Mirna Widiyanti
Balai Litbang Biomedis Papua. Jl. Kesehatan No. 10 Dok II, Jayapura, Papua.

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Analisis Subtipe HIV-1 dan Faktor Penyebarannya pada Penderita HIV di RS. Yowari Kabupaten Jayapura, Papua Widiyanti, Mirna; Sandy, Semuel; Wibowo, Holy A.
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Publisher : Jurnal Biologi Papua

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Acquaired immunodeficiency Syndrome (AIDS) is a symptoms caused by infection with Human Immuno-deficiency Virus (HIV). There are two types of HIV genetically distinguished as HIV-1 and HIV-2 subtype. Subtypes of HIV-1 globally have different distribution in state, where geographical factors could affected to the subtype differences. Papua is one of the provinces that have high case of HIV/AIDS. High number of people with HIV/AIDS in Papua caused by new regional area expansion and mobilization of the population in province and district area. This study was aimed to identify the sub type HIV-1 and the risk factors that correlated in the transmission of HIV-1 type. The research study was performed by cross-sectional design. There were 36 HIV patient sample respondent willing to participate in research and they were sign inform consent. Subtype HIV-1 identification was performed by used Nested-PCR, sequencing, and BLAST to found subtype HIV-1. The interview method used a questionnaires to found of  the risk factors  related to subtype HIV-1. The results of research showed that HIV-1 subtype found in people with HIV in Yowari hospital is CRF01_AE subtype (31 respondent) and subtype B ( 5 respondent). Chi-squre and Fisher exact test analysis of risk factors that influence the spread of HIV-1 subtype showed a non significant results. The research study concluded sub-type HIV-1 in patients is CRF01_AE and subtype B and  there were not correlated risk factors with HIV-1 subtype.Key words: HIV/AIDS , type HIV-1 , CRF01_AE , Sub type-B, RS Yowari.
Dampak Perpaduan Obat ARV pada Pasien HIV/AIDS ditinjau dari Kenaikan Jumlah Limfosit CD4+ di RSUD Dok II Kota Jayapura Widiyanti, Mirna
JURNAL PLASMA Vol 1, No 2 Jun (2015)
Publisher : Balai Penelitian dan Pengembangan Biomedis Papua

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The purpose of ARV is reducing the rate of transmission, reducing morbidity and mortalityassociated with HIV, restoring and maintaining the immune system and suppressing the viralreplication maximal. Dok II Hospital is one of the hospitals that provide care and ARV therapy forpatients HIV. The number of patients increasing each year, it is necessary to evaluate the success ofARV drugs on a regular basis in order to achieve optimal outcomes. One way of monitoring is tolook at the efficacy of a combination of ARV drugs on the immune response of the increase is theincrease in Lymphocyte CD4+ cell count. To determine the efficacy of ARV combination based onthe increase in CD4 cell counts of patients after 6-12 months of ARV treatment in Dok II Hospital in2011-2012. The study was an observational. Data were collected retrospectively on secondary datafrom medical records of patients who met the inclusion criteria. Data were analyzed by ANOVA. Sixobtained the drug combination gave good efficacy based on a significant increase in LymphocyteCD4+ cell counts in patients with HIV/AIDS who receive ARV drugs in combination II and V (pvalue = 0.002) and the combination of III and V (p value = 0.033) while for other combinationsbetween no significant difference. The sixth best combination ARV efficacy there are 2 that thecombination II and V combination.
Hubungan Jumlah Cluster of Differentiation 4 (CD4) dengan Infeksi Oportunistik Pada Pasien HIV/AIDS di Rumah Sakit Umum Daerah (RSUD) DOK II Jayapura Widiyanti, Mirna; Hutapea, Hotma
JURNAL BIOLOGI PAPUA Vol 7, No 1 (2015)
Publisher : JURNAL BIOLOGI PAPUA

