AbstrakToxoplasmosis cerebri merupakan salah satu infeksi oportunistik yang paling sering pada sistem saraf pusat pasien HIV. Infeksi toxoplasma Gondii pada pasien HIV terutama terjadi jika pada kondisi CD4 yang rendah, penurunan produksi sitokin dan interferon gama, dan menurunnya fungsi sel limfosit T sitotoksik sehingga menyebabkan reaktivasi dari infeksi laten T. Gondii. Telah dilaporkan laki-laki 31 tahun menderita HIV AIDS dengan toxoplasmosis cerebri. Pasien dirawat dengan penurunan kesadaran dan hemiparese sinistra, riwayat sakit kepala hebat dan sering berulang, memiliki riwayat menggunakan narkotik suntik dan pemakaian jarum suntik bergantian, tidak ada riwayat hipertensi, tidak ada riwayat tuberkulosis. Dari pemeriksaan fisik didapatkan kesadran apati, pupil isokor, pada mulut terdapat candidiasis oral, tidak ada kaku kuduk, terdapat lateralisasi tungkai ke kiri serta Babinski yang positif pada tungkai kiri. Pada pemeriksaan penunjang didapatkan Rapid test HIV yang positif, CD4 35sel/ul, dan gambaran CT scan otak yang sesuai Toxoplasmosis cerebri. Pasien ditatalaksana dengan pemberian Pirimetamin dan klindamisin selama 6 minggu ditambah steroid sampai pasien sadar. Abstract Cerebral Toxoplasmosis is one of commonest opportunistic infection of thr nervous system in HIV patient. In HIV infected patient opportunistic infection by T. Gondii occurs due to depletion of CD4 cells, decreased production of cytokine and interferon gamma and impaired cytotoxic T-Lymphocyte activity resulting in reactivation of latent infection. Reported a case, male 31 years old HIV AIDS with cerebral toxoplasmosis. Patient admitted to hospital with decreased of consciousness and left hemiparese, history of injecting drug used (IDU), no hypertension, no history of tuberculosis.In physical examination level of consciousness is apathy, pupil was isochor. there is oral candidiasis, absebce of stiffness of the neck, lateralitation to left lower extremity, and babinsky sign positif in left lower extremity. In laboratory found Rapid tes HIV testing was positif, CD4 cell count was 35cell/ul, Ig G anti toxoplasma positif dan brain ct scan suitable for cerebral toxoplasmosis. We treated patient with pyrimethamin, clindamycin for 6 weeks and steroid until conscious level was compos mentis cooperative.

Background: Hepatitis B is acute or chronic liver inflammation caused by hepatitis B viral and can progress to hepatic chirrosis or liver cancer. Chronic hepatitis B has a high risk for liver fibrosis. Chronic inflammation and liver fibrosis are interrelated processes. This study aimed to determine the differences in T-regulator cells, Alanine Aminotransferase (ALT) and Aspartate Aminotransferase (AST) between chronic hepatitis B patients with and without liver fibrosis.Method: This study used a cross-sectional method for patients diagnosed with chronic hepatitis B in the Inpatient and Outpatient Department of the Internal Medicine Department  DR. M. Djamil Padang and other hospitals in Padang city for 6 months. Samples were selected by consecutive sampling according to inclusion and exclusion criteria. Liver fibrosis is identified by fibroscan. Data were analyzed by SPSS 21.0.Results: thirty-two patients were diagnosed with chronic hepatitis B and 50% had liver fibrosis. The levels of T-regulator cells in chronic hepatitis B patients without liver fibrosis were 2.08% and liver fibrosis 2.25%, but this difference was not statistically significant (p 0.05). Mean ALT levels in the group without fibrosis were 19 IU/L (7IU/L-71IU/L) and liver fibrosis 61 IU / L (13IU/L-625IU/L). The mean AST level in the group without fibrosis were 15.5 IU/L (10IU/L-32IU/L) and liver fibrosis 35.5 IU/L (10IU/L-476IU/L). The difference between ALT and AST in the two groups was significant (p 0.05). Hepatitis B patients with liver fibrosis had higher ALT and AST levels than without fibrosis.Conclusion: There were differences levels of T-regulator cells in the two groups, but it was not statistically significant. ALT and AST levels were higher in the liver fibrosis group and statistically significant.