HIV dan AIDS merupakan salah satu permasalahan di Indonesia. Berdasarkan data dari Kementerian Kesehatan RI sampai dengan maret 2017, sebanyak 407 kota/kabupaten dari  507 kota/kabupaten dan lebih dari 87 ribu orang mengidap AIDS. Berbeda apabila dibandingkan dengan provinsi-provinsi lainnya, Papua mengalami epidemi HIV meluas tingkat rendah dengan prevalensi HIV sebesar 2.3 %. Jumlah penderita HIV lebih banyak terjadi pada perempuan usia reproduktif dibandingkan pada laki-laki. Meskipun HIV tersebar meluas di kelompok populasi umum baik untuk laki-laki maupun perempuan, kegiatan seks komersial memberikan kontribusi yang besar terhadap epidemi di semua wilayah Papua. Tujuan penelitian ini adalah menganalisis karakteristik demografi ODHA Di Papua Sebagai Baseline Data Di Indonesia. Penelitian dilakukan di tiga wilayah di Papua yaitu Kabupaten Nabire, Kab./Kota Jayapura, dan Kab. Jayawijaya dengan jumlah responden sebanyak 264 orang. Dari hasil penelitian yang dilakukan didapatkan hasil terdapat perbedaan karakteristik demografi ODHA di tiga wilayah Papua (Kabupaten Nabire, Kab./Kota Jayapura, dan Kab. Jayawijaya). Dari hasil penelitian dibutuhkan strategi penanganan ODHA yang berbeda di masing-masing wilayah.

<p class="Englishversionofabstract">HIV-TB co-infection still becomes a health problem in Indonesia, including in Nabire district, Papua province, which has the highest number of cases. HIV and TB infections are closely related and affect the epidemiology of one another. This study aims to determine the profile description of HIV-TB co-infected patients in Nabire. This research is a descriptive study with a cross-sectional design on 90 people with HIV/AIDS selected consecutively. Data were analyzed univariately and presented in the form of a frequency distribution table. The results showed that of 55 HIV/AIDS co-infected TB patients, almost all (90.9%) were Papuan ethnic, 70.9% were female and aged 30 to 49 years (50.9%) with a mean of 31.309.36 years. The majority of HIV-TB co-infected patients were married (63.6%), holding secondary education (58.2%), working (67.3%), engaging in sexual activity after 17 years of age, only having one sexual partner, and did not use drugs or obtain blood transfusions. The clinical profile of HIV-TB patients showed that 67.3% of the patients were with baseline CD4 count ≤350 cells/mm3, 64.8% had CD4 count at the time of study &gt;350 cells/mm3, and viral load values fewer than 5000 copies/ml (87.3%). The therapy most widely received for patients with HIV-TB coinfection was the combination of ARV 3TC+EFV+TDF (76.4%). The most common clinical symptoms of HIV/AIDS patients were weight loss (56.4%), cough (40%), recurrent oral thrush (36.4%), chickenpox (32.7%), and tuberculosis lymph nodes (18.2%).</p>

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 predictorsf 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 < 0.25 were then analyzed using binary logistic regression to determine predictors associated with anemia. A threshold of p < 0.05 indicates statistical significance. Results: This study showed that Body Mass Index (BMI) <18.50 (p = 0.01; OR = 5.63; 95% CI = 1.43 < OR < 22.19), length onRT ≤12 months (p = 0.00; OR = 4.90; 95% CI = 1.65 < OR < 14.53), and Cluster of Differentiation 4 (CD4+) percentage out of normal (p = 0.02; OR = 0.19; 95% CI = 0.05 < OR <0.77) had a significant association with anemia. Conclusion: BMI, length on ART, and CD4+ percentage were predictors of anemia among HIV patients taking antiretroviral therapy contain tenofovir, lamivudine, efavirenz regimen in Jayapura.