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Human Immunodeficiency Virus (HIV) is an infection that attacks and weakens the immune system. HIV infection causes a decrease in the number of Cluster Differentiation 4 (CD4) thereby increasing the progression of the disease and lead to high risk of opportunistic infections (OI). The purpose of this study was to examine the relationship between CD4 cell count with opportunistic infections in patients infected with HIV/AIDS. Analytical research methods using cross-sectional design, by taking medical records. The population in this study were 67 patients with HIV/AIDS in the VCT Clinic Dok II Hospital Jayapura 2014. Data were processed with the Chi Square test hypotheses. Based on the results of hypothesis testing of 67 patients, there were 21 people have opportunistic infections. Tuberculosis is an opportunistic infection that is most common (17.9%). Significance of the relationship seen in the low CD4 counts (< 350 cells/mm3) and found value of 0.02 (CI 95%) which indicates that there is a relationship if p
Analisis Subtipe HIV-1 dan Faktor Penyebarannya pada Penderita HIV di RS. Yowari Kabupaten Jayapura, Papua Widiyanti, Mirna; Sandy, Semuel; Wibowo, Holy A.
JURNAL BIOLOGI PAPUA Vol 6, No 1 (2014)
Publisher : JURNAL BIOLOGI PAPUA

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Acquaired immunodeficiency Syndrome (AIDS) is a symptoms caused by infection with Human Immuno-deficiency Virus (HIV). There are two types of HIV genetically distinguished as HIV-1 and HIV-2 subtype. Subtypes of HIV-1 globally have different distribution in state, where geographical factors could affected to the subtype differences. Papua is one of the provinces that have high case of HIV/AIDS. High number of people with HIV/AIDS in Papua caused by new regional area expansion and mobilization of the population in province and district area. This study was aimed to identify the sub type HIV-1 and the risk factors that correlated in the transmission of HIV-1 type. The research study was performed by cross-sectional design. There were 36 HIV patient sample respondent willing to participate in research and they were sign inform consent. Subtype HIV-1 identification was performed by used Nested-PCR, sequencing, and BLAST to found subtype HIV-1. The interview method used a questionnaires to found of the risk factors related to subtype HIV-1. The results of research showed that HIV-1 subtype found in people with HIV in Yowari hospital is CRF01_AE subtype (31 respondent) and subtype B ( 5 respondent). Chi-squre and Fisher exact test analysis of risk factors that influence the spread of HIV-1 subtype showed a non significant results. The research study concluded sub-type HIV-1 in patients is CRF01_AE and subtype B and there were not correlated risk factors with HIV-1 subtype. Key words: HIV/AIDS , type HIV-1 , CRF01_AE , Sub type-B, RS Yowari.
Subtypes and phylogenetic analysis of human immunodeficiency virus-1 in Jayapura Widiyanti, Mirna; Wibawa, Tri; Wibowo, Holy Arif
Universa Medicina Vol 33, No 1 (2014)
Publisher : Faculty of Medicine, Trisakti University

