Pemantauan Terapi ARV dan Penatalaksanaan HIV Fakultas

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Pemantauan Terapi ARV dan Penatalaksanaan HIV
Fakultas Kedokteran
Universitas
Brawijaya (FKUB)
bekerjasama dengan
Perhimpunan Alergi
Imunologi Indonesia
(PERALMUNI)
cabang Malang
menyelenggarakan
Malang-Allergy &
Immunology Update 2011. Kegiatan ini digelar selama dua hari, Jumat-Sabtu (28-29/10) di
Ruang Auditorium Lantai 6 FKUB. Pada hari pertama, acara meliputi simposium
pemeriksaan laboratorium untuk diagnosis dan pemantauan terapi Antiretroviral (ARV), serta
workshop penatalaksanaan Human Immunodeficiency Virus (HIV) terkini. Sedangkan pada
hari kedua dilakukan workshop diagnosis dan penatalaksanaan Systemic Lupus
Erythematosus (SLE) terkini.
Kepala instalasi patologi klinik RS Kanker Dharmais Jakarta Dr. Agus S. Kosasih, SpPK,
MARS menyampaikan materi “Peran pemeriksaan CD4 dalam terapi ARV”. Target dari virus
HIV adalah sel limfosit yang disebut sel CD4. Infeksi HIV menyebabkan jumlah sel CD4
menurun secara bertahap. “Bila jumlah CD4 turun dibawah 200 atau apabila infeksi
oportunistik atau kanker timbul, maka seseorang dengan infeksi HIV disebut sebagai
Acquired Immunodeficiency Syndrome (AIDS),” terang Agus. Agus menjelaskan
pemeriksaan CD4 berperan karena dapat menentukan status imun, mulainya pengobatan,
profilaksis infeksi oportunistik, serta dapat memonitor pengobatan. “Target yang ingin
dicapai dari pengobatan adalah gejala klinik hilang, CD4 meningkat dan viral load HIV tidak
terdeteksi,” jelasnya.
Dalam acara ini hadir pembicara tamu, Product Manager Infectious Disease Asia Tenggara
Dr. Somying Promso. Ia membawakan materi “Pemeriksaan HIV Viral Load”. Ia mengatakan
pemeriksaan CD4 dan Viral Load mengukur hal yang berbeda. “CD4 adalah pemeriksaan
yang sangat baik untuk mengetahui kondisi sistem imun, sedangkan Viral Load mendeteksi
seberapa aktif virus HIV tersebut,” jelas Somying.
Selain Agus dan Somying, pembicara yang hadir dalam seminar ini adalah M. Fauzi dengan
materi Pemeriksaan CD4 Sederhana, Prof.Dr.dr. Samsuridjal Djauzi, SpPD, K-AI (Siapa
yang perlu tes HIV), Dr. dr. Evy Yunihastuti, SpPD, K-AI (Memulai dan memantau terapi
ARV, serta indikasi pindah ke ARV lini-2), dan Dr. Teguh Harjono Karjadi, SpPD, K-AI
(Infeksi Opportunistik pada HIV).
Siapa Yang Perlu Tes HIV
Di ASEAN, Jumlah orang dengan HIV/AIDS (Odha) yang mendapat obat ARV hanya sekitar
25 persen dari yang seharusnya. Situasi di Indonesia masih mengharuskan kita berupaya
meningkatkan Odha memperoleh obat ARV dan di sisi lain juga harus menemukan infeksi
HIV pada stadium dini. Divisi Alergi-Imunologi Klinik Departemen Ilmu Penyakit Dalam
FKUI/RSCM Jakarta Prof. DR. dr. Samsuridjal Djauzi, SpPD, K-AI mengatakan, “Dari
sekitar 5600 Odha yang berobat di RSCM sekitar 80 persen sudah dalam masa gejala atau
CD4 dibawah 200”. “Dengan demikian ada dua tugas utama petugas kesehatan yaitu
mendorong masyarakat untuk menjalani tes HIV dan meningkatkan kepedulian agar
diagnosis HIV dapat ditegakkan secara lebih dini”, ujar Samsuridjal.
