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Widhani A, Koesnoe S, Maria S, Widjanarko AL, Karjadi TH, Hasibuan AS, Yunihastuti E, Rengganis I, Djauzi S. Factors Related to Severity, Hospitalization, and Mortality of COVID-19 Infection among Patients with Autoimmune Diseases. Trop Med Infect Dis 2023; 8:tropicalmed8040227. [PMID: 37104352 PMCID: PMC10145988 DOI: 10.3390/tropicalmed8040227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 04/14/2023] [Accepted: 04/14/2023] [Indexed: 04/28/2023] Open
Abstract
Patients with an autoimmune disease could be at higher risk of a poor outcome when contracting COVID-19 infection due to aberrant immune responses and use of immunosuppressant therapies for chronic autoimmune treatment. Here, we conducted a retrospective study to identify the factors related to severity, hospitalization, and mortality among patients with autoimmune diseases. We found 165 cases of patients with pre-existing autoimmune diseases who had contracted COVID-19 between March 2020 and September 2022. Data on demographical characteristics; autoimmune diagnosis and treatment; COVID-19 vaccination status; and time, severity, and outcome of COVID-19 infection were collected. Most of the subjects were female (93.3%) and autoimmune diagnoses included systemic lupus erythematosus (54.5%), Sjogren's syndrome (33.5%), antiphospholipid syndrome (23%), vasculitis (5.5%), autoimmune thyroid disease (3.6%), rheumatoid arthritis (3.03%), and inflammatory bowel disease (3.03%) among other autoimmune diseases. There were four COVID-19-related deaths in this study. Factors associated with moderate to severe COVID-19 infection in patients with autoimmune diseases included not being vaccinated against COVID-19, taking a steroid of ≥10 mg prednisone-equivalent per day, and having a cardiovascular disease. Taking a steroid of ≥10 mg prednisone-equivalent per day was also associated with hospitalization in the event of COVID-19 infection, while cardiovascular diseases also showed a significant correlation to mortality in patients with autoimmune diseases who had been hospitalized with COVID-19 infection.
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Affiliation(s)
- Alvina Widhani
- Allergy and Clinical Immunology Division, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia
- Department of Internal Medicine, Universitas Indonesia Hospital, Depok 16424, Indonesia
| | - Sukamto Koesnoe
- Allergy and Clinical Immunology Division, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia
| | - Suzy Maria
- Allergy and Clinical Immunology Division, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia
| | - Annisa Layalia Widjanarko
- Allergy and Clinical Immunology Division, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia
| | - Teguh Harjono Karjadi
- Allergy and Clinical Immunology Division, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia
| | - Anshari Saifuddin Hasibuan
- Allergy and Clinical Immunology Division, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia
| | - Evy Yunihastuti
- Allergy and Clinical Immunology Division, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia
| | - Iris Rengganis
- Allergy and Clinical Immunology Division, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia
| | - Samsuridjal Djauzi
- Allergy and Clinical Immunology Division, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia
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Maria S, Pelupessy DC, Koesnoe S, Yunihastuti E, Handayani DOTL, Siddiq TH, Mulyantini A, Halim ARV, Wahyuningsih ES, Widhani A, Awanis GS, Muda MG, Karjadi TH, Hasibuan AS, Rengganis I, Djauzi S. COVID-19 Booster Vaccine Intention by Health Care Workers in Jakarta, Indonesia: Using the Extended Model of Health Behavior Theories. Trop Med Infect Dis 2022; 7:tropicalmed7100323. [PMID: 36288064 PMCID: PMC9610584 DOI: 10.3390/tropicalmed7100323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/14/2022] [Accepted: 10/18/2022] [Indexed: 11/29/2022] Open
Abstract
In Indonesia, COVID-19 vaccination hesitancy persists among health care workers (HCWs). Understanding the motives and challenges impacting HCWs’ acceptance of the booster vaccination is critical. Efforts are still needed to overcome apprehension about taking a booster dosage. This study aims to analyze the vaccine acceptance among HCWs in Jakarta using an extended, modified model of health behavior theories, namely The Health Belief Model (HBM) and The Theory of Planned Behavior (TPB). A cross-sectional survey from November 2021 to January 2022 was distributed to health care workers in Jakarta. Bivariate analysis followed by multivariate regression was used to assess factors associated with the vaccine intention and collected 1684 responses. The results have shown that the final model combining the constructs and demographic characteristics could explain 50% of the variance of intention to receive a COVID-19 booster vaccination. Moreover, anticipated regret had the most significant standardized coefficient among the constructs (β = 0.381, p < 0.001). Other significant predictors in the model were attitude (β = 0.243, p < 0.001), perceived benefits (β = 0.103, p < 0.001), subjective norms (β = 0.08, p = 0.005), and perceived susceptibility (β = 0.051, p = 0.016). The findings can be used to strategize interventions to increase vaccine uptake.