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BACKGROUND Human immunodeficiency virus (HIV) is a retrovirus that infects human immune system. HIV is genetically differentiated into HIV-1 and HIV-2. HIV- 1 is classified into 3 groups : M,N and O. M Group is divided into 9 subtypes, namely : A, B, C, D, F, G, H, J and K. HIV subtype mapping would become a good reference to study the epidemiology of HIV-1. HIV phylogenetic analysis required to understand virus origin, geographical distribution and tracking parameter of HIV transmission process in sample area. The objective of this study was to determine HIV-1 subtype distribution and the relationship between HIV-1 subtypes from with genBank HIV isolate based on envelope gene fragment. METHODS A cross setional design was conducted involving 36 subjects in Jayapura between January to March 2013. Blood samples were taken and analyzed using reverse transcription polymerase chain reaction (RT-PCR), nested PCR and confirmed with sequencing. Phylogenetic analysis performed along 400 bp of envelope gene fragment. The data were analyzed with Bioedit ver.7 and MEGA 5.1. software. RESULT Two types of HIV-1 subtype were found in Jayapura Regency. CRF01_AE was confirmed in 31 patients (86.1%) and subtype B in 5 patients (13.9%). Phylogenetic analysis showed phylogenetic relationship between CRF01_AE from jayapura with subtype from Singapore and Thailand, while subtype B from Jayapura were closely related with subtype from United States and United Kingdom CONCLUSION This study reflect the independent introduction of multiple HIV-1 strains into Papua, with the rapid spread in the majority of infected patients tested of single strain of HIV-1 (CRF01_AE).
IDENTIFICATION OF ANTIRETROVIRAL MUTATION IN PROTEASE AND REVERSE TRANCRIPTASE INHIBITOR IN HUMAN IMMUNODEFICIENCY VIRUS-1 OF HIV/AIDS PATIENTS IN MIMIKA REGENCY, PAPUA Widiyanti, Mirna; Fitriana, Eva; Natalia, Evi Iriani; Wike, Irawati
Folia Medica Indonesiana Vol 53, No 1 (2017): JANUARY - MARCH 2017
Publisher : Faculty of Medicine, Universitas Airlangga

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Treatment with RT Inhibitors has been used as first line program in Mimika. Regular use of antiretroviral drugs can lower the amount of the virus, but after that HIV can become resistant to the drugs given. Viral resistance to the drugs can occur because of a mutation. If the resistance-associated mutations occur in the DNA of the virus, then the ARV provided will no longer be effective. The aim of this study was to identify the presence of resistance-associated mutations in DNA fragment that encodes the protease and reverse transcriptase. This study used cross sectional design with 84 subjects who had received antiretroviral for > 6 months. The study was conducted in Mitra Masyarakat Mimika Hospital. Laboratory process included extraction, RT-PCR, electrophoresis and sequencing. Data analysis used resistance interpretation algorithms in HIV Database. Results showed that 1 subject who did not receive protease therapy was identified as having minor mutation L10V, 1 subjects receiving NRTI inhibitors had mutation M184V motive and 1 subjects with M41L motive and 1 subjects who received NNRTI inhibitor therapy identified as having mutated Y181C and V108I motive. In conclusion, mutant HIV-1 related to ARV resistance has been identified in two subjects who had received antiretroviral therapy in Mitra Masyarakat Mimika Hospital.
KARAKTERISTIK PASIEN KOINFEKSI TB-HIV DI RUMAH SAKIT MITRA MASYARAKAT MIMIKA PAPUA Widiyanti, Mirna; Fitriana, Eva; Iriani, Evi
Sel Jurnal Penelitian Kesehatan Vol 3, No 2 (2016): SEL
Publisher : Loka Penelitian dan Pengembangan Biomedis Aceh

