Indonesia: A=100%,B=80%,C=18%,E=7%,G=3%,HIV=.05%

[Guest guest]

Indonesia

---------------

219 million people

4th Largest Nation

% of Population with a virus

-------------------------------------

HAV = 100%

HBV = 80%

HCV = 18%

HDV = 0

HEV = 7%

HGV = 3%

TTV = NL

-------

Hep = 208%

HIV = 0.05%

AIDS= 52,000 cases by 97

HAV

------

Am J Trop Med Hyg 1985 May;34(3):616-9

Serologic markers of hepatitis A and B in the population of Bali, Indonesia.

Brown P, Breguet G, Smallwood L, Ney R, Moerdowo RM, Gerety RJ

A total of 343 sera from Balinese subjects in different age groups and

geographic locations were tested by radioimmunoassay (RIA) for serum

antibodies to hepatitis B surface antigen (anti-HBs) and hepatitis B core

antigen (anti-HBc); most sera were also tested for hepatitis B surface

antigen (HBsAg), and for antibody to hepatitis A virus (anti-HAV).

One hundred percent [100%] of the adult population was found to have

anti-HAV,

with antibody acquisition beginning in early childhood and reaching a level

of 95% by the age of 10 years. Antibodies to hepatitis B virus were also

frequent in young children, rapidly peaking to near 80% in older children

and adolescents, then declining to a plateau that fluctuated between 40% and

60% throughout adult life. Overall, anti-HBc (49%) was detected slightly

more often than anti-HBs (45%), but the relative frequencies of the 2

antibodies varied considerably from group to group. Despite these high

antibody prevalences, HBsAg was detected in only 1.5% of the general

population, and in no woman of child-bearing age. In utero infection is thus

far less likely to account for the early acquisition of antibody to

hepatitis B virus than inapparent percutaneous transmission occurring under

conditions of close personal contact.

PMID: 2988352, UI: 85222868

HBV

------

Am J Trop Med Hyg 1985 May;34(3):616-9

Serologic markers of hepatitis A and B in the population of Bali, Indonesia.

Brown P, Breguet G, Smallwood L, Ney R, Moerdowo RM, Gerety RJ

A total of 343 sera from Balinese subjects in different age groups and

geographic locations were tested by radioimmunoassay (RIA) for serum

antibodies to hepatitis B surface antigen (anti-HBs) and hepatitis B core

antigen (anti-HBc); most sera were also tested for hepatitis B surface

antigen (HBsAg), and for antibody to hepatitis A virus (anti-HAV).

One hundred percent [100%] of the adult population was found to have

anti-HAV,

with antibody acquisition beginning in early childhood and reaching a level

of 95% by the age of 10 years. Antibodies to hepatitis B virus were also

frequent in young children, rapidly

peaking to near 80% in older children and adolescents,

then declining to a plateau that fluctuated between 40% and 60% throughout

adult life. Overall, anti-HBc (49%) was detected slightly more often than

anti-HBs (45%), but the relative frequencies of the 2 antibodies varied

considerably from group to group. Despite these high antibody prevalences,

HBsAg was detected in only 1.5% of the general population, and in no woman

of child-bearing age. In utero infection is thus far less likely to account

for the early acquisition of antibody to hepatitis B virus than inapparent

percutaneous transmission occurring under conditions of close personal

contact.

PMID: 2988352, UI: 85222868

HCV

-------

J Clin Microbiol 2000 Feb;38(2):662-8

Prevalence of GB virus C/Hepatitis G virus infection among various

populations in surabaya, indonesia, and identification of novel groups of

sequence variants.

Handajani R, Soetjipto, Lusida MI, Suryohudoyo P, Adi P, Setiawan PB, Nidom

CA, Soemarto R, Katayama Y, Fujii M, Hotta H

Departments of Biochemistry, Faculty of Medicine, Airlangga University,

Surabaya, Indonesia.

