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All Journal Journal of Community Empowerment for Health Indonesian Journal of Pharmacology and Therapy
Chandra, Lukman Ade
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Education Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health

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Early drug-induced hepatotoxicity in newly diagnosed HIV-positive patients on ARV therapy: A retrospective follow-up study of liver function profiles Chandra, Lukman Ade; Subronto, Yanri Wijayanti; Thobari, Jarir At
Indonesian Journal of Pharmacology and Therapy Vol 4 No 2 (2023)
Publisher : Faculty of Medicine, Public Health, and Nursing Universitas Gadjah Mada and Indonesian Pharmacologist Association or Ikatan Farmakologi Indonesia (IKAFARI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/ijpther.7817

Abstract

Antiretroviral therapy (ART) is a primary therapeutic modality for managing individuals with Human Immunodeficiency Virus (HIV) infection, and its efficacy has been established. However, the safety profiles of ART need to be continually monitored, including early elevated liver function test (LFT) after antiretroviral (ARV) initiation. This study aimed to assess the incidence of abnormal LFT among HIV-positive patients receiving initial ARV and to identify factors associated with abnormal LFT. A retrospective cohort study without a control group summarised medical records from Dr Sardjito General Hospital, Yogyakarta between January 2014 and December 2021. The study subjects were adult HIV patients taking their first ARV and underwent follow-up visits for at least two weeks. Study outcomes were LFT levels, abnormal LFT, and factors associated with abnormal LFT during follow-up visits at 2 wk, 6 mo, and 12 mo. Univariate and multivariate analyses will be performed with a significance level of p<0.05. A total of 137 subjects with 203 visits were retrieved from medical records. The subjects' mean age was 33.4 years, predominantly male, younger, unmarried, in the early stage of HIV infection, and without comorbidities. The findings showed a significant increase in alanine transaminase (ALT) at all three follow-up visits: 2 wk (p=0.02), 6 mo (p=0.003), 12 mo (p=0.001) and an increase in aspartate aminotransferase (AST) after 6 mo (p=0.007) and 12 mo (p=0.04). Abnormal LFT levels (AST and/or ALT) were observed in 23.4% of patients after a normal baseline, with ALT increase being more common. Furthermore, homosexuality was identified as a significant independent factor associated with abnormal LFT (AOR=3.1; 95% CI 1.27-7.51; p=0.01). The findings indicate exceptionally elevated LFT levels and the occurrence of abnormal LFTs among HIV-positive patients initiating ARVs. The increase in abnormal LFTs was significantly associated with patients identifying as homosexual, where hepatitis co-infection may be a contributing factor. The limited study design and measured variables warrant further investigation.
The drive-through COVID-19 vaccination in Yogyakarta Chandra, Lukman Ade; Nirwati, Hera; Puspitasari, Ika; Dibtyanusa, Ajib; Sutono, Sutono; Achmad, Bayu Fandi; Kumara, Intan Fatah; Siswishanto, Rukmono
Journal of Community Empowerment for Health Vol 7, No 2 (2024)
Publisher : Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jcoemph.82335

Abstract

Introduction: COVID-19 vaccination is the government's priority to control viral transmission. Drive-through system provides quick means of product or service delivery; however, it has not been extensively adopted as a vaccination method. This study aims to describe the implementation of the drive-through COVID-19 vaccination conducted by the Faculty of Medicine, Public Health, and Nursing at Universitas Gadjah Mada in collaboration with several national and regional, governmental and non-governmental institutions. Methods: The drive-through vaccination involved online registration, data collecting, reporting, on-site dose preparation, injection, and post-vaccination monitoring while participants remained in their vehicles. The events were scheduled between July and September 2021 in either FK-KMK UGM Campus or Grha Sabha Pramana, UGM. These venues are on the inner property side of UGM, therefore is no disruption of public traffic. Participants who are eligible and receive an invitation may attend the immunization venue according to the schedule. Results: In ten vaccination events, 20,870 doses of the COVID-19 vaccine were administered. Most participants were young people, with slightly more women than men. The drive-through vaccination went relatively well and offered many benefits such as improving vaccine coverage, time efficiency, social distancing, and herd immunity. Yet, issues like mild Adverse events following immunization and an accumulation of vehicles occurred. Therefore, careful planning and risk anticipation are necessary. Conclusion: The drive-through vaccination generally provides rapid and safe vaccine delivery to large communities. This method could be an alternative to delivering mass vaccinations requiring rapid and extensive coverage.
Co-Authors Achmad, Bayu Fandi Dibtyanusa, Ajib Hera Nirwati Ika Puspitasari Jarir At Thobari Kumara, Intan Fatah Rukmono Siswishanto Sutono Sutono Yanri Wijayanti Subronto