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ABSTRAK Penyakit Tuberkulosis (TB) merupakan salah satu penyakit menular di Indonesia, dan saat ini berada pada urutan kelima Negara dengan beban TB tertinggi di dunia. Koinfeksi HIV-TB sekarang merupakan penyebab mortalitas utama di dunia. Mengetahui karakteristik pasien koinfeksi tuberkulosis pada pasien HIV/AIDS di Rumah Sakit Mitra Masyarakat  Timika Papua. Penelitian observasional dengan desain potong lintang, menggunakan rekam medik sebagai sumber data penelitian. Sampel terdiri dari 67 kasus pasien  HIV/AIDS periode Januari – April 2015.  Kelompok pasien koinfeksi HIV-TB lebih banyak terdapat pada usia 15-35 tahun (87.4%), perempuan (78.8%), pasien yang bersekolah pada tingkat menengah dan atas (80.4%), tidak bekerja (83.4%), pasien yang belum menikah (87.5%), CD4 &lt;350 sel/mm³ sebanyak 89.2% dan pasien yang memiliki kadar Hb &lt;12 g/dL sebanyak 78.9%. Koinfeksi TB-HIV banyak ditemukan pada kelompok usia muda dan produktif. ABSTRACT Tuberculosis (TB) has been an infectious disease in Indonesia, and  currently Indonesia is the fifth country with the highest TB burden in the world. HIV-TB co-infection is currently the main cause of mortality in the world. To determine the characteristic of HIV/AIDS with tuberculosis co-infection  in Mitra Masyarakat Hospital Mimika, Papua. The study was observasional cross-sectional design, using medical records data. The sample consisted of 67 cases of patient with HIV/AIDS admitted from January to April 2015. The highest prevalence of HIV-TB co-infection was:of  group of age 15-35 years (87.5%); female (78.8%); attend school at the secondary level and above (80.4%); unemployed (83.4%); unmarried (87.5%); CD4&lt;350 cells/mm³ ( 89.2%) and patients with Hb &lt;12 g/dL (78.9%). HIV-TB coinfection is common in young and productive age group
Risiko Malnutrisi terhadap Jumlah CD4⁺ Orang dengan HIV/AIDS yang Menjalani Terapi Antiretroviral di Mimika Adiningsih, Setyo; Widiyanti, Mirna
Jurnal Kedokteran Brawijaya Vol 30, No. 1 (2018)
Publisher : Fakultas Kedokteran Universitas Brawijaya

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Hubungan status gizi dengan Cluster of Differentiation 4 (CD4⁺) pada Orang Dengan HIV/AIDS (ODHA) yang menjalani terapi antiretroviral (ARV) di Papua belum banyak diketahui. Penelitian bertujuan menganalisis hubungan status gizi terhadap jumlah CD4⁺ subjek penelitian. Parameter status gizi yang digunakan yaitu Indeks Massa Tubuh (IMT) dan anemia. Jenis penelitian adalah observasional deskriptif dengan desain cross-sectional. Inklusi yaitu pasien laki-laki dan perempuan sedang terapi ARV minimal 6 bulan, memiliki data CD4⁺ dan rekam medis lengkap. Subjek penelitian yaitu 64 pasien HIV/AIDS yang menjalani terapi ARV di Rumah Sakit Mitra Masyarakat (RSMM) Mimika Papua bulan Januari sampai Oktober 2015, telah menyetujui inform consent dan memenuhi kriteria inklusi. Data dianalisis menggunakan statistik Fishers Exact test dan Odds Ratio (OR). Mayoritas subjek penelitian adalah perempuan sebanyak 76,6%, kisaran umur 15-35 tahun sebanyak 60,9%, IMT &gt;18,5 sebanyak 85,9%, kadar hemoglobin (Hb) &lt;13g/dL sebanyak 73,4%, dan lama terapi ≤60 bulan sebanyak 75%. Hasil Fishers Exact test dan OR, ada hubungan signifikan IMT terhadap jumlah CD4⁺ dengan nilai p˂0,05=0,006 dan OR=13,867 serta 95% interval konvidensi (CI)=2,396-80,266. Hal ini menunjukkan subjek penelitian dengan IMT≤18,5 atau malnutrisi berisiko 13,867 kali untuk memiliki jumlah CD4⁺ ≤200sel/ul dibandingkan subjek dengan IMT˃18,5. Variabel jenis kelamin, umur, kadar Hb, dan lama terapi ARV tidak berhubungan signifikan dengan jumlah CD4⁺. IMT kurus (malnutrisi) berhubungan signifikan dengan jumlah CD4⁺ rendah yaitu ≤200sel/ul. Jumlah CD4⁺ ≤200sel/ul berisiko mempercepat status HIV menjadi stadium 4 atau sakit berat yang mengarah kepada AIDS. 
Habit of cooking pork on hot stones as main risk of cysticercosis Sandy, Semuel; Oktavian, Antonius; Kawulur, Hanna S; Widiyanti, Mirna; Sasto, Iman HS; Maladan, Yustinus
Universa Medicina Vol 37, No 2 (2018)
Publisher : Faculty of Medicine, Trisakti University

