Diseases caused by the Human immunodeficiency virus (HIV) are now treatable but not curable. Last year, seven people died of HIV-related illnesses every hour, and 171 people were newly infected worldwide. A total of 38 million people are now living with HIV and that number is still growing in 2021. Fortunately, two out of three people living with HIV have access to antiretroviral treatment (ART), but only 50% are taking it regularly to suppress infection. The life expectancy of patients has increased over the past 20 years. There is no gap in life expectancy in well-managed HIV patients with demographically matched healthy subjects in the US. However, in low-middle-income countries, the life expectancy of HIV patients is still 16 years lower than that of healthy individuals. The problem is that long-term antiretroviral therapy does not completely restore immune balance in HIV patients, so patients exhibit an increased frequency of cancer, metabolic disease, stroke, kidney disease, and cardiovascular disease. This is due to chronic inflammatory conditions in HIV patients. Coinfection can cause this condition – especially a common virus called cytomegalovirus (CMV). CMV is a clever virus that can hide from immune cells and create constant re-infection. JakCCANDO (Jakarta CMV Cardiovascular Antiretroviral Neurology Dentistry and Opthalmology) is a comprehensive cohort study that followed HIV patients for five years in Jakarta. The JakCCANDO study began in 2012 as a collaborative study between the University of Indonesia and Curtin University.
The research team was led by A/Prof. Patricia Price (Curtin University). The clinical team in Jakarta includes Dr.dr.Ika Prasedya Wijaya, Sp.PD-KKV, Dr.dr.Riwanti Estiasari, Sp.S, Dr.dr.Lukman Edwar, Sp.M(K), Dr.drg.Endah Ayu Tri W, dr. Birry Karim, Sp. PD-KKV with the laboratory of Ibnu Ariyanto, M. Biomed, and Faizah as case managers. The research was conducted at POKDISUS RSCM under the guidance of Dr.dr.Evy Yunihastuti and laboratory research was conducted at the Research Center for Virology and Cancer Pathobiology (PRVKP) with the support of dr. Ibrahim, Sp.MK(K), Ph.D. and Dr.dr. Budiman Bela Sp.MK(K). All JakCCANDO patients had high levels of antibodies to CMV. CMV antibodies are associated with memory function, retinal artery shrinkage, and vessel wall thickening in JakCCANDO patients. However, their CMV antibodies are not ideal markers for CMV-associated symptoms because their levels increase as the patient’s immune system improves with ART. This study tried to find a stable marker that associated CMV coinfection with the patient’s clinical condition. Ibnu Ariyanto explored the altered unconventional T cell population in HIV patients – specifically gamma delta (γδ) T cells which have two subsets Vδ2+ and Vδ2-. Previous research has linked T cells to vascular damage in the general population. Ibnu found that the Vδ2- population increased and the Vδ2+ population decreased relative to healthy subjects. He also found a large number of activated Vδ2 T-cells and this correlated with an increase in blood vessel wall thickness in HIV patients and with CMV antibody levels. In conclusion, T cells have the potential to be used as a biomarker that can predict the risk of cardiovascular disease in HIV patients because the proportion is stable when patients start therapy and after therapy. The results of the research were presented by Ibnu Agus Arianto, S. in his doctoral promotion session which took place virtually on Tuesday, January 12, 2021, at 10.00 WIB. Ibn Agus Ariyanto, S.Si., M.Biomed straightforwardly managed to defend his dissertation by answering questions and rebuttals from the examiner team chaired by dr. R. Fera Ibrahim, M.Sc., Ph.D., SpMK(K) with a member of the testing team Dr. dr. Evi Yunihastuti, SpPD-KAI; Dr. Drs. Heri Wibowo, M.S; and Deirdre R. Coombe, Ph.D., BSc from Curtin University. The promoter in this research is Prof. dr. Amin Soebandrio, Ph.D., SpMK(K) with co-promoter Prof. Patricia Price, Ph.D. and Dr. dr. Budiman Bela, SpMK. At the end of the session, the chairman of the session who is also the Dean of FKUI Prof. Dr. dr. Ari Fahrial Syam, SpPD-KGEH, MMB, appointed Ibnu Agus Ariyanto, S.Si., M.Biomed to become a Doctor in the Doctoral Program in Biomedical Sciences at FKUI.