Background Indonesia is a tropical country, warm and humid, with numerous environmental fungi. Data on fungal disease burden help policymakers and clinicians. Objectives We have estimated the incidence and prevalence of serious fungal diseases. Methods We found all published and unpublished data and estimated the incidence and prevalence of fungal diseases based on populations at risk. HIV data were derived from UNAIDS (2017), pulmonary tuberculosis (PTB) data from 2013–2019, data on chronic pulmonary aspergillosis (CPA) were used to estimate CPA prevalence and likely deaths, COPD data from Hammond (2020), lung cancer incidence was from Globocan 2018, and fungal rhinosinusitis was estimated using community data from India. Results Overall ~7.7 million Indonesians (2.89%) have a serious fungal infection each year. The annual incidence of cryptococcosis in AIDS was 7,540. Pneumocystis pneumonia incidence was estimated at 15,400 in HIV and an equal number in non‐HIV patients. An estimated 1% and 0.2% of new AIDS patients have disseminated histoplasmosis or Talaromyces marneffei infection. The incidence of candidaemia is 26,710. The annual incidence of invasive aspergillosis was estimated at 49,500 and the prevalence of CPA is at 378,700 cases. Allergic bronchopulmonary aspergillosis prevalence in adults is estimated at 336,200, severe asthma with fungal sensitisation at 443,800, and fungal rhinosinusitis at 294,000. Recurrent vulvovaginal candidiasis is estimated at 5 million/year (15–50 years old). The incidence of fungal keratitis around 40,050. Tinea capitis prevalence in schoolchildren about 729,000. Conclusions Indonesia has a high burden of fungal infections.

Altered T cell profiles have been linked with metrics of persistent cytomegalovirus (CMV) infections in healthy aging and older HIV patients stable on antiretroviral therapy (ART). In this study, we use CMV DNA to identify active infections, and levels of CMV-reactive antibody to assess the persistent burden of CMV in a longitudinal study of 78 young adult patients beginning ART in Jakarta, Indonesia, with <200 CD4 T cells/μL. CMV antibodies, inflammatory markers (C-reactive protein [CRP], soluble interferon-α/β receptor) and T cell phenotypes were assessed before ART (V0) and after 1, 3, 6, and 12 months (V1-V12). CMV DNA was detected in 41 patients (52%) at V0, irrespective of CD4 T cell counts, gender, age, or plasma HIV RNA. CMV DNA+ patients had higher levels of antibody reactive with CMV Immediate Early 1 (IE-1) at V0 and V12 (p = 0.04), and with CMV lysate at V12 (p = 0.01). Detectable CMV DNA did not align with inflammatory markers, but associated with lower CD4/CD8 ratios until V3. CMV antibody levels correlated inversely with proportions of naive CD4 and CD8 T cells, and directly with proportions of CD57 and activated memory T cells (CD3 CD45RA) after 3-12 months on ART. Overall, active CMV replication is common in HIV patients beginning ART in Indonesia and associates with low CD4/CD8 ratios. Elevated levels of CMV-reactive antibody measured on ART also mark a depletion of naive T cells, accumulation of memory T cells, and may be a stable metric of the burden of CMV.

ART reduces the prevalence of OPC, and the total fungal and C. albicans burden. Levels of salivary β-defensin-2 may associate with OPC in HIV patients responding to ART.

