Background and Aim:The immunocompromised condition is considered a defect in the immune system. This condition tends to increase the risk of oral candidiasis, due to the inability of the immune system to eliminate the adhesion of Candida albicans and leads to systemic candidiasis with a mortality rate of 60%. Green tea (Camellia sinensis) contains potential antioxidant and immunomodulatory which acts as anticancer, antifungal, and antivirus agent. The aim of this study was to invent herbal-based medicine, which acts as an immunomodulator and antifungal agent to treat fungal infection in immunocompromised patients.Materials and Methods:Thirty-five immunocompromised Wistar rats induced with C. albicans were divided into 7 groups (n=5): Control group (C+); treated for 4 days with green tea extract 1.25% (GT 4), epigallocatechin gallate (EGCG) 1% (EGCG 4), EGC 1% (EGC 4); and treated for 7 days with green tea extract 1.25% (GT 7), EGCG 1% (EGCG 7), and EGC 1% (EGC 7). Tongue tissue was collected and analyzed with immunohistochemistry staining using monoclonal antibody; interleukin (IL)-17A, IL-8, and human beta-defensin 2 (HBD)-2. Data were analyzed using analysis of variance test and Tukey honest significant differences test.Results:The expression of IL-17A, IL-8, and HBD-2 was significantly increased (p=0.000) after green tea extract administration in 7 days, whereas in 7 days, the expression of IL-8, IL-17A, and HBD-2 after EGCG and EGC administration did not give a significant result (p>0.005).Conclusion:Within the limits of this study, green tea extract has the ability as an immunomodulatory agent in an immunocompromised patient infected by C. albicans through expression augmentation of IL-8, IL-17A, and HBD-2 compared to EGCG and EGC.

Introduction: Indonesia is stated as one of Asia's fastest growing HIV epidemics, yet to date, studies on the characteristics of human immunodeficiency virus (HIV) infection, especially on Indonesian children, are very limited. Opportunistic infections, such as oral candidiasis have been an integral part of the disease and related to important diagnostic and prognostic values of the infection. The aim of this study was to determine the candidiasis profile of the Indonesian HIV-infected pediatric patients, and to correlate the clinical types of candidiasis with highly active antiretroviral therapy (HAART) use and the level of immune suppression. Material and methods: HIV-infected pediatric patients attending the Intermediate Care and Infectious Disease Centre (UPIPI), Dr. Soetomo Hospital outpatient clinic between June-October 2017 were examined intraorally for the presence of oral candidiasis. Identification of Candida species was based on colony morphology on CHROM-Agar, hydrolysis of urea, carbohydrate fermentation tests, thermotolerance test, and microscopic morphology on slide culture from oral swab samples. Other relevant data regarding each patient were also obtained from medical records. Results: Oral candidiasis was found in 55.17% patients, with 3 different clinical types: pseudomembranous (21.43%), erythematous (14.29%), and angular cheilitis (46.3%). There was a significant relationship between HAART with erythematous type (p < 0.05) and even stronger with the pseudomembranous type of Candida (p < 0.01). There was significant relationship between the level of immune suppression and pseudomembranous type (p < 0.05) and even stronger with the erythematous type (p < 0.01). Conclusions: Concurrent pseudomembranous and erythematous candidiasis may indicate advanced progression of HIV-infected pediatric patients, therefore further studies are required to validate our findings.

