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Treatment challenges of nevirapine-induced Stevens-Johnson syndrome: a case report Rosandy, Milanitalia Gadys; Indiastari, Dewi; Candradikusuma, Didi; Budiarti, Niniek; Sutanto, Heri; Amalia, Dinda
Indonesian Journal of Biomedicine and Clinical Sciences Vol 56 No 4 (2024)
Publisher : Published by Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/inajbcs.v56i4.13026

Abstract

Nevirapine, a non-nucleoside reverse transcriptase inhibitor (NNRTI), is a crucial component of antiretroviral therapy (ART) in HIV management. However, nevirapine carries a rare but potentially life-threatening risk of Stevens-Johnson syndrome (SJS). We reported a case of severe cutaneous manifestations of extensive necrolysis in an HIV-positive patient on the ARV nevirapine. This case highlights the importance of recognizing nevirapine-induced SJS, particularly in the early stages, to ensure prompt discontinuation of the drug and initiation of appropriate supportive care. Clinicians managing HIV patients on nevirapine-based ART should remain vigilant for early signs of SJS and maintain a high index of suspicion.
Association of Antiretroviral Regimens and CD4 Counts with Dyslipidemia in HIV Patients: Implications for Metabolic Management Rosandy, Milanitalia Gadys; Candradikusuma, Didi; Yudha, Nyoman Satvika Dharma
Indonesian Journal of Medicine Vol. 10 No. 1 (2025)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/theijmed.2025.10.1.797

Abstract

Background: Dyslipidemia, a key risk factor for cardiovascular disease, is prevalent among people living with HIV/AIDS receiving antiretroviral therapy. This study aims to evaluate the impact of different ART regimens on lipid profiles in HIV patients and identify regimens with better outcomes in lipid profile levels. Subjects and Method: An observational study was conducted from June to August 2024 at Dr. Saiful Anwar Regional General Hospital, Malang, Indonesia. Participants were recruited using consecutive random sampling, including HIV patients on ART for at least three months. Independent variables included ART regimens and CD4 counts, while the dependent variable was dyslipidemia status. Data were collected via demographic forms, medical record reviews, and lipid profile analysis. Statistical analysis was performed using chi-square and t-tests, with significance set at p < 0.05. Results: Of the 110 participants, 38.2% were identified with dyslipidemia. The highest dyslipidemia rates were observed in patients using the Duviral Alluvial regimen (80.0%), followed by Duviral Neviral (71.4%). Newer regimens, TLD and TLE, were associated with lower dyslipidemia rates (31.3% and 36.0%, respectively; p = 0.045). A significant association was also noted between dyslipidemia and CD4 counts, with dyslipidemic patients showing higher mean CD4 counts (560.29 cells/μL) compared to non-dyslipidemic individuals (378.40 cells/μL; p = 0.009). Conclusion: Newer ART regimens such as TLD and TLE are associated with better lipid profile outcomes and lower dyslipidemia risk compared to older regimens. Higher CD4 counts may reflect an increased risk of lipid abnormalities, emphasizing the need for lipid monitoring and regimen optimization in HIV care.
A Case of  HIV and Disseminated Tuberculosis: Unrecognized Co-Infection and the Importance of Early Diagnosis Rosandy, Milanitalia Gadys; Fadli, M Luqman; Nurdiana, Farah; Kamal Hadi, Muchamad
Jurnal Kedokteran Brawijaya Vol. 33 No. 4 (2025)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2025.033.04.9

Abstract

Tuberculosis (TB) is still the main cause of death in people living with HIV (PLHIV). TB preventive therapy (TPT) and ARVs can reduce morbidity, mortality, and incidence of TB in PLHIV. With the severity of the immunodeficiency, extrapulmonary TB or disseminated TB occurs more often. Disseminated TB occurs due to the hematogenous spread of Mycobacterium tuberculosis, which occurs as a result of progressive primary infection or reactivation of latent TB infection. Disseminated TB can involve many organs such as the lungs, liver, and spleen. Delays in diagnosis often occur due to non-specific clinical manifestations; thus, the diagnosis needs to be supported by radiological and microbiological examination, as well as definite histopathological diagnosis. Treatment is given according to existing therapy guidelines with a more extensive duration and regard to the patient's clinical condition.