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BackgroundCysticercosis is an infectious disease caused by the larval form of Taenia solium (cysticercus cellulosae) and has been ranked as the most important food-borne parasite of humans in terms of public health, socioeconomic and trade impact. Cysticercosis is still a health problem in Papua and is inseparable from socio-cultural factors, hygiene and environmental sanitation. The aim of this study was to investigate the seroprevalence of cysticercosis and the risk factors that contribute to cysticercosis.MethodsA cross-sectional study was conducted in March-November 2016 involving 800 subjects. Demographic data and risk factors were collected using questionnaires. Cysticercosis serological examination was performed by means of the magnetic microsphere bead immunoassay technique coupled with rT24H recombinant protein to detect serum rT24H cysticercosis specific antibodies. The data obtained were analyzed by bivariate test (chi-square) and logistic regression.ResultsCysticercosis seroprevalence in Papua was 3.6% (284/7 874). The logistic regression analysis found that the risk factors playing the role of predictor were cooking pork with hot stones [OR=3.06; 95%CI: 2.19-4.28; p=0.000], nail hygiene [OR=2.05; 95%CI: 1.57-2.67; p=0.000], consumption of raw vegetables or salads [OR=0.52; 95%CI: 0.30-0.91; p=0.022], use of river water for washing foods [OR= 1.92; 95%CI: 1.39-2.64; p=0.000].ConclusionsCooking pork with hot stones was the main risk factor of cysticercosis. Suspected cases of T. solium in pigs should be confirmed by molecular methods. Both taeniasis and human cysticercosis should be notifiable and surveillance in animals should be improved.
PENURUNAN CD4 PADA ODHA SETELAH TERAPI ARV LEBIH DARI 39 BULAN Hutapea, Hotma Martogi Lorensi; Mirino, Yunita; Widiyanti, Mirna; Fitriana, Eva; Maladan, Yustinus; Oktavian, Antonius
Media Kesehatan Masyarakat Indonesia Vol 13, No 3: SEPTEMBER 2017
Publisher : Faculty Of Public Health, Hasanuddin University, Makassar

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Nilai hitung CD4 telah dijadikan indikator efikasi terapi antiretroviral (ARV). Peningkatan nilai hitung CD4 diharapkan terjadi setelah terapi dilakukan, tetapi penurunan nilai hitung CD4 ditemui pada ODHA yang diterapi dalam jangka waktu lama. Anemia dianggap sebagai salah satu penyebab penurunan nilai hitung CD4. Penelitian ini bertujuan melihat hubungan terapi ARV terhadap perubahan nilai hitung CD4 sebelum dan sesudah terapi, dan hubungan anemia terhadap perubahan nilai hitung CD4. Populasi adalah ODHA yang terdaftar di RS. Mitra Masyarakat, Mimika. Sampel adalah 90 ODHA yang terdaftar di VCT RS. Mitra Masyarakat, Mimika yang sudah menerima terapi ARV lebih dari 6 bulan. Sebanyak 67 dari 90 subyek yang memiliki data CD4 sebelum dan sesudah terapi dianalisis menggunakan uji wilcoxon. Hubungan anemia dengan perubahan nilai hitung CD4 dianalisis menggunakan chi square. Mayoritas subyek penelitian adalah perempuan sebanyak 49 orang (73,1%), dengan kelompok umur 25-35 tahun yaitu 27 orang (40,3%). Sebanyak 38 orang (56,7%) diterapi ARV kurang dari 39 bulan, dan sisanya lebih dari 39 bulan. Uji statistik menunjukkan bahwa terdapat penurunan nilai hitung CD4 meskipun telah diterapi ARV, tetapi anemia bukan faktor risiko penyebab penurunan tersebut. Untuk itu, perlu dilakukan evaluasi berkesinambungan pada ODHA yang diterapi ARV.