Acquired Immune Deficiency Syndrome (AIDS) is one of the leading health problems in Papua and antiretroviral (ARV) therapy increases cluster of differentiation 4 (CD4 + ). We examined whether the CD4 + counts correlated with factors affecting adherence of ARV therapy in Papua. A cross-sectional study was conducted from June to September 2017 at VCT RSUD Dok II Jayapura. We assessed 85 respondents receiving ARV therapy for 12-24 months, who had fulfilled inclusion criteria agreed to sign the informed consent. Information of CD4 + and factors affecting adherence were obtained from blood samples analysis and questionnaires. Data were analyzed using Fisher exact test and Odds Ratio at p<0,05. The result showed that the high percentages of respondents' characteristics include female, aged 15-30 years, employed, had formal education, indigenous Papuan, good treatment knowlegde, never switch ARV, had ARV side effects, had health insurance, never stigmatized, always got adherence counseling, easy access to health services, had family support, no community support. Most of the respondents were adherent to taking ARVs and had an increase in CD4 + cell counts. Women, working status, and stigma had a greater risk for immunodeficiency. Evaluation was required for respondents whose good adherence but did not experienced an increase in CD4 + cell counts. AbstrakAcquired Immune Deficiency Syndrome (AIDS) menjadi salah satu permasalahan kesehatan di Papua. Terapi antiretroviral (ARV) meningkatkan jumlah Cluster of Differentiation 4 (CD4 + ). Penelitian bertujuan menganalisis hubungan CD4 + dengan faktor yang memengaruhi kepatuhan terapi di Papua. Sampling dilakukan Juni sampai September 2017. Responden 85 pasien terapi ARV 12-24 bulan di VCT RSUD Dok II Jayapura yang telah memenuhi kriteria inklusi dan setuju untuk menandatangani informed consent. Data CD4 + dan faktor kepatuhan diperoleh dari pemeriksaan sampel darah dan kuesioner. Data dianalisis dengan uji Fisher exact dan Odds Ratio pada p <0,05. Hasil menunjukkan bahwa persentase karakteristik responden terbesar adalah perempuan, berumur 15-30 tahun, bekerja, sekolah dan asli Papua. Informasi berkaitan dengan ARV dengan persentase terbesar adalah pengetahuan pengobatan baik, tidak pernah ganti ARV pernah mengalami efek samping ARV, memiliki jaminan kesehatan, tidak pernah mengalami stigma, selalu mendapat konseling kepatuhan, akses layanan kesehatan mudah, mendapat dukungan keluarga, tidak mendapat dukungan komunitas. Mayoritas responden patuh minum ARV dan mengalami kenaikan jumlah CD4 +. Perempuan, status bekerja, dan stigma memiliki risiko lebih besar untuk imunodefisiensi. Diperlukan evaluasi pada responden patuh minum ARV tetapi tidak mengalami kenaikan CD4+.Kata kunci : CD4 + , faktor memengaruhi kepatuhan, terapi ARV, HIV/AIDS, Jayapura

<p>Hubungan status gizi dengan Cluster of Differentiation 4 (CD4⁺) pada Orang Dengan HIV/AIDS (ODHA) yang menjalani terapi antiretroviral (ARV) di Papua belum banyak diketahui. Penelitian bertujuan menganalisis hubungan status gizi terhadap jumlah CD4⁺ subjek penelitian. Parameter status gizi yang digunakan yaitu Indeks Massa Tubuh (IMT) dan anemia. Jenis penelitian adalah observasional deskriptif dengan desain cross-sectional. Inklusi yaitu pasien laki-laki dan perempuan sedang terapi ARV minimal 6 bulan, memiliki data CD4⁺ dan rekam medis lengkap. Subjek penelitian yaitu 64 pasien HIV/AIDS yang menjalani terapi ARV di Rumah Sakit Mitra Masyarakat (RSMM) Mimika Papua bulan Januari sampai Oktober 2015, telah menyetujui inform consent dan memenuhi kriteria inklusi. Data dianalisis menggunakan statistik Fisher's Exact test dan Odds Ratio (OR). Mayoritas subjek penelitian adalah perempuan sebanyak 76,6%, kisaran umur 15-35 tahun sebanyak 60,9%, IMT &gt;18,5 sebanyak 85,9%, kadar hemoglobin (Hb) &lt;13g/dL sebanyak 73,4%, dan lama terapi ≤60 bulan sebanyak 75%. Hasil Fisher's Exact test dan OR, ada hubungan signifikan IMT terhadap jumlah CD4⁺ dengan nilai p˂0,05=0,006 dan OR=13,867 serta 95% interval konvidensi (CI)=2,396-80,266. Hal ini menunjukkan subjek penelitian dengan IMT≤18,5 atau malnutrisi berisiko 13,867 kali untuk memiliki jumlah CD4⁺ ≤200sel/ul dibandingkan subjek dengan IMT˃18,5. Variabel jenis kelamin, umur, kadar Hb, dan lama terapi ARV tidak berhubungan signifikan dengan jumlah CD4⁺. IMT kurus (malnutrisi) berhubungan signifikan dengan jumlah CD4⁺ rendah yaitu ≤200sel/ul. Jumlah CD4⁺ ≤200sel/ul berisiko mempercepat status HIV menjadi stadium 4 atau sakit berat yang mengarah kepada AIDS. </p>

