Human immunodeficiency virus (HIV)-infected patients present complex immunological alterations. Multiple drugs that usually prescribed for prevention or treatment of opportunistic infections and antiretroviral pose these patients a higher risk of developing drug hypersensitivity. All antiretroviral agents and drugs to treat opportunistic infections have been reported to cause drug hypersensitivity reactions. Allergic reactions with antiretroviral are not restricted to older agents, although newer drugs usually more tolerated. Cutaneous adverse drug reactions are the most common manifestation of drug hypersensitivity in HIV, typically manifesting as maculopapular rash with or without systemic symptoms in the presence or absence of internal organ involvement. The onset of an allergic reaction is usually delayed. Severe drug hypersensitity reactions as erythema multiforme, Stevens Johnson syndrome and toxic epidermal necrolysis develop more often in HIV-infected patients compared to other populations. Mild to moderate rash without systemic symptom or organ involvement usually do not need drug discontinuation. Appropriate diagnosis and management of drug hypersensitivity reactions are essential, especially in patients with very low CD4+ T-cell count and multiple opportunistic infections. Clinicians should aware of different half-life of each drug when decided to stop the drug. Knowledge of the metabolism, recognition of the risk factors, and the ability to suggest the probability of particular drug as causative are also important points. A step wise rechallenge test or desensitization with the offending drug might be a preferable action and more commonly used in managing drug hypersensitivity in HIV-infected patients. Desensitization protocols have been successfully done for several antiretroviral and opportunistic infection drugs.
Background: Health care workers (HCWs) are a high-priority group for COVID-19 vaccination for several reasons. Health behavior theory-based studies on the intention or acceptability of COVID-19 vaccination among Indonesian HCWs is lacking. Using an integrated behavioral model, this research sought to identify Indonesian health care workers’ intentions to obtain COVID-19 vaccines. Methods: A countrywide cross-sectional questionnaire-based survey was conducted. The questionnaire was constructed on the basis of IBM (integrated behavioral model) constructs and scored on a seven-point bipolar scale. A hierarchical multivariable regression was used to evaluate the fit of the predictor model as well as the correlations between variables in the study. Results: 3304 people responded to the survey. A model combining demographic and IBM characteristics predicted 42.5 percent (adjusted R2 = 0.42) of the COVID-19 vaccination intention. Vaccination intention was associated with favorable vaccine attitudes, perceived norms, and self-efficacy. Among the determining constructs, behavior belief predicted vaccination intention the best. Being female, being married, having a history of COVID-19 infection, living outside Java Island, and having a low income were all linked to lower vaccination intentions. Conclusions: This study confirms the IBM model’s robustness in predicting health care workers’ intention to vaccinate against COVID-19.
Purpose This study aimed to analyze the knowledge, attitude, and behavior of people living with HIV (PLWH) during the COVID-19 pandemic and the pandemic’s impact on their socioeconomic conditions, antiretroviral adherence, and worries. Materials and Methods This cross-sectional study was conducted in May–August 2020 at the Integrated HIV Center of Dr. Cipto Mangunkusumo General Hospital, Indonesia. The data were collected using an online questionnaire and an offline paper-based questionnaire. Results A total of 545 subjects participated in this study, 72.8% (397) of which were male. Most subjects were middle-aged (36–55 years old) (66.5%). Many subjects reported to have experienced reduced incomes (49.2%) or losses of income (22.4%), while 15.6% reported losing their job during the COVID-19 pandemic. Most subjects (97%) wished to continue treatment despite the many obstacles, and the subjects’ knowledge about COVID-19 and its prevention was considerably good. More than 70% of subjects reported that they have been implementing the general precautions of the COVID-19 pandemic: maintaining distance, wearing a mask, washing hands, and avoiding crowds. Conclusion This study provides an overview of what PLWH are experiencing, which will allow for policy-making that can help them continue their treatment with consideration of the possibility of having to live a “new normal” future.
Pendahuluan. Pencegahan transmisi hepatitis C pada pasangan seksual pasien koinfeksi HIV/HCV merupakan upaya penatalaksanaan hepatitis C. Namun demikian, belum ada data prevalensi hepatitis C dan faktor yang berhubungan dengan transmisi hepatitis C pada pasangan seksual pasien koinfeksi HIV/HCV di Indonesia, sehingga perlu dilakukan penelitian untuk memperoleh data tersebut. Penelitian ini bertujuan untuk mengetahui prevalensi hepatitis C dan faktor-faktor yang berhubungan dengan kejadian hepatitis C pada pasangan seksual pasien koinfeksi HIV/HCV.Metode. Studi potong lintang pada pasangan heteroseksual pasien koinfeksi HIV/HCV yang berobat di Pokdisus RSCM. Faktor yang diteliti meliputi penggunaan narkotika suntik, transfusi darah, status HIV, penggunaan kondom, jumlah hubungan seksual, jumlah pasangan seksual, tipe hubungan seksual dan hitung CD4+ pasien koinfeksi HIV/HCV. Pengambilan data dilakukan dengan wawancara secara terpisah dan pemeriksaan darah antiHCV total dan antiHIV. Analisis statistik dilakukan dengan uji chi-square dan Fisher dan regresi logistik menggunakan program SPSS.Hasil. Selama periode Mei-Agustus 2008, diperoleh 119 subyek penelitian pada rentang usia 19-39 tahun (median 26 tahun) dan 95,8% diantaranya berjenis kelamin perempuan. Didapatkan prevalensi hepatitis C sebesar 10,1%. Hasil analisis bivariat kelompok subyek nonpengguna narkotika suntik didapatkan status HIV reaktif dan hubungan seksual nonvaginal berhubungan dengan kejadian hepatitis C. Pada hasil analisis multivariat didapatkan hanya tipe hubungan nonvaginal yang berhubungan dengan kejadian hepatitis C (adjusted RP 8,051; IK95% 1,215-53,353).Simpulan. Prevalensi hepatitis C pada pasangan seksual pasien koinfeksi HIV/HCV sebesar 10,1%. Tipe hubungan nonvaginal dan status antiHIV positif dapat meningkatkan risiko terjadinya kejadian hepatitis C sebesar 8 kali. Dibutuhkan studi lanjutan dengan sampel yang lebih besar dan desain yang lebih baik untuk menentukan transmisi seksual hepatitis C.
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