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Effect of Fixed‐Dose Combinations Antituberculosis and Separate Formulations on Clinical Symptoms, Weight Gain, Adverse Effect and Plasma Concentration in Tuberculosis and HIV Coinfection Cases Sundari, Titi; Mariana, Nina; Permatasari, Debby Intan; Rusli, Adria; Sitompul, Pompini Agustina; Rosamarlina, Rosamarlina; Widiantari, Aninda Dinar; Maemun, Siti; Lisdawati, Vivi
Medica Hospitalia : Journal of Clinical Medicine Vol. 10 No. 2 (2023): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v10i2.867

Abstract

BACKGROUND: Fixed Dose Combination (FDC) was aimed to simplify TB therapy and facilitate physician and patient compliance. OBJECTIVE: We aimed to evaluate the effect of FDC antituberculosis and separate formulations (SF) on clinical symptoms, weight gain, adverse effect and plasma concentration in TB/HIV cases during the intensive phase. METHOD: Prospective cohort study was conducted in public hospital, Jakarta. We recruited TB-HIV patients in May 2018-May 2019. Patients (over than 18 years old) diagnosed with TB-HIV who consumed either FDC or SF and had not received antiretroviral. A total of 36 subjects were included in this study, 20 subjects in FDC group and 16 subjects in SF group. RESULT:  There was not significant different between FDC and SF groups with an improvement of clinical symptoms (P = 0.70) and weight gain (P = 1.00). Gastrointestinal syndrome was 75% in FDC group; 62.5 % in SF group. Mean (±SD) of rifampicin, isoniazid, pyrazinamide plasma concentration after 2 weeks therapy in FDC group were 5.49 mg/L (±3.40 mg/L), 1.35 mg/L (±1.20 mg/L), 19.87 mg/L (±17.00 mg/L), respectively. Mean (±SD) of rifampicin, isoniazid, pyrazinamide plasma concentration in SF group were 6.42 mg/L (±4.80mg/L), 0.87 mg/L (±0.70 mg/L), 5.03 mg/L (±7.60 mg/L), respectively. CONCLUSION: There was not significant different between FDC and SF groups on improvement of clinical symptoms and weight gain in intensive phase of therapy, the highest of adverse effects was gastrointestinal syndrome, and all subjects had normal reference ranges of rifampicin concentrations, and isoniazid and pyrazinamide below the normal range.
Screening for Latent Tuberculosis Infection using Interferon-Gamma Release Assay Test among Healthcare Workers Rosamarlina, Rosamarlina; Mariana, Nina; Sundari, Titi; Setianingsih, Tri Yuli; Jahiroh, Jahiroh; Pertiwi, Intan; Widiantari, Aninda Dinar; Setiawaty, Vivi; Murtiani, Farida
Global Medical & Health Communication (GMHC) Vol 11, No 2 (2023)
Publisher : Universitas Islam Bandung

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.29313/gmhc.v11i2.10927

Abstract

Healthcare workers (HCWs) represent a significant demographic for screening latent tuberculosis infection (LTBI) due to their potential exposure to infectious patients. Tests based on immunology detection, such as the tuberculin skin test (TST) and the interferon-gamma release assay (IGRA), have been pivotal in diagnosing LTBI. The objective of this study was to evaluate the efficacy of the IGRA test in detecting LTBI compared to the TST among HCWs in an infectious disease hospital. In a cross-sectional study conducted in August 2019 at the Sulianti Saroso Infectious Disease Hospital, we examined 84 HCWs selected through consecutive sampling. Participants were assessed using questionnaires, and the IGRA and TST tests were performed. The findings revealed that 42 (50%) HCWs tested positive for LTBI based on the IGRA test. Most were female, aged 36–45 years, had direct exposure to TB patients, and had been in the healthcare profession for over a decade. The concordance between the TST and IGRA test, as indicated by a κ value, was 0.234. Furthermore, a significant correlation was observed between the incidence of LTBI and the duration of the healthcare profession (p=0.016). In conclusion, our research suggests that both TST and IGRA tests can effectively detect LTBI. The IGRA test had a higher positivity rate among HCWs with over ten years of service. 
Profile of Clinical, Radiological and Laboratory Pattern in TB-HIV Coinfection in National Infection Centre of Indonesia Rosamarlina, Rosamarlina; Hatta, Mochammad; Murtiani, Farida; Widiantari, Aninda Dinar
Jurnal Ilmiah Kedokteran Wijaya Kusuma Vol 13, No 2 (2024): September 2024
Publisher : Universitas Wijaya Kusuma Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30742/jikw.v13i2.3959