A molecular epidemiological study was performed to investigate the

prevalence of GB virus C/hepatitis G virus (GBV-C/HGV) infection among

various populations in Surabaya, Indonesia. The prevalence of GBV-C/HGV RNA,

determined by reverse transcription-PCR for a portion of the NS3 region of

the viral genome,

was 2.7% (4 of 150) among randomly collected blood donor sera,

which were all negative for both hepatitis B virus surface antigen and

antibodies against hepatitis C virus (HCV). On the other hand, the

prevalence among

anti-HCV-positive blood donors was 17.8% (13 of 73),

with the ratio being significantly higher than that observed with the

anti-HCV-negative blood donors (P < 0.001). A high prevalence of GBV-C/HGV

infection was also observed among patients with chronic liver disease, such

as chronic hepatitis (5.7%), liver cirrhosis (11. 5%), and hepatocellular

carcinoma (7.0%), and patients on maintenance hemodialysis (29.0%). No

correlation was observed between GBV-C/HGV viremia and serum alanine

aminotransferase levels in the populations tested, suggesting the

possibility that GBV-C/HGV does not cause apparent liver injury.

Phylogenetic analysis of sequences of a portion of the 5' untranslated

region and the E1 region of the viral genome identified, in addition to a

previously reported then novel group of GBV-C/HGV variants (group 4),

another novel group of variants (group 5). This result suggests that

GBV-C/HGV can be classified into at least five genetic groups. GBV-C/HGV

isolates of group 4 and group 5 were each shown to comprise approximately

40% of the total Indonesian isolates.

PMID: 10655364, UI: 20122441

HDV

------

Trop Geogr Med 1988 Jan;40(1):17-9

Prevalence of anti-delta antibodies in pregnant women in Bandung, Indonesia.

Vranckx R, Reniers J, Alisjahbana A, Ngantung W, Sugita E, Meheus A

Department of Microbiology, Institute of Hygiene and Epidemiology, Brussels,

Belgium.

Knowledge of the epidemiology of hepatitis D virus (HDV)-infection is very

scarce in many parts of the world. The endemicity of delta-infection is

believed to be maintained and spread through the network of hepatitis B

surface antigen (HBsAg) carriers in the community. In the Far East and the

Pacific area, the prevalence of chronic HBsAg carriers is mostly high.

Markers of HDV infection are very frequent in some regions (e.g. parts of

China, Fiji Isles, Samoa), in other regions they are almost absent (e.g.

Taiwan, Thailand, parts of China). In the Bandung region (West Java,

Indonesia) we found 26 (2.8%) HBsAg carriers

among 926 pregnant women. Most of them are chronic carriers (anti hepatitis

B core (HBc) IgM negative). Although HBsAg is frequent in this Indonesian

population, we

could not find any anti-HD positive.

This data warrants the conclusion that HDV infection has not yet been

introduced in that densely populated area of Indonesia.

PMID: 3381311, UI: 88249196

HEV

-------

Trop Med Int Health 1997 Sep;2(9):885-91

Emerging viral pathogens in long-term expatriates (I): Hepatitis E virus.

Janisch T, Preiser W, Berger A, Mikulicz U, Thoma B, Hampl H, Doerr HW

Institut fur Medizinische Virologie, Zentrum der Hygiene, Klinikum der J.

W.

Goethe-Universitat, furt am Main, Germany.

Hepatitis E virus (HEV) is one of the so-called 'emerging' viral pathogens,

whose role is increasingly being recognized. To estimate the risk of HEV

infection during long-term stays in HEV-endemic countries, 500 serum

samples

obtained from development aid workers and their family members who had

spent

on average 9 years in HEV-endemic regions were tested for antibodies

against

HEV by ELISA and Immunoblot.

We found seroprevalence rates of 5-6% with no significant differences

related to gender or area of upbringing (raised in an HEV-endemic vs.

nonendemic region). Seroprevalence rates did not increase with increasing

number of stays or number of expatriate years. None of 77 children and

adolescents tested was positive for anti-HEV.

The Indian subcontinent showed the highest seropositive rate with 10%.