Introduction: Strikingly, more than 95% pediatric HIV infections worldwide are in developing countries.Although ART can reduce significantly the risk of HIV transmission to children born from HIV-infected mothers, this can be effective only if the women know their HIV status. In many developing countries, such as Indonesia, the lack of access by pregnant mothers to laboratory facilities may deprive them of knowing their HIV status, thus the opportunity to transmit the disease to their children is high, knowing no preventive intervention is attempted. To date, it is estimated that the number of HIV infected children in Indonesia who are left undiagnosed is still high, therefore a study on clinical markers of HIV that can aid in the diagnosis and predict the severity of the disease among children is critical. In this study, Linear Gingival Erythema is assessed on its correlation to degree of immune suppression to be used as HIV clinical marker in laboratorypoor settings in Indonesia. Method: HIV-infected children admitted to Soetomo General Hospital between June -October 2017 were screened and examined intraorally for the presence of LGE. Other relevant data were obtained from questionnaire-guided interview to parents/guardians and from patient's medical record. Results:LGE was found in 21.43% children and statistical analysis shows significant correlation of LGE to degree of immune suppression. Conclusion: Further study with larger study population size is required to analyze the sensitivity and specificity of LGE to be used as HIV marker in predicting a particular degree of immune suppression, specific to Indonesian pediatric population.

Objective: To investigate the correlation Cluster of Differentiation 4 + (CD4 +) counts with a high prevalence of dental caries in Children Living with Perinatal Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (CLWPHA). Material and Methods: An analytical observational research with a cross-sectional design was conducted at Tertiary General Hospital, Surabaya, Indonesia. Randomized total sampling consisted of 29 CLWPHA 1-12 years old at outpatient ward Infectious Disease Intermediate Unit (UPIPI) Tertiary General Hospital Doctor Soetomo Surabaya. Demographic details and recent CD4 + counts obtained from medical records. Decayed, missing, filled teeth (dmft) in primary teeth and DMFT in permanent teeth index were used. Pearson's and Spearman's Correlation test (p<0.05) were performed. Results: Dental caries prevalence was 86.2%; meanwhile, the dmft/DMFT index score found were high (8.2 / 6.3). CD4 + count and caries showed significant correlation (r=-0.394, p<0.05). Tooth brushing frequency with caries showed a significant correlation (r=-0.419, p<0.05). Antiretroviral (ARV) therapy and caries showed an insignificant negative correlation (p<0.05). Conclusion: The high prevalence of dental caries in CLWPHA correlated with low CD4 + counts.

Human immunodeficiency virus (HIV) dan Acquired Immunodeficiency Syndrome (AIDS) telah menjadi masalah kesehatan dunia. Kasus HIV siap tahunnya terus meningkat sehingga membahayakan manusia selama lebih dari 20 tahun. Lesi oral terkait HIV dapat digunakan sebagai penanda status imun seseorang. Angular Cheilitis (AC) adalah salah satu dari tujuh lesi oral yang sangat terkait dengan infeksi HIV yang telah diidentifikasi dan dikalibrasi secara internasional. Tujuan penelitian ini adalah untuk mengidentifikasi AC dan hubungan dengan nilai hitung Cluster of Differentiation 4 (CD4 +) pada pasien HIV/AIDS di Unit Perawatan Penyakit Infeksi intermediet (UPIPI) RSUD Dr. Soetomo Surabaya 2014. Penelitian analitik observasional secara cross-sectional dan total sampling. Sampel terdiri dari 88 pasien HIV / AIDS yang dirawat di RSUD Dr Soetomo UPIPI Surabaya dari Juli hingga Agustus 2014. Diagnosis dari AC dilakukan secara klinis, rongga mulut subjek penelitian diperiksa oleh dokter gigi spesialis Penyakit Mulut (IPM). Nilai hitung CD4 + diperoleh dari rekam medis pasien. Delapan puluh delapan pasien HIV/AIDS telah diperiksa dan dijumpai 120 kasus manifestasi oral, diantaranya terdapat 31 kasus AC (25,83%). AC ditemukan secara signifikan berkorelasi dengan penurunan jumlah sel CD4 + di bawah 200 sel/mm 3 (p<-,245). Analisis Risiko relatif menunjukkan bahwa pasien HIV / AIDS dengan Oral Candidiasis 7.5 kali lebih sering menderita AC. Terdapat Korelasi yang erat antara AC dan OC (p< 0,357). AC dapat digunakan sebagai alternatif untuk memprediksi nilai CD4 + dan memprediksi status imun pasien yang terinfeksi HIV secara klinis.