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PEMBERIAN N-ASETYLSISTEIN TERHADAP KADAR IFN-GAMMA PADA PENDERITA HIV/AIDS YANG MENJALANI PENGOBATAN ANTIRETROVIRAL Sri Sulpha Siregar; Eddy Mart Salim; Zen Hafy; Nova Kurniati; Harun Hudari; Erial Bahar; Agustian Dwi Putra; Afriyana Siregar
JURNAL KEDOKTERAN DAN KESEHATAN Vol 8, No 2 (2021)
Publisher : Fakultas Kedokteran Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/V8I2.13269

HIV merupakan penyakit infeksi yang masih menjadi masalah besar kesehatan di Indonesia maupun dunia. Berbagai macam bentuk infeksi yang disebabkan oleh HIV, salah satunya ditandai dengan turunnya jumlah sel limfosit T CD4+ dan juga penurunan kadar IFN-GAMMA yang dapat menyebabkan percepatan replikasi virus hingga terjadi kegagalan sistem imun. NAC yang merupakan antioksidan diharapkan dapat memperbaiki kondisi tersebut. Penelitian ini bertujuan untuk mengetahui efek pemberian NAC terhadap perubahan kadar IFN-GAMMA pada penderita HIV/AIDS di RSUP dr. Mohammad Hoesin Palembang. Penelitian ini merupakan uji klinik acak tersamar ganda. Sampel yang digunakan dalam penelitian ini sebanyak 32 pasien HIV/AIDS yang menjalani pengobatan ARV di RSUP dr. Mohammad Hoesin Palembang dibagi secara acak ke dalam 2 kelompok, yaitu kelompok Plasebo dan NAC. Pada kelompok Plasebo, pasien diberi kapsul yang berisi laktosa dengan dosis 3x1 kapsul/hari, sedangkan kelompok NAC, diberi NAC dengan dosis 3x 200 mg/hari. Setiap kelompok diberi perlakuan sama selama 12 minggu. Darah pasien diambil sebelum dan setelah perlakuan untuk diperiksa kadar IFN-GAMMA . Hasil penelitian menunjukkan bahwa kelompok uji yang diberikan NAC maupun placebo tidak menunjukkan perubahan kadar IFN-GAMMA yang bermakna setelah 12 minggu perlakuan. Kesimpulan penelitian, pemberian NAC tidak mempengaruhi kadar IFN-GAMMA pada penderita HIV/AIDS yang menjalani pengobatan ARV.HIV is an infectious disease that becomes a major health problem in Indonesia and the world. There are various forms of infection caused by HIV, one of which is marked by a decrease in the number of CD4 + T lymphocytes and a decrease in IFN-GAMMA level which can accelerate viral replication to the point of immune system failure. NAC, an antioxidant, is expected to improve this condition. This research aimed to determine the effect of NAC on IFN-GAMMA levels in HIV / AIDS patients in Dr. Mohammad HoesinCentral Hospital, Palembang. This research was a randomized double blind clinical trial. The samples were 32 HIV / AIDS patients who were undergoing ARV treatment at Dr. Mohammad Hoesin Central Hospital, Palembang, which were randomly divided into 2 groups; the placebo and the NAC groups. In the placebo group, patients were given capsules containing lactose at a dose of 3x1 capsules / day, while patients in the NAC group were given NAC at a dose of 3 x 200 mg / day. Each group was given the same treatment for 12 weeks. The patients’ blood were taken before and after treatment to check their IFN-GAMMA levels. The results showed that both groups did not show any significant changes in IFN-GAMMA levels after 12 weeks of treatment. The conclusion of this researchis that NAC administration did not affect IFN-GAMMA levels in HIV / AIDS patients who were undergoing ARV treatment.