In subjects returning from West and Central Africa, East Africa,

South-east Asia and Latin America seroprevalence rates were around 7%.

We found a comparatively low seroprevalence rate of 2.1% for the Arab

countries and the Middle East.

Our results show that there definitely is a risk for long-term expatriates

to acquire HEV infection; however, in most of our cases infection seems to

have been non- or oligo-symptomatic.

PMID: 9315047, UI: 97460665

HGV

-------

J Clin Microbiol 2000 Feb;38(2):662-8

Prevalence of GB virus C/Hepatitis G virus infection among various

populations in surabaya, indonesia, and identification of novel groups of

sequence variants.

Handajani R, Soetjipto, Lusida MI, Suryohudoyo P, Adi P, Setiawan PB, Nidom

CA, Soemarto R, Katayama Y, Fujii M, Hotta H

Departments of Biochemistry, Faculty of Medicine, Airlangga University,

Surabaya, Indonesia.

A molecular epidemiological study was performed to investigate the

prevalence of GB virus C/hepatitis G virus (GBV-C/HGV) infection among

various populations in Surabaya, Indonesia. The prevalence of GBV-C/HGV RNA,

determined by reverse transcription-PCR for a portion of the NS3 region of

the viral genome,

was 2.7% (4 of 150) among randomly collected blood donor sera,

which were all negative for both hepatitis B virus surface antigen and

antibodies against hepatitis C virus (HCV). On the other hand, the

prevalence among

anti-HCV-positive blood donors was 17.8% (13 of 73),

with the ratio being significantly higher than that observed with the

anti-HCV-negative blood donors (P < 0.001). A high prevalence of GBV-C/HGV

infection was also observed among patients with chronic liver disease, such

as chronic hepatitis (5.7%), liver cirrhosis (11. 5%), and hepatocellular

carcinoma (7.0%), and patients on maintenance hemodialysis (29.0%). No

correlation was observed between GBV-C/HGV viremia and serum alanine

aminotransferase levels in the populations tested, suggesting the

possibility that GBV-C/HGV does not cause apparent liver injury.

Phylogenetic analysis of sequences of a portion of the 5' untranslated

region and the E1 region of the viral genome identified, in addition to a

previously reported then novel group of GBV-C/HGV variants (group 4),

another novel group of variants (group 5). This result suggests that

GBV-C/HGV can be classified into at least five genetic groups. GBV-C/HGV

isolates of group 4 and group 5 were each shown to comprise approximately

40% of the total Indonesian isolates.

PMID: 10655364, UI: 20122441

Am J Trop Med Hyg 1997 Oct;57(4):455-6

Short report: evidence of worldwide transmission of hepatitis G virus.

Corwin AL, Hyams KC, Kim JP, Wages J, Doss R, Sulaiman A, B, Arthur

R, Bassily S, Punjabi NH, Laras K, Duc DD, Watts D

U.S. Naval Medical Research Unit No. 2, Jakarta, Indonesia.

Hepatitis G virus (HGV) has been recently documented in the Americas,

Europe, and Australia. Distinct risk populations from North Africa, South

America, and Southeast Asia were screened for HGV, in addition to hepatitis

B and C viruses. First time recognition of HGV is described from Egypt and

Indonesia. Notable is the high proportion of

HGV positive individuals among multiply transfused children, ranging from

24% of those sampled from Egypt to 32% in Indonesia.

Also, data from Peru suggest the likely association of HGV infection with

progressive liver disease. Hepatitis G virus should be considered a

world-wide health concern.

PMID: 9347963, UI: 98006186

TTV

------

Arch Virol 2000 Jan 25;145(1):63-72

TT virus (TTV) genotypes in native and non-native prostitutes of Irian Jaya,

Indonesia: implication for non-occupational transmission.