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Affiliation(s)
- Suzy Maria
- Allergy and Clinical Immunology Division, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia
- Correspondence: ; Tel.: +62-21-3141160
| | | | - Sukamto Koesnoe
- Allergy and Clinical Immunology Division, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia
| | - Evy Yunihastuti
- Allergy and Clinical Immunology Division, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia
| | | | - Tommy Hariman Siddiq
- Faculty of Psychology and Education, Universitas Al-Azhar Indonesia, Jakarta 12110, Indonesia
| | | | | | | | - Alvina Widhani
- Allergy and Clinical Immunology Division, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia
| | - Ghina Shabrina Awanis
- Allergy and Clinical Immunology Division, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia
| | - Maulana Girsang Muda
- Allergy and Clinical Immunology Division, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia
| | - Teguh Harjono Karjadi
- Allergy and Clinical Immunology Division, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia
| | - Anshari Saifuddin Hasibuan
- Allergy and Clinical Immunology Division, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia
| | - Iris Rengganis
- Allergy and Clinical Immunology Division, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia
| | - Samsuridjal Djauzi
- Allergy and Clinical Immunology Division, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia
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Yunihastuti E, Karjadi TH, Widhani A, Mahdi HIS, Sundari S, Hapsari AF, Koesnoe S, Djauzi S. Incidence and severity prediction score of COVID-19 in people living with HIV (SCOVHIV): experience from the first and second waves of the pandemic in Indonesia. AIDS Res Ther 2022; 19:47. [PMID: 36192742 PMCID: PMC9527391 DOI: 10.1186/s12981-022-00472-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 09/14/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND People living with HIV (PLHIV) have higher risk of COVID-19 infection and mortality due to COVID-19. Health professionals should be able to assess PLHIV who are more likely to develop severe COVID-19 and provide appropriate medical treatment. This study aimed to assess clinical factors associated with COVID-19 severity and developed a scoring system to predict severe COVID-19 infection among PLHIV. METHODS This retrospective cohort study evaluated PLHIV at four hospitals diagnosed with COVID-19 during the first and second wave COVID-19 pandemic in Indonesia. The independent risk factors related to the severity of COVID-19 were identified with multivariate logistic regression. RESULTS 342 PLHIV were diagnosed with COVID-19, including 23 with severe-critical diseases. The cumulative incidence up to December 2021 was 0.083 (95% CI 0.074-0.092). Twenty-three patients developed severe-critical COVID-19, and the mortality rate was 3.2% (95% CI 1.61%-5.76%). Having any comorbidity, CD4 count of < 200 cells/mm3, not being on ART, and active opportunistic infection were independent risk factors for developing severe COVID-19. SCOVHIV score was formulated to predict severity, with 1 point for each item. A minimum score of 3 indicated a 58.4% probability of progressing to severe COVID-19. This scoring system had a good discrimination ability with the area under the curve (AUC) of 0.856 (95% CI 0.775-0.936). CONCLUSION SCOVHIV score, a four-point scoring system, had good accuracy in predicting COVID-19 severity in PLHIV.