The Effect of Vitamin D Supplementation on the Increase in CD4 count of HIV/AIDS Patients Receiving Antiretroviral Therapy Mega Permata; Harun Hudari; Mediarty; Taufik Indrajaya
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 5 No. 1 (2021): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/bsm.v5i1.186

Introduction. Vitamin D plays a role in health overall, but hypovitaminosis D stilloccurs throughout the world. HIV/AIDS patients are prone to suffer fromhypovitaminosis D because of the infection itself and the side effects of antiretroviraltherapy. Various effort have been tried to improve the immune status of HIV/AIDSpatients, one of them is by adding vitamin D. Vitamin D acts as an antiinflammatoryso that it can prevent apoptosis of CD4 T cells and increase CD4 cell count.Methods. This is a randomized control trial add on a study that aims to determinethe effect of vitamin D to increase in CD4 counts of HIV / AIDS patients who havereceived antiretroviral drugs. Subjects were HIV / AIDS patients who had receivedantiretroviral drugs. A total of 20 subjects were divided randomly into two groups;one group received vitamin D (calcitriol 0.5 mcg per day) for eight weeks, and theother group that received a placebo. Each group was measured of CD4 cell countbefore and after treatment. Results. There was a significant increase in the CD4 cellcount of the vitamin D group (p = 0.046), but not in the CD4 cell count of bothgroups (p = 0.985). The comparison of mean CD4 cell counts between groups beforetreatment was not significantly different (p = 0.057), but after treatment, it becamesignificantly different (p = 0.040). Conclusion. Vitamin D has been successful inincreasing CD4 cell count in the vitamin D group, and it is recommended to giveHIV / AIDS patients to increase CD4 cell count.

Comparison of Omega-3 Serum Level Between Hiv-Aids Patients Along with Their Clinical Profiles and Healthy Population in Mohammad Hoesin General Hospital Palembang Lidiawati Handayani; Harun Hudari; Eddy Mart Salim; Erial Bahar; Nova Kurniati; Zulkhair Ali; Ferry Usnizar
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 5 No. 12 (2021): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/bsm.v5i4.382

Introduction. Human Immunodeficiency Virus (HIV) infection has been a concerning health problem worldwide. It causes reduction in body immune system and inflammation that can affect its clinical profile. Undergoing ARV therapy patients causes intestine microbiota dysbiosis and translocation that lead to imperfect absorbtion of fatty acid. One way to control microbiota dysbiosis is by controlling the nutritional factor, especially with omega-3. However, different regions upstands different custom in fish consumption especially those of which are rich in omega-3. The purpose of this research is to compare omega-3 serum level between HIV-AIDS patients and healthy population, as well as analyzing the correlation of omega-3 serum level with of HIV-AIDS patient clinical profile.Methods. The research will be applying observational analytic study using comparative study approach which will be performed in Tropical Infection Internal Medicine polyclinic and Medical Check-Up Polyclinic in RSMH Palembang starting from April 2020 until January 2021. Sample consisted of 32 HIV-AIDS patients from 20-58 years of age and 16 healthy population from 27-35 years of age on whom will be performed physical examination as well as clinical profile and omega-3 serum level examination. All data processing and analysis will be performed using SPSS v.25 for windows.Results. Out of 32 HIV-AIDS patients, we obtained low omega-3 serum level with median value at 3 (2-4) Umol/L, while in healthy population was 4 (3-6) Umol/L. Multivariate analysis inferred that the lower omega-3 serum level correlated with HIV-AIDS stage, duration of ARV therapy, blood pressure, and sex.Conclusion. Omega-3 serum levels in HIV-AIDS patients were lower than the healthy population. There was a correlation between omega-3 serum levels and their clinical profile of HIV-AIDS patients in Mohammad Hoesin General Hospital Palembang.

Correlation of Interleukin-6 Levels with Clinical Features and Chest X-Ray Imaging in Coronavirus Disease-19 (COVID-19) Patients at Dr. Mohammad Hoesin General Hospital Palembang Raden Yudistira Dwi Ananda; Nova Kurniati; Harun Hudari; Erial Bahar
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 6 No. 5 (2022): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v6i5.515

