Introduction: More than 1,300 children aged 0-14 years were infected with HIV in Indonesia by 2016. Adequate antiretroviral therapy (ART) can increase nutritional and immunological status, reduce incidence of opportunistic infection and mortality caused by HIV infection. After ART initiation, the children's treatment response needs to be monitored with CD4 + cell count and Viral Load (VL) evaluation. In resourcelimited setting, clinical and immunological parameters can be used to evaluate ART outcomes. The aimed of this study to know immunological status of the patient after 6 months ART in Dr. Sardjito Hospital in Yogyakarta, Indonesia. Methodology: A retrospective study was conducted from January 2010 to May 2016. HIV-infected children aged 0-18 years who were given first-line ART at least 6 months were included in this study. Age when ART initiation, gender, residence, nutritional status, clinical staging based on WHO criteria, incidence of hospitalization, baseline CD4 + cell count and CD4 + cell count after 6 months of therapy, tuberculosis treatment, and ART regimens were collected from medical records. Data were entered and analyzed using SPSS version 20.0 Results: Thirty-five subjects were included in this study. Median CD4 + T cell percentage increased from 3.16 (IQR 1-18) % to 11.0 (IQR 2-32) %, whereas median CD4 + absolute cell count increased from 9.5 (IQR 3-176) cell/mm 3 to 419.5 (IQR 202-1428) cell/mm 3 . Conclusion: Immunologic conditions could improve even with very low levels of CD4 + T cell percentage and CD4 + absolute cell count. Monitoring immunologic conditions and adherence of children with ART are essential to improve treatment outcomes.

Scurvy is a rare case found in many countries, but it is often found in refugeeareas, especially in Africa. Vitamin C deficiency varies based on season and occursmore in men with age. The purpose of this research is to avoid misdiagnosis so thatit can be a reference in the field of medicine to diagnose and provide managementon scurvy. This prospective research was conducted with one sample of research.Observation had been carried out for two months, starting at one month after thepatient was suspected with the diagnosis of scurvy. Computer Tomography (CT)Scan lumbosacral to pelvic results were normal. Laboratory test of HB result was9.5 g/dl, in which MCV was 63.2 fL, MCH was 20.3 pg, and MCHC was 32.1 g/dl.Scurvy treatment in the first visit was 3x1 tablets vitamin C, 3x5 ml ibuprofen Syr,and physiotherapy. The results were that the patient still suffered swollen andbleeding gums, but the pain no longer existed, pale, behavioural disorders, unableto walk, and pain in both knees. After the second visit, the child got therapy of 4x50mg vitamin C, 1x1 tablets vitamin B12, 1x150 IU vitamin E, 1x1 tablets cavit D3,and physiotherapy. After two weeks of treatment, there were no complaints ofswelling, painful or bleeding gums. The child could straighten her legs, but she wasstill unable to walk due to the trauma of feeling great pain while walking. Specialattention is required to diagnose appropriately so the doctor can minimize andprevent complications.

Scurvy is a rare case found in many countries, but it is often found in refugee areas, especially in Africa. Vitamin C deficiency varies based on season and occurs more in men with age. The purpose of this research is to avoid misdiagnosis so that it can be a reference in the field of medicine to diagnose and provide management onscurvy. This prospective research was conducted with one sample of research. Observation had been carried out for two months, starting at one month after the patient was suspected with the diagnosis of scurvy. Computer Tomography (CT) Scan lumbosacral to pelvic results were normal. Laboratory test of HB result was 9.5 g/dl, in which MCV was 63.2 fL, MCH was 20.3 pg, and MCHC was 32.1 g/dl. Scurvy treatment in the first visit was 3x1 tablets vitamin C, 3x5 ml ibuprofen Syr, and physiotherapy. The results were that the patient still suffered swollen and bleeding gums, but the pain no longer existed, pale, behavioural disorders, unable to walk, and pain in both knees. After the second visit, the child got therapy of 4x50 mg vitamin C, 1x1 tablets vitamin B12, 1x150 IU vitamin E, 1x1 tablets cavit D3, and physiotherapy. After two weeks of treatment, there were no complaints of swelling, painful or bleeding gums. The child could straighten her legs, but she was still unable to walk due to the trauma of feeling great pain while walking. Special attention is required to diagnose appropriately so the doctor can minimize and prevent complications.