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Affiliation(s)
- Evy Yunihastuti
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jl. Diponegoro no. 71, Jakarta, 10430, Indonesia. .,HIV Integrated Unit, Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
| | - Teguh Harjono Karjadi
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jl. Diponegoro no. 71, Jakarta, 10430, Indonesia.,HIV Integrated Unit, Cipto Mangunkusumo Hospital, Jakarta, Indonesia.,Sentra Medika Hospital, Depok, West Java, Indonesia
| | - Alvina Widhani
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jl. Diponegoro no. 71, Jakarta, 10430, Indonesia.,HIV Integrated Unit, Cipto Mangunkusumo Hospital, Jakarta, Indonesia.,Department of Internal Medicine, Universitas Indonesia Hospital, Depok, West Java, Indonesia
| | | | - Salma Sundari
- HIV Integrated Unit, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | | | - Sukamto Koesnoe
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jl. Diponegoro no. 71, Jakarta, 10430, Indonesia
| | - Samsuridjal Djauzi
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jl. Diponegoro no. 71, Jakarta, 10430, Indonesia.,Department of Non-Oncology Internal Medicine, Dharmais National Cancer Hospital, Jakarta, Indonesia
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Koesnoe S, Siddiq TH, Pelupessy DC, Yunihastuti E, Awanis GS, Widhani A, Karjadi TH, Maria S, Hasibuan AS, Rengganis I, Djauzi S. Using Integrative Behavior Model to Predict COVID-19 Vaccination Intention among Health Care Workers in Indonesia: A Nationwide Survey. Vaccines (Basel) 2022; 10:719. [PMID: 35632476 PMCID: PMC9145718 DOI: 10.3390/vaccines10050719] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 04/30/2022] [Accepted: 05/02/2022] [Indexed: 02/06/2023] Open
Abstract
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.
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Affiliation(s)
- Sukamto Koesnoe
- Allergy and Clinical Immunology Division, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia; (E.Y.); (G.S.A.); (A.W.); (T.H.K.); (S.M.); (A.S.H.); (I.R.); (S.D.)
| | - Tommy Hariman Siddiq
- Faculty of Psychology and Education, Universitas Al-Azhar Indonesia, Jakarta 12110, Indonesia;
| | - Dicky C. Pelupessy
- Faculty of Psychology and Education, Universitas Indonesia, Depok 16424, Indonesia;
| | - Evy Yunihastuti
- Allergy and Clinical Immunology Division, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia; (E.Y.); (G.S.A.); (A.W.); (T.H.K.); (S.M.); (A.S.H.); (I.R.); (S.D.)
| | - Ghina Shabrina Awanis
- Allergy and Clinical Immunology Division, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia; (E.Y.); (G.S.A.); (A.W.); (T.H.K.); (S.M.); (A.S.H.); (I.R.); (S.D.)
| | - Alvina Widhani
- Allergy and Clinical Immunology Division, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia; (E.Y.); (G.S.A.); (A.W.); (T.H.K.); (S.M.); (A.S.H.); (I.R.); (S.D.)
| | - Teguh Harjono Karjadi
- Allergy and Clinical Immunology Division, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia; (E.Y.); (G.S.A.); (A.W.); (T.H.K.); (S.M.); (A.S.H.); (I.R.); (S.D.)
| | - Suzy Maria
- Allergy and Clinical Immunology Division, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia; (E.Y.); (G.S.A.); (A.W.); (T.H.K.); (S.M.); (A.S.H.); (I.R.); (S.D.)
| | - Anshari Saifuddin Hasibuan
- Allergy and Clinical Immunology Division, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia; (E.Y.); (G.S.A.); (A.W.); (T.H.K.); (S.M.); (A.S.H.); (I.R.); (S.D.)
| | - Iris Rengganis
- Allergy and Clinical Immunology Division, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia; (E.Y.); (G.S.A.); (A.W.); (T.H.K.); (S.M.); (A.S.H.); (I.R.); (S.D.)
| | - Samsuridjal Djauzi
- Allergy and Clinical Immunology Division, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia; (E.Y.); (G.S.A.); (A.W.); (T.H.K.); (S.M.); (A.S.H.); (I.R.); (S.D.)