Tenofovir lamivudine efavirenz (TLE) as a single-tablet regimen is preferred to the long use of combination antiretroviral therapy. TLE is safer than another antiretroviral drug regimen for first-line of Human immunodeficiency virus (HIV) treatment. However, there is little information about the side effects of TLE during first-time therapy among people living with HIV in Jayapura. This study aimed to assess the TLE side effect and its efficacy among people living with HIV in Jayapura, Papua. This was a cross-sectional study involving 77 people living with HIV who took a single-tablet regimen of TLE for one to two years of antiretroviral therapy, comply the inclusion criteria, and provided consent to participate. Data collection was conducted through CD4 + tests, medical records, and interviews at Jayapura City Hospital. Descriptive statistics were used to determine the proportion of relevant variables. The results described that most groups of people living with HIV were adult group (93.5%), female (61.0%), Papuan (64.9%), had WHO clinical stage III-IV (67.5%), had CD4 + counts < 350 cell/µL in the early therapy (79.2%) and CD4 + counts ≥ 350 cell/µL at the time of the study (57.1%), and experienced TLE side effect (71.4%). The most symptoms of TLE side effects among people living with HIV were headache (61.8%), nausea (34.5%), and nightmare (29.1%). As many as 70.9% of people living with HIV experienced these symptoms for less than 2 weeks. TLE was still effective, indicated by an increase of CD4 + cell count average from 242.6 cell/mm 3 at the early therapy to 436.6 cell/mm 3 during this study, with good adherence to drug therapy (>95% adherence) by 53.2% of people living with HIV. The side effects of TLE can still be tolerated by most people living with HIV so the therapy can be continued without altering the regimen.

Human Immunodeficiency Virus (HIV) genetic variability is classified into types, groups, and subtypes. HIV is divided into 2 types, HIV-1 and HIV-2. HIV-1 was divided into groups M (Main), N (New), and O (Outlier). Group M was divided into 9 subtypes and 48 Circulating Recombinant Form (CRF). Understanding HIV-1 subtype distribution and epidemiology can assist preventive measures and clinical decisions. Sequence variation may affect drug resistance, disease progression, and transmission route. This study aimed to determine human immunodeficiency virus type-1 (HIV-1) subtypes which circulate in West Papua based on gene fragments encoding the glycoprotein-41 (gp41) of the HIV envelope. The descriptive-analytic method was attended at the VCT clinic in West Papua. Samples of blood plasma from patients with HIV were amplified using RT-PCR and nested PCR. Genetic variability was analyzed using DNA sequencing. The HIV-1 subtype was determined for 35 samples which 15 were from female patients and 20 were from male patients. 3 subtypes were detected: Circulating Recombinant Form AE (CRF01_AE, n=21), B (n=12), and 52_01B (n=2). Subtypes AE predominated in HIV-1 acquired heterosexually 100 % and clinical stage level III. Subtypes AE strains of group M viruses predominated in West Papua in HIV transmitted by heterosexual contact.

Background : Antiretroviral (ARV) therapy is one of the efforts to combat HIV/AIDS in Indonesia, especially West Papua. One of the side effects using ARV is impaired liver function in People Living with HIV/AIDS (PLWHA). ARV therapy evaluation to liver disorders can be seen from the Serum Glutamic Oxaloacetic Transaminase (SGOT)/ Serum Glutamic Pyruvic Transaminase (SGPT) level.Objective : To find out the effect of ARV Fixed Dosed Combination (FDC) to liver function of PLWHA patients in West Papua.Methods : A cross-sectional study, involving 110 respondents who were PLWHA patients receiving ARV at Voluntary Counselling and Testing (VCT) service of hospital in Manokwari, Sorong, and Fak-fak. Laboratory tests was used to examine the liver function. Other variable data were obtained from medical records. The Fisher Exact Test with a significance level of <0.05 was used to determine the effect of ARV to liver function.Results : Respondents had no liver problems with normal SGOT and SGPT values, i.e. 72,7% and 76.4%, respectively. While, the rest had mild and moderate toxicity. Respondent experiencing moderate toxicity was 2 patients who regularly took FDC in Sorong.Conclussion : The FDC using in ARV therapy did not significantly influence the increase of SGOT and SGPT on PLWHA patients in West Papua.