Background. COVID-19 infection, both moderate and severe symptoms can cause pneumonia that can be detected on a chest X-ray. Along with the increasing severity of the clinical picture of COVID 19, it can also trigger a cytokine storm, one of which is an increase in Interleukin-6 levels. This study was conducted to see the correlation between IL-6 levels with clinical features and chest radiographs in patients with COVID-19 Methods. This research is a cross-sectional study using an observational analytic. The samples in this study were confirmed COVID-19 patients who were being treated at Dr. Mohammad Hoesin General Hospital, Palembang. A history and physical examination were performed to determine the clinical picture as well as a chest X-ray and IL-6 levels. Results. There were 31 samples of COVID 19 patients. High levels of IL-6 were found in 26 (83.9%) samples. The clinical picture of the patient was dominated by dyspnea as much as 19 (61.3%), fever 16 (5.6%), low O2 saturation 12 (38.4%) and a chest X-ray of pneumonia 26 (83.9%). There was a significant relationship (P<0.05) between IL-6 levels with clinical features and chest X-rays. The R-value on the thorax with pneumonia (0.692), lesion area (0.711) and clinical features with temperature (0.906), respiratory rate (0.706) indicated a strong correlation, while O2 (-0.732) indicated a strong negative correlation. Conclusion. There is a significantly strong correlation between Interleukin 6 levels with clinical features and chest X-rays in patients with COVID-19.

Hiv Stage 4 With Pulmonary Tuberculosis, Collitis Tuberculosis, Oral Candidiasis, Wasting Syndrome, And Sensorineural Deafness: A Case Report Fadel Fikri Suharto; Edwin Nugraha Fetriawan; Muhamad Satria Yudha Pratama; R. Yudistira Dwi Ananda; Zen Ahmad; Raden Ayu Linda Andriani; Harun Hudari
Jurnal RSMH Palembang Vol. 2 No. 2 (2021): Jurnal RSMH Palembang
Publisher : RSUP Dr Moh Hoesin Palembang

Human immunodeficiency virus (HIV) is a retrovirus type virus that infects cells of the human immune system (especially CD4 positive T-cells and major components of the cellular immune system) and interferes with their function. This viral infection results in a continuous decline in the immune system, which will result in immune deficiency. People who are immune deficient/immunodeficiency become more susceptible to various types of infections. A 23 year male, a cafe employee, was admitted to hospital with complaints of weakness since 2 weeks before. He has productive cough for 3 weeks. He had decrease of food appetite, nauseas and vomiting. He had weight loss about 10 kg in the last 4 months. Patient had history of free sex, LGBT, since 2016 and history of hearing loss for 3 months. Laboratory finding showed rhonchi were found at the apex of the right and left lungs, Anti-HIV reactive and Absolute CD-4 count was 53 cell/uL, Gene Xpert MTB was detected, and Acid fast bacilli in stool is positive. Audiometry showed bilateral sensorineural deafness. Patient was diagnosed with HIV stage 4 with pulmonary tuberculosis, tuberculosis collitis, oral candidiasis, wasting syndrome, and sensorineural deafness.

The Effect of Vitamin D Supplementation on the Increase in CD4 count of HIV/AIDS Patients Receiving Antiretroviral Therapy Mega Permata; Harun Hudari; Mediarty; Taufik Indrajaya
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 5 No. 1 (2021): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/bsm.v5i1.186

Introduction. Vitamin D plays a role in health overall, but hypovitaminosis D stilloccurs throughout the world. HIV/AIDS patients are prone to suffer fromhypovitaminosis D because of the infection itself and the side effects of antiretroviraltherapy. Various effort have been tried to improve the immune status of HIV/AIDSpatients, one of them is by adding vitamin D. Vitamin D acts as an antiinflammatoryso that it can prevent apoptosis of CD4 T cells and increase CD4 cell count.Methods. This is a randomized control trial add on a study that aims to determinethe effect of vitamin D to increase in CD4 counts of HIV / AIDS patients who havereceived antiretroviral drugs. Subjects were HIV / AIDS patients who had receivedantiretroviral drugs. A total of 20 subjects were divided randomly into two groups;one group received vitamin D (calcitriol 0.5 mcg per day) for eight weeks, and theother group that received a placebo. Each group was measured of CD4 cell countbefore and after treatment. Results. There was a significant increase in the CD4 cellcount of the vitamin D group (p = 0.046), but not in the CD4 cell count of bothgroups (p = 0.985). The comparison of mean CD4 cell counts between groups beforetreatment was not significantly different (p = 0.057), but after treatment, it becamesignificantly different (p = 0.040). Conclusion. Vitamin D has been successful inincreasing CD4 cell count in the vitamin D group, and it is recommended to giveHIV / AIDS patients to increase CD4 cell count.

