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All Journal Bioscientia Medicina : Journal of Biomedicine and Translational Research Bioscientia Medicina : Journal of Biomedicine and Translational Research
Rohayat Bilmahdi
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Biochemistry, Genetics & Molecular Biology Immunology & microbiology Medicine & Pharmacology Neuroscience

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Successful Management of Panuveitis and Associated Complications in a Patient with Clinical Stage III HIV: A Case Report Putra, Ikhsan Amanda; Fadrian; Rohayat Bilmahdi
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 12 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i12.1144

Abstract

Background: Human immunodeficiency virus (HIV) infection can lead to a myriad of ocular complications, including panuveitis, an inflammatory condition affecting the entire uvea and surrounding structures. The management of panuveitis in HIV patients is complex, often requiring a multidisciplinary approach to address both the underlying immunodeficiency and the ocular inflammation. Case presentation: We present the case of a 37-year-old male patient with clinical stage III HIV who presented with panuveitis in the right eye (OD) secondary to herpes zoster ophthalmicus (HZO). The patient also had post-herpetic neuralgia, oral candidiasis, and malnutrition. He reported a history of unprotected sexual encounters with multiple partners. The patient's CD4 count was critically low at 15 cells/µL, indicating severe immunosuppression. He was initiated on antiretroviral therapy (ART), prophylactic medications to prevent opportunistic infections, and pain management for post-herpetic neuralgia. Conclusion: This case highlights the challenges in managing panuveitis and associated complications in patients with advanced HIV infection. Early diagnosis, prompt initiation of ART, and a multidisciplinary approach are crucial for successful management and improving patient outcomes.
The Diagnostic Accuracy of IgG Avidity Testing for Differentiating Acute from Chronic Toxoplasmosis in Pregnant Women: A Meta-Analysis Hermalina Sherli Utami; Rohayat Bilmahdi; Fadrian
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 12 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i12.1467

Abstract

Background: Differentiating acute from chronic Toxoplasma gondii infection during pregnancy is a critical diagnostic challenge. Persistent Immunoglobulin M (IgM) antibodies create ambiguity, complicating clinical management. The IgG avidity test serves as a key tool to estimate infection timing. This meta-analysis aimed to systematically evaluate and quantify the diagnostic accuracy of the IgG avidity test for identifying acute toxoplasmosis in pregnant women. Methods: A systematic literature search was conducted across PubMed, Scopus, Web of Science, EMBASE, and LILACS for studies published between January 2015 and December 2025 evaluating the IgG avidity test's diagnostic accuracy in pregnant women. Included studies required data for a 2x2 contingency table. The QUADAS-2 tool was used for bias assessment. A bivariate random-effects model was used to pool sensitivity, specificity, likelihood ratios (PLR, NLR), and the diagnostic odds ratio (DOR). Results: Seven studies, comprising 1,250 pregnant women, were included. The pooled sensitivity was 0.96 (95% Confidence Interval [CI]: 0.92–0.98), and the pooled specificity was 0.97 (95% CI: 0.94–0.99). The pooled PLR was 32.5 (95% CI: 15.1–69.8), the NLR was 0.04 (95% CI: 0.02–0.08), and the DOR was 785 (95% CI: 289–2134). The area under the SROC curve was 0.99 (95% CI: 0.97–1.00). Substantial heterogeneity was observed across studies. A sensitivity analysis excluding one study with a high risk of bias did not significantly alter the results, and Deeks' test showed no evidence of publication bias (p=0.21). Conclusion: The IgG avidity test demonstrated excellent pooled diagnostic accuracy for differentiating acute from chronic toxoplasmosis in pregnancy. However, significant heterogeneity across studies underscores that a single performance estimate is not universally applicable. The test is a powerful tool for resolving diagnostic uncertainty, but results must be interpreted based on assay-specific performance and in the context of the complete clinical picture.
The Diagnostic Accuracy of IgG Avidity Testing for Differentiating Acute from Chronic Toxoplasmosis in Pregnant Women: A Meta-Analysis Hermalina Sherli Utami; Rohayat Bilmahdi; Fadrian
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 12 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i12.1467

Abstract

Background: Differentiating acute from chronic Toxoplasma gondii infection during pregnancy is a critical diagnostic challenge. Persistent Immunoglobulin M (IgM) antibodies create ambiguity, complicating clinical management. The IgG avidity test serves as a key tool to estimate infection timing. This meta-analysis aimed to systematically evaluate and quantify the diagnostic accuracy of the IgG avidity test for identifying acute toxoplasmosis in pregnant women. Methods: A systematic literature search was conducted across PubMed, Scopus, Web of Science, EMBASE, and LILACS for studies published between January 2015 and December 2025 evaluating the IgG avidity test's diagnostic accuracy in pregnant women. Included studies required data for a 2x2 contingency table. The QUADAS-2 tool was used for bias assessment. A bivariate random-effects model was used to pool sensitivity, specificity, likelihood ratios (PLR, NLR), and the diagnostic odds ratio (DOR). Results: Seven studies, comprising 1,250 pregnant women, were included. The pooled sensitivity was 0.96 (95% Confidence Interval [CI]: 0.92–0.98), and the pooled specificity was 0.97 (95% CI: 0.94–0.99). The pooled PLR was 32.5 (95% CI: 15.1–69.8), the NLR was 0.04 (95% CI: 0.02–0.08), and the DOR was 785 (95% CI: 289–2134). The area under the SROC curve was 0.99 (95% CI: 0.97–1.00). Substantial heterogeneity was observed across studies. A sensitivity analysis excluding one study with a high risk of bias did not significantly alter the results, and Deeks' test showed no evidence of publication bias (p=0.21). Conclusion: The IgG avidity test demonstrated excellent pooled diagnostic accuracy for differentiating acute from chronic toxoplasmosis in pregnancy. However, significant heterogeneity across studies underscores that a single performance estimate is not universally applicable. The test is a powerful tool for resolving diagnostic uncertainty, but results must be interpreted based on assay-specific performance and in the context of the complete clinical picture.
Successful Management of Panuveitis and Associated Complications in a Patient with Clinical Stage III HIV: A Case Report Putra, Ikhsan Amanda; Fadrian; Rohayat Bilmahdi
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 12 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i12.1144

Abstract

Background: Human immunodeficiency virus (HIV) infection can lead to a myriad of ocular complications, including panuveitis, an inflammatory condition affecting the entire uvea and surrounding structures. The management of panuveitis in HIV patients is complex, often requiring a multidisciplinary approach to address both the underlying immunodeficiency and the ocular inflammation. Case presentation: We present the case of a 37-year-old male patient with clinical stage III HIV who presented with panuveitis in the right eye (OD) secondary to herpes zoster ophthalmicus (HZO). The patient also had post-herpetic neuralgia, oral candidiasis, and malnutrition. He reported a history of unprotected sexual encounters with multiple partners. The patient's CD4 count was critically low at 15 cells/µL, indicating severe immunosuppression. He was initiated on antiretroviral therapy (ART), prophylactic medications to prevent opportunistic infections, and pain management for post-herpetic neuralgia. Conclusion: This case highlights the challenges in managing panuveitis and associated complications in patients with advanced HIV infection. Early diagnosis, prompt initiation of ART, and a multidisciplinary approach are crucial for successful management and improving patient outcomes.
Co-Authors Fadrian, Fadrian Hermalina Sherli Utami Ikhsan Amanda Putra, Ikhsan Amanda