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Yunihastuti E, Karjadi TH, Nafrialdi N, Mediana I, Sundari S, Wiraguna A, Hapsari AF, Adhari AI, Khumaini ANSP, Putri TK. The Use of Complementary Alternative Medicine in HIV-infected Patients during COVID-19 Pandemic: Its Related Factors and Drug Interactions with Antiretroviral Therapy. Acta Med Indones 2022; 54:97-106. [PMID: 35398830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND The use of complementary and alternative medicine (CAM) is widespread among patients with chronic disease despite lack of supporting evidence for most CAM types. Concerned regarding higher risk of COVID-19 for HIV-infected patients, probably increase the use of CAM during COVID-19 pandemic in this population. This study aimed to assess the prevalence and factors related to CAM use among HIV-infected patients during COVID-19 pandemic, then identify drug- to-drug interaction (DDI) of antiretroviral (ARV) drugs with CAM that they used. METHODS The study was conducted in HIV Clinic Cipto Mangunkusumo Hospital in September-October 2021, specifically targeting adults HIV-infected patients routinely using ARV. Demographic and clinical data, including COVID-19 and vaccine history, were taken from clinic survey and hospital medical records data. RESULTS 554 of 1275 patients (43.5%) reported using any type of ingested CAM during COVID-19 pandemic, mostly vitamins and/or minerals. Factors related to CAM use were history of COVID-19 infection (aOR 2.28; 95% CI 1.65-3.14) and 2-5 years ARV duration compared to more than 10 years (aOR 1.4; 95% CI 1.02-1.91). Five known potential interactions involving 20 patients and two potential weak interactions involving 8 patients were found, but many of other interactions categorized as unknown. Only limited number of patients (3.8%) were aware about the drug interaction between ARV and CAM that they used. CONCLUSION CAM was commonly used by HIV-infected patients on ARV during the COVID-19 pandemics, but patient awareness related to CAM-ARV drug interactions was exteremely low.
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Affiliation(s)
- Evy Yunihastuti
- 1. Division of Allergy and Clinical Immunology, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia. 2. HIV Integrated Unit, Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
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Karjadi TH, Maria S, Yunihastuti E, Widhani A, Kurniati N, Imran D. Knowledge, Attitude, Behavior, and Socioeconomic Conditions of People Living with HIV in Indonesia During the COVID-19 Pandemic: A Cross-Sectional Study. HIV AIDS (Auckl) 2021; 13:1045-1054. [PMID: 34938124 PMCID: PMC8685388 DOI: 10.2147/hiv.s333469] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 11/12/2021] [Indexed: 02/04/2023] Open
Abstract
Purpose Materials and Methods Results Conclusion
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Affiliation(s)
- Teguh Harjono Karjadi
- Integrated HIV Center, Dr. Cipto Mangunkusumo General Hospital, Central Jakarta, DKI Jakarta, Indonesia
- Allergy and Clinical Immunology Division, Internal Medicine Department, Faculty of Medicine of Universitas Indonesia, Central Jakarta, DKI Jakarta, Indonesia
| | - Suzy Maria
- Integrated HIV Center, Dr. Cipto Mangunkusumo General Hospital, Central Jakarta, DKI Jakarta, Indonesia
- Allergy and Clinical Immunology Division, Internal Medicine Department, Faculty of Medicine of Universitas Indonesia, Central Jakarta, DKI Jakarta, Indonesia
- Correspondence: Suzy Maria Allergy and Clinical Immunology Division, Internal Medicine Department, Faculty of Medicine of Universitas Indonesia, Jalan Pangeran Diponegoro No. 71, Senen, Central Jakarta, IndonesiaTel +62 21 3141160Fax +62 21 3904546 Email
| | - Evy Yunihastuti
- Integrated HIV Center, Dr. Cipto Mangunkusumo General Hospital, Central Jakarta, DKI Jakarta, Indonesia
- Allergy and Clinical Immunology Division, Internal Medicine Department, Faculty of Medicine of Universitas Indonesia, Central Jakarta, DKI Jakarta, Indonesia
| | - Alvina Widhani
- Integrated HIV Center, Dr. Cipto Mangunkusumo General Hospital, Central Jakarta, DKI Jakarta, Indonesia
- Allergy and Clinical Immunology Division, Internal Medicine Department, Faculty of Medicine of Universitas Indonesia, Central Jakarta, DKI Jakarta, Indonesia
| | - Nia Kurniati
- Integrated HIV Center, Dr. Cipto Mangunkusumo General Hospital, Central Jakarta, DKI Jakarta, Indonesia
- Allergy and Clinical Immunology Division, Pediatric Department, Faculty of Medicine of Universitas Indonesia, Central Jakarta, DKI Jakarta, Indonesia
| | - Darma Imran
- Integrated HIV Center, Dr. Cipto Mangunkusumo General Hospital, Central Jakarta, DKI Jakarta, Indonesia
- Infection and Immunology Division, Neurology Department, Faculty of Medicine of Universitas Indonesia, Central Jakarta, DKI Jakarta, Indonesia