Objectives: Atherosclerosis has been linked with periodontitis in the general population and with persistent immune activation and a high burden of cytomegalovirus (CMV) in HIV patients responding to antiretroviral therapy (ART). Here, we assess risk factors for cardiovascular changes in younger HIV patients representative of patient populations in Asia. Study Design: HIV-infected adults (n = 82) with <200 CD4 T-cells/μl were examined as they began ART at Cipto Mangunkusumo Hospital, Jakarta, and after 3 months. 32 patients were re-assessed after 5 years, alongside 32 age-matched healthy controls. Methods: We assessed the community periodontal index of treatment needs, carotid -thickness (cIMT), plasma markers of immune activation (using commercial enzyme-linked immunosorbent assay) and CMV antibodies by in-house enzyme-linked immunosorbent assay. Results: Periodontitis persisted in 16/32 patients after 5 years and was potentiated by greater age (P = 0.03) and poor oral hygiene (P = 0.05), with no effect of smoking, pulmonary tuberculosis, oral candidiasis, or low CD4+ T-cell counts (P > 0.05). After 5 years on ART, right and left cIMT were greater in HIV patients with periodontitis (P = 0.02, 0.006, respectively). Moreover, cIMT values were higher in patients with periodontitis (P = 0.05–0.01) than in equivalent controls. Simple linear regressions showed that patients with periodontitis had greater right (P = 0.01) and left (P = 0.004) cIMT than those without periodontitis. Multiple linear regressions showed that periodontitis and CMV antibody levels optimally predicted poor right and left cIMT (Adjusted R2 = 0.36, P = 0.0013; Adjusted R2 = 0.40, P = 0.001, respectively). Conclusions: Our data identify periodontitis and CMV as independent predictors of atherosclerosis in young adult HIV patients.

AbstrakLimbah molas merupakan hasil samping dari pabrik gula yang tidak dapat dikristalkan kembali. Salah satu kandungan limbah molas yaitu kaya akan karbohidrat. Salah satu upaya untuk memanfaatkan limbah molas yaitu dengan melakukan penelitian terhadap nutrisi yang masih terkandung dalam molas masih dapat dimanfaatkan. Penelitian ini bertujuan untuk mengetahui kemampuan mikroorganisme dalam memanfaatkan karbohidrat (glukosa) yang terdapat dalam limbah molas untuk perkembangbiakan. Mikroorganisme yang digunakan adalah jenis ragi yaitu Candida utilis, Endomycopsis fibuligera dan Saccharomyces cerevisiae. Waktu pengamatan yang dilakukan adalah 0, 6, 12, 18, 24, 30 jam dengan suhu inkubasi 37 o C. Pengamatan yang dilakukan meliputi : pengukuran berat biomassa dengan cara menimbang berat kering mikroorganisme, pengukuran konsentrasi glukosa limbah molas yang dimanfaatkan mikroorganisme dengan cara Somogyi-Nelson dan perhitungan tingkat efektifitas penggunaan molas terhadap pertkembangbiakan mikroorganisme. Hasil: Berat biomassa tertinggi dicapai oleh Saccharomyces cerevisiae dengan biomassa tertinggi 156,33 mg dalam waktu 18 jam. Konsentrasi glukosa yang dimanfaatkan oleh Endomycopsis fibuligera lebih tinggi dibandingkan dengan mikroorganisme yang lain, yaitu dalam waktu 30 jam mencapai 3,13 mg/mL dan kemungkinan dengan bertambahnya waktu inkubasi masih mampu memanfaatkan glukosa lebih banyak. Mikroorganisme yang memiliki tingkat efektifitas dalam memnfaatkan limbah molas sebagai sumber glukosa adalah Saccharomyces cerevisiae dengan tingkat efektifitas 126,4 mL/mg berat biomassa dalam waktu 12 jam. Kesimpulan :Saccharomyces cerevisiae yang terbaik dalam pemanfaatan glukosa dari limbah molas untuk pertumbuhan biomassa. AbstractWaste molase was the result of beside from the sugar mill that had not became to crystal again. One of the waste content molase that has rich of carbohydrate. One of the effort to exploited of the waste molas that was by doing the research to nutrition which still implied in molase admit of to be exploited. This research aimed to know ability microorganism in exploited the carbohydrate (glucose) which there was in waste molas for propagation. The Microorganism used yeast that Candida utilis, Endomycopsis fibuligera and Saccharomyces cerevisiae. Perception time taken was 0, 6, 12, 18, 24, 30 hour with incubation temperature 37 o C. It was analysed for measurement of weight biomassa by considered drying to constant weight of microorganism, measurement of waste glucose concentration molase exploited mikroorganisme by Somogyi-Nelson and calculation of efectivity level could be used molase to microorganism propagation. Result : Weight biomass highest dried to constant weight by Saccharomyces cerevisiae conteined 156,33 mg during 18 hour. the Glucose concentration exploited by Endomycopsis fibuligera higher compared to microorganism other, that is during 30 hour 3,13 mg/mL and possibility with increased of of time incubation still could more exploited the glucose. Microorganism has been good efectivi...

