Article Per Year (5 Year)
p-Index From 2021 - 2026
2.753
P-Index
This Author published in this journals
All Journal Jurnal Profesi Medika: Jurnal Kedokteran dan Kesehatan SRIWIJAYA JOURNAL OF MEDICINE Sriwijaya Journal of Ophthalmology Jurnal Pengabdian Masyarakat: Humanity and Medicine Bioscientia Medicina : Journal of Biomedicine and Translational Research Conferences of Medical Sciences Dies Natalis Ophthalmologica Indonesiana
Petty Purwanita
Bagian Ilmu Kesehatan Mata, Fakultas Kedokteran, Universitas Sriwijaya
Biochemistry, Genetics & Molecular Biology Dentistry Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

Published : 21 Documents Claim Missing Document
Claim Missing Document
Check
Articles

Found 21 Documents
Search

 1   2   3 
Diagnostic Accuracy and Optimal CD4 Threshold for Detecting Cytomegalovirus Retinitis in Advanced HIV Disease: A Prospective Indonesian Study Ramzi Amin; Fadillah Amrina; Petty Purwanita; Nuzulul Aini
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 4 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i4.1663

Abstract

Background: Cytomegalovirus retinitis (CMVR) is a leading preventable cause of AIDS-related blindness where systematic screening is absent, and World Health Organization guidance triggers ophthalmic assessment below a CD4 count of 50–100 cells/µL, a range not previously calibrated in an Indonesian population. Objective: To determine the diagnostic accuracy of the CD4 count against adjudicated cytomegalovirus retinitis, and to derive an optimal CD4 threshold for triggering ophthalmic screening, in Indonesian adults with advanced HIV disease. Methods: This prospective single-gate diagnostic accuracy study, reported to STARD 2015, enrolled 51 consecutive adults with HIV-1 infection and a CD4 count below 100 cells/µL at Dr. Mohammad Hoesin Central General Hospital, Palembang, from January 2024 to January 2025. The index test was the CD4 count by flow cytometry; the reference standard was masked adjudication by two retina specialists using dilated ophthalmoscopy, fundus photography and optical coherence tomography (Cohen's κ = 0.91). Because only aggregated summaries were released, estimands the data do not identify are reported as sharp bounds. Results: CMVR was present in 17 of 51 participants (33.3%, 95% CI 22.0–47.0); the median CD4 count was 17.0 cells/µL (IQR 11.0–27.0) versus 48.0 (30.0–72.0). The area under the ROC curve was 0.863 (95% CI 0.741–0.985). At the Youden-derived threshold of 32.5 cells/µL apparent sensitivity was 88.2% (95% CI 65.7–96.7) and specificity 91.2% (77.0–97.0); after correction for in-sample threshold selection these became 80.5% and 93.8%, and across two admissible reconstructions sensitivity ranged from 76.5% to 88.2%. CD4 rose monotonically across fulminant, indolent and frosted-branch phenotypes (bounded Kruskal–Wallis p = 0.001–0.013). Conclusion: A CD4 count of approximately 30–35 cells/µL, with an unconditional visual-symptom over-ride, prioritises dilated retinal examination within the World Health Organization stratum in Indonesian HIV services.
Co-Authors ADRIAN PRATAMA Anang Tribowo Anang Tribowo ANCI WINAS Cicilia, Monica Putri DEZCA NINDITA Disty Andryani Eka Rahmadini Elsa Iskandar Erial Bahar Fadillah Amrina Fahcreza Frashad Fanseca Alvarez Indri Seta Septadina Muhammad Aulia Molid Ogest Putra Calisanie Muhammad Reza Arlas Natsir, Novia Novia Natsir Nurmalia Purnama Sari Nuzulul Aini Okta Kurniawan Saputra Prima Maya Sari Prima Maya Sari Putri Dwi Kartini RACHMAT HIDAYAT Ramzi Amin Ramzi Amin Ramzi Amin Ramzi Amin Ramzi Amin Ramzi Amin, Ramzi Rezandi Pratama Ria Mutiara Riani Erna Riani Erna Ririn Rahayu Rizka Yunanda Siti Shalihah Ramadhani Novizar Tribowo, Anang vidya hestika