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Yunihastuti E, Amelia F, Hapsari AI, Wicaksana B, Natali V, Widhani A, Sulaiman AS, Karjadi TH. Impact of sofosbuvir and daclastavir on health-related quality of life in patients co-infected with hepatitis C and human immunodeficiency virus. Health Qual Life Outcomes 2021; 19:154. [PMID: 34039353 PMCID: PMC8152304 DOI: 10.1186/s12955-021-01777-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 04/21/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND We conducted a real-life study of health-related quality of life (HRQoL) transformation before and 12 weeks after sofosbuvir and daclatasvir therapy in HCV/HIV co-infected patients. Factors related to the significant changes of each HRQoL domain/item were also evaluated. METHODS A prospective study was performed in the HIV integrated clinic at Cipto Mangunkusumo Hospital, Jakarta. HCV/HIV co-infected patients who started sofosbuvir and daclatasvir from government free DAA program in 2017-2019. WHOQoL-HIV BREF and RAND SF-36 questionnaires were recorded at baseline and post-treatment week 12. RESULTS 145 patients with mean age of 37.8 years (SD = 4.2) were included in the analysis. Most of patients were male (89%), previous IVDU (89%), active smoker (50.4%) and non-cirrhosis (80%). SVR12 was achieved in 95.5% of patients. Sofosbuvir and daclatasvir treatments showed positive impacts on 2 domains and 2 other items of WHOQoL-HIV BREF and 2 domains and 1 item of SF-36. Predicting factors of significant increase in each domain/item were: male and normal body mass index (BMI) for level of independence (RR 4.01,95% CI 1.09-14.74 and 4.80,95% CI 1.79-12.81); higher HCV-RNA for overall perception of QoL (RR 0.42,95% CI 0.18-0.94); non-smoking status for overall perception of health (RR 0.32,95% CI 0.15-0.66); male and fibrosis stage 0-1 for general health (RR 6.21,95% CI 1.69-22.88 and 2.86,95% CI 1.16-7.00); and the use of NNRTI-based ART (RR 5.23, 95% CI 1.16-23.65). Spiritual/personal belief decline was predicted by non-smoking status (RR 0.46, 95% CI 0.23-0.95). Treatment success was not associated with any changes of HR-QoL domain/item. CONCLUSIONS HCV/HIV co-infected patients were successfully treated with sofosbuvir and daclatasvir and experienced improvement of HRQoL 12 weeks after treatment completion.
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Affiliation(s)
- Evy Yunihastuti
- Allergy and Clinical Immunology Division, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia/Ciptomangunkusumo Hospital, Diponegoro 71, Jakarta, Indonesia.
- HIV Integrated Services, Ciptomangunkusumo Hospital, Jakarta, Indonesia.
| | - Fhadilla Amelia
- HIV Integrated Services, Ciptomangunkusumo Hospital, Jakarta, Indonesia
| | - Arini Ika Hapsari
- HIV Integrated Services, Ciptomangunkusumo Hospital, Jakarta, Indonesia
| | | | - Veritea Natali
- HIV Integrated Services, Ciptomangunkusumo Hospital, Jakarta, Indonesia
| | - Alvina Widhani
- Allergy and Clinical Immunology Division, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia/Ciptomangunkusumo Hospital, Diponegoro 71, Jakarta, Indonesia
- HIV Integrated Services, Ciptomangunkusumo Hospital, Jakarta, Indonesia
| | - Andri Sanityoso Sulaiman
- Hepatobilliary Division, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Teguh Harjono Karjadi
- Allergy and Clinical Immunology Division, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia/Ciptomangunkusumo Hospital, Diponegoro 71, Jakarta, Indonesia
- HIV Integrated Services, Ciptomangunkusumo Hospital, Jakarta, Indonesia
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Yunihastuti E, Lestari Agusin R, Sari V, Jhariah Hidayah A, Wulunggono W, Pramukti H, Shinta M, Shatri H, Harjono Karjadi T. Prevalence and associated factors of depressive symptoms among people living with HIV on antiretroviral therapy in Jakarta, Indonesia. Trop Med Int Health 2021; 26:908-915. [PMID: 33930230 DOI: 10.1111/tmi.13597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE We aimed to investigate the prevalence of depressive symptoms among people living with HIV (PLHIV) on antiretroviral therapy (ART) in a large HIV treatment facility in Jakarta, Indonesia, and to assess associated factors. METHODS The Indonesian version of Beck Depression Inventory-II was used to assess depressive symptoms of 346 participants visiting the HIV Integrated Clinic Cipto Mangunkusumo hospital between June and November 2018. RESULTS Depressive symptoms (BDI-II score ≥14) were exhibited by 50.9% of participants, with prevalences of mild, moderate and severe depression of 30.4%, 15.6% and 4.9%, respectively. Poisson regression with robust variance analysis indicated that having lower income (aPR = 1.38, 95% CI 1.12-1.63), duration of ART for 1-5 years (aPR = 1.25, 95% CI 1.01-1.54) and same-sex partnership (aPR = 1.27, 95% CI 1.02-1.58) were positively associated with depressive symptoms. Age, sex and history of using intravenous drugs, and ART-based regimen were not associated with depressive symptoms. CONCLUSIONS Depressive symptoms were common among our population despite long-term ART use and were associated with having low-income, ART for 1-5 years and same-sex partnership.