Background: Jatropha is known as anti-inflammatory, antioxidant, anti-fungal, anti-cancer, and has coagulant activity. Jatropha curcas (Jatropha curcas L.) contains toxic compounds such as cursin, ricin and gallic acid. The liver has an important role in the process of metabolism and detoxification of xenobiotic substances. Repeated exposure to toxic compounds can damage hepatic hepatocytes. If the hepatocyte cells are injured, the AST/ALT enzyme is excreted and goes into the blood vessels, as an indicator of liver damage. This is also indicated by changes in the thickness of the central veins. This study aims to determine the effect of giving jatropha seed extract (Jatropha curcas L.) on AST/ALT activity and the central vein thickness in the liver. Materials and Methods: The research design was experimental, using male rats (Rattus novergicus L) Sprague Dawley strain. The rats were given Jatropha seed extract at doses of 0, 5, 25, 50, and 250 mg/ KgBW for 28 days. To assess liver damage, measurements of AST/ ALT activity and thickness of the central vein in the liver were performed. Results: Jatropha seed extract increased ALT activity at doses of 25.50, and 250 mg / KgBW compared to the control group (1.207; 1.62; 1.548 IU/L/ mg tissue x 10-3); and increased AST activity at doses of 5, 25, 50, and 250 mg / KgBW compared to the control group (0.769; 0.974; 1.449; 1.185 IU/L/ mg tissue x 10-3); Central vein thickness increased at doses of 25 and 50 mg/KgBW (6.17 and 4.9 µm) (Kruskal Wallis; p> 0.05). Conclusion: Jatropha curcas L. seed extract increased the activity of AST/ALT and the thickness of the central vein in the liver.

No abstract

Background: Persistent immune activation and inflammation in HIV-infection are linked to excess cardiovascular risk and other non-communicable diseases. Periodic asymptomatic CMV-reactivity in HIV infected patients over a lifetime may contribute to non-AIDS defining morbidity. Despite undetectable levels of HIV and CMV, these patients continue to have increased levels of biomarkers and immune activations. Statin administration is thought to reduce subclinical atherosclerosis by decreasing LDL-C levels. It may also add beneficial effects against CMV infection. Methods: We are conducting a double-blind placebo-controlled trial in which patients are randomized to receive either atorvastatin or placebo with a ratio of 1:1. This trial aims to study the effect of atorvastatin in statin-naive virally-suppressed HIV-infected patients with stable ART and CMV seropositivity on carotid intima media thickness (CIMT), tool that evaluates subclinical atherosclerosis. The study recruits 80 patients at HIV integrated care unit of Cipto Mangunkusumo hospital. All eligible subjects have CIMT evaluation as primary outcome, along with flow mediated vasodilatation (FMD), liver fibrosis and steatosis evaluation, fasting lipid, neurocognitive test, community periodontal index (CPI), and residual immune activation as secondary outcomes in 48 weeks. Ethics and dissemination: This study has received an ethical approval from Health Research Ethics Commitee–Universitas Indonesia and Cipto Mangunkusumo Hospital. Before joining the study, all participants fill in an informed consent form. At the end of study analysis, the trial results will be published and disseminated in peer-reviewed journals. Discussion: The main purpose of our study is to evaluate the effect of atorvastatin administration on CIMT changes in statin naïve virally suppressed HIV-infected patients with stable ART and CMV seropositivity Registration: ClinicalTrials.gov ID NCT04101136; registered on 24 September 2019.