Comparison of Omega-3 Serum Level Between Hiv-Aids Patients Along with Their Clinical Profiles and Healthy Population in Mohammad Hoesin General Hospital Palembang Lidiawati Handayani; Harun Hudari; Eddy Mart Salim; Erial Bahar; Nova Kurniati; Zulkhair Ali; Ferry Usnizar
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 5 No. 12 (2021): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/bsm.v5i4.382

Introduction. Human Immunodeficiency Virus (HIV) infection has been a concerning health problem worldwide. It causes reduction in body immune system and inflammation that can affect its clinical profile. Undergoing ARV therapy patients causes intestine microbiota dysbiosis and translocation that lead to imperfect absorbtion of fatty acid. One way to control microbiota dysbiosis is by controlling the nutritional factor, especially with omega-3. However, different regions upstands different custom in fish consumption especially those of which are rich in omega-3. The purpose of this research is to compare omega-3 serum level between HIV-AIDS patients and healthy population, as well as analyzing the correlation of omega-3 serum level with of HIV-AIDS patient clinical profile.Methods. The research will be applying observational analytic study using comparative study approach which will be performed in Tropical Infection Internal Medicine polyclinic and Medical Check-Up Polyclinic in RSMH Palembang starting from April 2020 until January 2021. Sample consisted of 32 HIV-AIDS patients from 20-58 years of age and 16 healthy population from 27-35 years of age on whom will be performed physical examination as well as clinical profile and omega-3 serum level examination. All data processing and analysis will be performed using SPSS v.25 for windows.Results. Out of 32 HIV-AIDS patients, we obtained low omega-3 serum level with median value at 3 (2-4) Umol/L, while in healthy population was 4 (3-6) Umol/L. Multivariate analysis inferred that the lower omega-3 serum level correlated with HIV-AIDS stage, duration of ARV therapy, blood pressure, and sex.Conclusion. Omega-3 serum levels in HIV-AIDS patients were lower than the healthy population. There was a correlation between omega-3 serum levels and their clinical profile of HIV-AIDS patients in Mohammad Hoesin General Hospital Palembang.

Correlation of Interleukin-6 Levels with Clinical Features and Chest X-Ray Imaging in Coronavirus Disease-19 (COVID-19) Patients at Dr. Mohammad Hoesin General Hospital Palembang Raden Yudistira Dwi Ananda; Nova Kurniati; Harun Hudari; Erial Bahar
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 6 No. 5 (2022): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v6i5.515

Background. COVID-19 infection, both moderate and severe symptoms can cause pneumonia that can be detected on a chest X-ray. Along with the increasing severity of the clinical picture of COVID 19, it can also trigger a cytokine storm, one of which is an increase in Interleukin-6 levels. This study was conducted to see the correlation between IL-6 levels with clinical features and chest radiographs in patients with COVID-19 Methods. This research is a cross-sectional study using an observational analytic. The samples in this study were confirmed COVID-19 patients who were being treated at Dr. Mohammad Hoesin General Hospital, Palembang. A history and physical examination were performed to determine the clinical picture as well as a chest X-ray and IL-6 levels. Results. There were 31 samples of COVID 19 patients. High levels of IL-6 were found in 26 (83.9%) samples. The clinical picture of the patient was dominated by dyspnea as much as 19 (61.3%), fever 16 (5.6%), low O2 saturation 12 (38.4%) and a chest X-ray of pneumonia 26 (83.9%). There was a significant relationship (P<0.05) between IL-6 levels with clinical features and chest X-rays. The R-value on the thorax with pneumonia (0.692), lesion area (0.711) and clinical features with temperature (0.906), respiratory rate (0.706) indicated a strong correlation, while O2 (-0.732) indicated a strong negative correlation. Conclusion. There is a significantly strong correlation between Interleukin 6 levels with clinical features and chest X-rays in patients with COVID-19.

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