Abstract

Background: The study aims to map TB (Tuberculosis) – HIV (Human Immunodeficiency Virus) patients based on clinical, radiological, and laboratory patterns. Objective: This study is expected to provide previous research investigating radiologic and laboratory examinations in TB-HIV patients. Method: We conducted a cross-sectional study based on medical records of TB-HIV patients at RSPI Sulianti Saroso from January 2004 - March 2017. Samples were 240 TB-HIV patients from a population of 1014 People Living with HIV/AIDS (PLWHA). Inclusion criteria were PLWHA, aged over 18 years, diagnosed with TB with completed medical record status. Result: Characteristics of the majority of patients were in the productive age group (99.2%) with an average age of 33 years and male sex (78%). The main symptom is cough (91.7%) and cough with phlegm (59.1%). Most patients (83.37%) have not received ART (Anti-Retroviral Therapy). Pulmonary physical examination showed that most patients had Ronchi (95.8%) while others got wheezing (5%). Laboratory tests revealed an initial CD4 cell count of 71.6 cells/ml and a negative Acid-Fast Bacillus (AFB) smear (59.2%). The patient's radiology was mainly with an infiltrate (82.5%); most infiltrate was presented in apex (52.4%). Conclusion:  The majority of TB-HIV coinfected patients are young males, presenting with common TB symptoms, low CD4 counts, and negative AFB smears, complicating diagnosis. Radiological findings frequently show infiltrates, particularly in the apex. These findings emphasize the importance of early diagnosis and ART initiation to improve outcomes in TB-HIV coinfected patients
The Combination Diagnostic Test for Tuberculosis Screening in HIV Patients in Referral Hospitals in Indonesia Murtiani, Farida; Rosamarlina, Rosamarlina; Purnama, Asep; Farhanah, Nur; Utama, Made Susila; Agustin, Heidy; Sarif, Armaji Kamaludi; Widiantari, Aninda Dinar; Hasugian, Armedy Ronny
Public Health of Indonesia Vol. 11 No. 3 (2025): July - September
Publisher : YCAB Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36685/phi.v11i3.1094

Abstract

Background: Screening tests are needed to help screen suspected Tuberculosis (TB) pulmonary with HIV positive. With the limitation of specificity of the screening test and the need for combination with laboratory tools to increase that, a combination with standard examination is still needed, especially for limited healthcare facilities. Objective: This study aimed to determine Pulmonary TB screening tests with Human Immunodeficiency Syndrome (HIV) positive. Method: This observational study with a cross-sectional design was conducted in four government hospitals. Study subjects were inpatients and outpatients who met study inclusion criteria (> 14 years of age, HIV positive based on HIV test results, had clinical symptoms of episodic history of fever, and volunteered to take part in the study). Total subjects were 193 people, with episodic history of fever from <24 hours to 120 hours. Result: This study assessed a subject's clinical manifestation, physical examination and X-ray test. The “Night Sweat”, Infiltrates in the Upper Lobe”, “Enlargement of Lymph Nodes and “Left Rhonchi” and their combination have a sensitivity of>85%. Still, only the complete combination has a specificity of> 70%. The combination of “Night Sweat + Enlargement of Lymph Nodes + Left Rhonchi + Infiltrates in the Upper Lobe” and then “Enlargement of Lymph Nodes + Left Rhonchi + Infiltrates in the Upper Lobe” can be an alternative for screening Pulmonary TB-HIV positive with history of fever. Conclusion: Pulmonary TB screening in HIV patients with a history of fever can be used by completely combining clinical manifestation, physical examination, and X-ray. the variables "Night Sweat, Enlarged Lymph Nodes, left rhonchi breath sounds and pulmonary upper lobe infiltrates" in a gradual manner. Keywords: Diagnostic Combination Test; HIV-Tb Coinfection; Tuberculosis Screening; Clinical Manifestations in TB-HIV; Pulmonary TB in HIV Patients