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Affiliation(s)
- Evy Yunihastuti
- Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.,HIV Integrated Unit RSUPN Dr Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Regina Lestari Agusin
- Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Vidya Sari
- Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | | | - Wulunggono Wulunggono
- Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Hikmat Pramukti
- Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Mutiara Shinta
- HIV Integrated Unit RSUPN Dr Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Hamzah Shatri
- Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Teguh Harjono Karjadi
- Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.,HIV Integrated Unit RSUPN Dr Cipto Mangunkusumo Hospital, Jakarta, Indonesia
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Yunihastuti E, Ratih DM, Aisyah MR, Hidayah AJ, Widhani A, Sulaiman AS, Karjadi TH, Soejono CH. Needlestick and sharps injuries in an Indonesian tertiary teaching hospital from 2014 to 2017: a cohort study. BMJ Open 2020; 10:e041494. [PMID: 33293397 PMCID: PMC7725075 DOI: 10.1136/bmjopen-2020-041494] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE Needlestick and sharps injuries among healthcare workers (HCWs) pose significant occupational health problems. We aim to provide incidence and other epidemiological aspects of needlestick and sharp injuries (NSSIs) among HCWs in a tertiary teaching hospital in Indonesia, to inform the evaluation of NSSIs prevention programme. METHODS A cohort study was conducted at Cipto Mangunkusumo Hospital in Jakarta. We analysed data of the sharps injury programme at the hospital between January 2014 and December 2017. Incidence of NSSIs was calculated per 1000 person-years (1000-PY). RESULTS Over the 4-year period, a total of 286 NSSIs were reported. The mean NSSIs incidence rate for 4 years was 13.3/1000-PY, peaking in 2015 (15.5/1000-PY) then decreasing afterward. Most NSSIs were experienced by nurses (42.7%), but the highest incidence was among midwives (18.9/1000-PY), followed by nurses, medical students and medical doctors (15.2/1000-PY, 12.6/1000-PY and 11.8/1000-PY, respectively). The devices causing the highest proportion of NSSIs were hollow-bore needles (66.8%), followed by suture needles (14.3%) and solid needles (10.8%). 9.4% of NSSIs were related to insulin pen injection. Of all the incidents, 31.3% occurred during surgical procedures, 25.9% during blood collections, 14.3% during administering injection of drugs and 13.3% during waste cleaning. CONCLUSION In conclusion, this study showed varied incidences of NSSI among different occupations, with the highest among midwives and nurses. Many unsafe work practices still continue, which is of utmost concern. We suggest opportunities for prevention including training and cultivating safer workplace practices.
