program (NACO). To assess the trend of new people living with human immunodeficiency virus (PLHIV) registered at an ART centre in Bangalore and their treatment status.Methods: All the PLHIV registered at an ART centre from 1st January, 2009 to 31st December, 2018 were included in the study. PLHIV registered but not initiated on treatment, were excluded.Results: Out of 4428 PLHIV registered at an ART centre, 2964 were initiated on treatment. The youngest PLHIV registered was 6 years, oldest was 79 years and the decadal median age was 38 years. Majority (41.4%) were in the age group of 31 to 40 years. Predominant gender was male. A declining trend of new PLHIV, LFU/stopped/missed cases over the past decade was observed. The 1658 are alive, 402 died, 305 cases either missed, stopped or lost to follow up, 32 cases were opted out of the treatment and 567 cases were transferred out.Conclusions: A decline in number of new PLHIV, LFU, missed and stopped over the decade was observed.

Implementasi Kebijakan Pencegahan Dan Penanggulangan Human Immunodeficiency Virus-Acquired Immune Deficiency Syndrome (Hiv & Aids) Di Kota Tasikmalaya

Implementasi Kebijakan Pencegahan dan Penanggulangan Human Immunodeficiency Virus – Acquired Immune Deficiency Syndrome (HIV & AIDS) Di Kota Tasikmalaya masih memiliki permasalahan dimana Kota Tasikmalaya adalah salsatu yang memiliki kasus infeksi HIV & AIDS tinggi di provinsi Jawa Barat. Untuk mengatasi masalah tingginya jumlah kasus penyakit HIV & AIDS yang terjadi di Kota Tasikmalaya, pemerintah Kota Tasikmalaya menetapkan sebuah peraturan dalam upaya melakukan pencegahan dan penanggulangan HIV & AIDS, yakni Perda Kota Tasikmalaya No. 2 Tahun 2008 Tentang Pencegahan dan Penanggulangan Human Immunodeficiency Virus-Acquired Immune Deficiency Syndrome (HIV & AIDS). Namun ternyata dari hasil observasi awal yang dilakukan penulis Perda tersebut belum sepenuhnya dapat diimplementasikan dengan baik, dapat dilihat dari (1) Kurangnya sosialisasi peraturan daerah tersebut kepada masyarakat, (2) Minimnya sumber daya manusia di KPA Kota Tasikmalaya, dimana belum seluruh anggota KPA mengetahui secara detail pelaksanaan Perda tersebut. (3) Belum seluruh kegiatan pencegahan dan penanggulangan HIV & AIDS dilakukan. Serta (4) belum terdapatnya sarana prasarana yang memadai dalam rangka pencegahan dan penanggulangan HIV & AIDS.Tujuan penelitian ini adalah untuk mengetahui bagaimanakah implementasi kebijakan Pencegahan dan Penanggulangan Human Immunodeficiency Virus-Acquired Immune Deficiency Syndrome (HIV & AIDS) di Kota Tasikmalaya. Jenis penelitian yang digunakan adalah penelitian deskriptif dengan pendekatan kualitatif dengan menggunakan teknik Purposive sampling. Teknik pengumpulan data yang dilakukan berupa observasi, wawancara dan dokumentasi.teknik analisis data dengan, reduksi data, display data, seta penarikan kesimpulan, teknik keabsahan data dengan menggunakan triangulasi sumber. Hasil penelitian menunjukan bahwa (1) Perda belum tersosialisasi dengan baik karena masing-masing pihak merasa mempunyai tugasnya sendiri, Dinas Kesehatan maupun KPA belum merata dalam mensosialisasikan upaya pencegahan dan penanggulangan HIV & AIDS dan belum mampu melaksanakannya. (2) Sumber daya manusia serta anggaran yang ada masih jauh dari cukup untuk mengimplementasikan Perda ini. (3) Struktur birokrasi dalam upaya pencegahan dan penanggulangan HIV & AIDS di kota Tasikmalaya sudah cukup baik, hanya tinggal memaksimalkan kinerja masing-masing aktor dan kesadaran akan tanggung jawabnya tersebut. (4) Sikap para pelaksana atau implementor kebijakan ini masih terhambat oleh kesadaran dan aturan akan tugas dan fungsi masing-masing pihak dalam upaya pencegahan dan penanggulangan HIV & AIDS di Kota Tasikmalaya ini. Hal ini disebakan belum adanya Peraturan yang spesifik menggambarkan tugas masing-masing aktor. Kesimpulannya implementasinya belum efektf.

Cytomegalovirus Encephalitis with Decreased Vision in Immunocompromised Patients Treated with Valganciclovir: Case Report

Introduction: Cytomegalovirus (CMV) is a significant cause of morbidity and mortality in patients with Acquired Immune Deficiency Syndrome (AIDS). Almost all Human Immunodeficiency Virus (HIV) infected patients develop CMV rapidly with manifestation in the central nervous system. Most CMV encephalitis is preceded by the presence of CMV in other places. Therefore, immediate therapy will be more effective and the delay in therapy can be detrimental. Case: A 40-year-old man with the major complaint of vision decrease in both eyes for 3 months claimed that he felt worse after 7 days, accompanied by headache and fever. This patient was diagnosed with HIV 2 years ago. The examination obtained GCS 456, negative meningeal sign, headache with NRS 7. The visual acuity of the right eye was negative light perception and in the left eye of vision 1/300. The patient experienced clinical improvement after oral Valganciclovir therapy with a dose of 2x450 mg. Conclusion: CMV encephalitis must be considered to diagnose earlier in HIV patients with complaints of decreased vision. With valganciclovir 2x450 mg tablets improve reduction of headache scale NRS from 7 to 2, increasing left eye vision from 1/300 to 6/60. Keywords: Encephalitis CMV, HIV, Valganciclovir.

Nurse Support on Health Cadre Empowerment and the Influence on the Ability of Women’s Mentoring Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome

BACKGROUND: In the context of community empowerment, the role of nurses as health workers is very important to transform the knowledge and skills of cadres. However, the support of nurses in empowering human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) health cadres has not been widely explained. AIM: This study examines the effect of nurse support and empowerment on the ability of HIV/AIDS cadres to assist mothers with HIV/AIDS. METHODS: This study used a cross-sectional approach. We involved 119 HIV/AIDS cadres including local residents who care about AIDS (WPA, n = 90), facilitators of families of hope (PKH, n = 17), and peer support groups (KDS, n = 12). Data collection was carried out from February to April 2020, the sample was selected using multistage cluster sampling in Kudus Regency, Central Java, Indonesia. Multiple linear regression analysis was conducted to determine the support of nurses, empowerment of HIV/AIDS cadres, and its effect on the ability of cadres in assisting women with HIV/AIDS. RESULTS: We found that nurses’ support for the empowerment of HIV/AIDS cadres was low in almost all aspects (instrumental, informational, emotional, and affiliation). Nurse support and cadre empowerment affect the ability of HIV/AIDS cadres by 28%. Regression test formula Y = −97.080 + 0.738X1 + 1.944X2. CONCLUSION: The results showed that the four types of nurse social support may be interrelated and are generally still low in the process of empowering HIV/AIDS cadres. There is an effect of nurse support and empowerment of HIV/AIDS cadres on the ability of cadres to assist women with HIV/AIDS.