Di Indonesia baru sekitar 100 ribu penduduk yang melakukan tes HIV padahal estimasi orang
yang terinfeksi HIV di Indonesia mencapai 300 ribu orang. Dengan penduduk sekitar 240 juta
orang tidak mudah bagi Indonesia melakukan tes HIV pada seluruh penduduknya. “Karena
itu kita perlu menganjurkan tes HIV bagi pasangan Odha, pengguna narkoba suntikan,
penderita Penyakit Menular Seksual, penderita penyakit Tuberkulosis, ibu hamil, anak yang
lahir dari ibu hamil positif HIV, serta mereka yang berminat untuk tes HIV”, jelas
Samsuridjal. Sudah tentu peningkatan jumlah orang yang tes HIV harus disukung oleh tindak
lanjut untuk dukungan diagnosis dan terapi ARV. “Untunglah sampai saat ini pemerintah
Indonesia masih terus menyediakan obat ARV gratis untuk masyarakat yang
memerlukannya”, pungkasnya. [mit]
Monitoring ARV Theraphy and HIV Management
Medical Faculty of
Universitas
Brawijaya (FKUB)
cooperates with
Immunology Allergy
Association of
Indonesia
(PERALMUNI)
local Malang held
Malang-Allergy &
Immunology Update 2011. This event was conducted for two days, Friday to Saturday (2829/10) in Auditorium Room of 6th Floor FKUB. On the first day, the event included
symposium of laboratory check to diagnose and monitor Antiretroviral (ARV) theraphy, also
a workshop of the latest Human Immunodeficiency Virus (HIV) management. While on the
second day, there was a workshop of the latest Systemic Lupus Erythematosus (SLE)
diagnose and management.
The Head of clinical pathology installation Dharmais Cancer Hospital Jakarta, Dr. Agus S.
Kosasih, SpPK, MARS, stated “The Examination of CD4 in ARV theraphy”. The target of
this virus is lymphocyte cell which is called CD4. HIV infection causes the number of CD4
cell decrease gradually. “If the number of CD4 decreases below 200 or if the opportunistic
infection or appears a cancer, then someone with HIV infection is called as Acquired
Immunodeficiency Syndrome (AIDS), “ explained Agus. Agus explained that the
examination of CD4 had a role because it can determine the immune status, starting from
medication, prophylaxis of opportunistic infections, as well as to monitor treatment. “The
target that wants to be achieved from medication is the missing of clinical symptoms, CD4
cell increases and HIV viral load undetectable," he explained.
In this event, attended as the guest speaker, a Product Manager of Infectious Disease South
East Asia, Dr. Somying Promso, who presented "Examination of HIV Viral Load". He said
the examination of CD4 and Viral Load measure different things. "CD4 is a very good
examination to determine the condition of immune system, while the viral load detects how
active is HIV virus," explained Somying.
In addition to Agus and Somying, other speakers who attended this seminar were M. Fauzi
with CD4 Simple Examination, Prof. Dr. dr. Samsuridjal Djauzi, SpPD, K-AI (Who needs an
HIV test), Dr. dr. Evy Yunihastuti, SpPD, K-AI (Initiate and monitor ARV therapy, as well
as indications of moving into ARV line-2), and Dr. Teguh Harjono Karjadi, SpPD, K-AI
(opportunistic infection in HIV).
Who Needs HIV Test
In ASEAN, the number of people with HIV/AIDS (Odha) who receives antiretroviral (ARV)
drugs is only 25 percent than it should. The situation in Indonesia still requires that we work
to improve Odha to get antiretroviral drugs and on the other side must also be found in the
early stages of HIV infection. Division of Allergy-Clinical Immunology Department of
Internal Disease Medical Faculty Universitas Indonesia/RSCM Jakarta, Prof. DR. dr.
Samsuridjal Djauzi, SpPD, K-AI said, "Of the approximately 5600 Odha(s) who do
medication in RSCM is about 80 percent had in a period of symptoms or CD4 belows 200".
"Thus there are two main tasks, to encourage community health workers to undergo HIV test
and increase awareness of HIV diagnoses in order to be enforced early", said Samsuridjal.
In Indonesia, it is only around 100 thousand people who have HIV test, whereas the
estimation of people who are infected with HIV in Indonesia reach 300 thousand people.
With a population of about 240 million people, it is not easy for Indonesia to do HIV test on
the entire population. "Therefore we need to encourage HIV test for couples living with HIV,
injection drug users, people with Sexually Transmitted Diseases, Tuberculosis disease
patients, pregnant women, children who are born from pregnant women with positive HIV,
as well as those who are interested in HIV test," explained Samsuridjal. Certainly an
increased number of people who have HIV test should be continued by follow-up to support
the diagnosis and antiretroviral therapy. "Fortunately, until now the Indonesian government
continues to provide free antiretroviral drugs to people who need it," he concluded. [mit/ps2]
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