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Affiliation(s)
- Evy Yunihastuti
- Department of Internal Medicine Faculty of Medicine Universitas Indonesia, Hospital Dr Cipto Mangunkusumo, Central Jakarta, DKI Jakarta, Indonesia
- HIV Integrated Unit, Hospital Dr Cipto Mangunkusumo, Central Jakarta, DKI Jakarta, Indonesia
| | - Dewi Mira Ratih
- Department of Internal Medicine Faculty of Medicine Universitas Indonesia, Hospital Dr Cipto Mangunkusumo, Central Jakarta, DKI Jakarta, Indonesia
| | - Matdoan Rifkiah Aisyah
- HIV Integrated Unit, Hospital Dr Cipto Mangunkusumo, Central Jakarta, DKI Jakarta, Indonesia
| | - Ainum Jhariah Hidayah
- HIV Integrated Unit, Hospital Dr Cipto Mangunkusumo, Central Jakarta, DKI Jakarta, Indonesia
| | - Alvina Widhani
- Department of Internal Medicine Faculty of Medicine Universitas Indonesia, Hospital Dr Cipto Mangunkusumo, Central Jakarta, DKI Jakarta, Indonesia
- HIV Integrated Unit, Hospital Dr Cipto Mangunkusumo, Central Jakarta, DKI Jakarta, Indonesia
| | - Andri Sanityoso Sulaiman
- Department of Internal Medicine Faculty of Medicine Universitas Indonesia, Hospital Dr Cipto Mangunkusumo, Central Jakarta, DKI Jakarta, Indonesia
| | - Teguh Harjono Karjadi
- Department of Internal Medicine Faculty of Medicine Universitas Indonesia, Hospital Dr Cipto Mangunkusumo, Central Jakarta, DKI Jakarta, Indonesia
- HIV Integrated Unit, Hospital Dr Cipto Mangunkusumo, Central Jakarta, DKI Jakarta, Indonesia
| | - Czeresna Heriawan Soejono
- Department of Internal Medicine Faculty of Medicine Universitas Indonesia, Hospital Dr Cipto Mangunkusumo, Central Jakarta, DKI Jakarta, Indonesia
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Widhani A, Rengganis I, Susanto AJ, Surachmanto EE, Hasibuan AS, Fetarayani D, Mulya DP, Kurniati N, Yunihastuti E, Masri R, Karjadi TH, Koesnoe S, Zubir Z, Alimudin S, Estiasari R, Safri AY, Maria S. Factors Related to Knowledge, Perception, and Practices Towards COVID-19 Among Patients with Autoimmune Diseases: A Multicenter Online Survey. Acta Med Indones 2020; 52:214-226. [PMID: 33020333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND autoimmune patients can be more susceptible to infection. Proper knowledge, perception, and practices towards COVID-19 are essential for these patients during pandemic. This study aimed to know their knowledge, perception, and practices regarding COVID-19. METHODS cross sectional study using online survey was conducted from April to May 2020. Patients with autoimmune disease were asked about demographic characteristics, diagnosis, history of treatment, knowledge, perception, and practice regarding COVID-19. RESULTS there were 685 respondents. Most of them were female and had systemic lupus erythematosus with median age of 37 years old. Almost all respondents had good knowledge regarding transmission of COVID-19 and did proper prevention practices. Adequacy of information and steroid or mycophenolate mofetil/mycophenolic acid (MMF/MPA) use were related to perception of the effect of pandemic to their own health. Visiting private clinic and receiving hydroxychloroquine/chloroquine sulfate or sulfasalazine were related to perception that autoimmune conditions would make them more prone to COVID-19. Work from home was related to perception that when contracting COVID-19, the symptoms would be more severe. Living in Sumatra region and getting hydroxychloroquine/chloroquine sulfate or MMF/MPA were related to perception that autoimmune medications could reduce risk of getting COVID-19. Adequate information, university education, private clinic visit, and hydroxychloroquine/chloroquine sulfate use were related to perception that COVID-19 pandemic would cause difficulties in getting medications. CONCLUSION almost all respondents had good knowledge and practices regarding COVID-19. Adequacy of information, autoimmune treatment, work from home, educational background, area of living, and health care facilities contributed to perception regarding COVID-19 pandemic.
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Affiliation(s)
- Alvina Widhani
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Faculty of Medicine, University of Indonesia, Cipto Mangunkusumo Hospital Jakarta, University of Indonesia Hospital, Indonesia.
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Yunihastuti E, Widhani A, Karjadi TH. Drug hypersensitivity in human immunodeficiency virus-infected patient: challenging diagnosis and management. Asia Pac Allergy 2014; 4:54-67. [PMID: 24527412 PMCID: PMC3921866 DOI: 10.5415/apallergy.2014.4.1.54] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Accepted: 01/16/2013] [Indexed: 01/11/2023] Open
Abstract
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.
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Affiliation(s)
- Evy Yunihastuti
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Faculty of Medicine, University of Indonesia, Jakarta 10430, Indonesia. ; HIV Integrated Clinic Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia
| | - Alvina Widhani
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Faculty of Medicine, University of Indonesia, Jakarta 10430, Indonesia
| | - Teguh Harjono Karjadi
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Faculty of Medicine, University of Indonesia, Jakarta 10430, Indonesia. ; HIV Integrated Clinic Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia
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