Mulyanto, Hijikata M, Matsushita M, Ingkokusmo G, Widjaya A, Sumarsidi D,

Kanai K, Ohta Y, Mishiro S

West Nusa Tenggara Hepatitis Laboratory, Mataram, Indonesia

We investigated prostitutes in Irian Jaya, an Indonesian territory of New

Guinea, to know whether TT virus (TTV) is sexually transmitted and what

genotypes of TTV exist there. An ORF2 region of the TTV genome was analyzed

for 44 isolates from prostitutes (19 were Irian Jaya natives but 25 were

immigrants from Java or other islands of Indonesia) and 26 isolates from

women of child-bearing age in Surabaya as a control. The

WX(7)HX(3)CX(1)CX(5)H motif sequence of the ORF2 was compared across the 70

Indonesian isolates with a reference of 47 Japanese isolates (filed in

databases) and the prototype TTV isolate TA278. A total of 77 different

sequences were generated from the comparison, but a phylogenetic analysis

suggested that they could be divided into three categories: group A, group B

and others (the third group was highly diverse). Interestingly, most of the

Indonesian isolates belonged to group B (74%): this rate was considerably

higher than that observed previously in Japanese isolates. Group B isolates

were further compared for the N-terminal 95 amino acids of the ORF2, with a

result that the natives of Irian Jaya had a different pattern of genotype

distribution from other groups. In particular, 9 out of 19 isolates from the

Irian Jaya-natives were co-classified under a distinct branch, to which none

of the other Indonesian and Japanese isolates belonged. Our data indicate

that

TTV genotypes reflect the birth place

of the infected prostitutes rather than their work environment, and thus

suggest that an infection is more likely during the early period of life

than through sexual transmission.

In addition, the presence of an Irian Jaya-specific genotype is intriguing

from an anthropological and viral evolutionary point of view, because Irian

Jaya has been isolated from contact with other areas for a long time.

PMID: 10664406

AIDS

-------

Soc Sci Med 1999 Oct;49(8):1101-14

Female commercial sex workers in Kramat Tunggak, Jakarta, Indonesia.

Sedyaningsih-Mamahit ER

Communicable Disease Research Center, Ministry of Health, Jakarta,

Indonesia. esedyani@...

Indonesia is predicted to face a severe AIDS epidemic in the near future.

More than 60% of the reported HIV-positive cases in Indonesia can be

attributed to heterosexual transmission; therefore, by the nature of their

work, female commercial sex workers (FCSWs) constitute one of the

communities at risk. No meaningful or effective STD/HIV prevention programs

for FCSWs can be planned if there is no contextual understanding of these

women as persons, the nature and the risks of their job and their relations

with their clients and managers. Just as it is incorrect to assume that all

women enter prostitution for the same reasons, educational approaches that

are modeled on shallow stereotypes will be ineffective. Interweaving

qualitative and quantitative methods, this research investigates the FCSWs

in an 'official' brothel complex in Jakarta, Indonesia. Results of this

study give insights of four typologies of FCSWs observed in Kramat Tunggak.

The personal, professional, social and other differences which influenced

the women into full-time sex work and affected their willingness and ability

to engage in healthy and protective behaviors, are presented. Finally, based

on those findings a recommendation on how to deliver health messages to the

FCSWs is offered.

PMID: 10475673, UI: 99402658

Ann Acad Med Singapore 1997 Sep;26(5):628-31

Emerging disease surveillance in Southeast Asia.

Corwin A, Simanjuntak CH, Ansari A

Emerging Disease Program, US Naval Medical Research Unit No. 2, Jakarta,

Indonesia.

The emergence of infectious disease causing agents/pathogens necessitates a

rational surveillance approach leading to early detection and appropriate

intervention. Surveillance activities with

support from the US Naval Medical Research Unit No. 2 (NAMRU-2),

targeting susceptible populations/areas in Southeast Asia, have been

organised using a multi-design strategy: 1) systematic multi-size (usually

hospital-based) study; 2) investigation of (suspected) outbreak events

involving significant case populations (and associated fatalities); and 3)

monitoring of unique " risk opportunities " that include pre- and

post-screening of immunologically naive (susceptible) persons (including

military personnel and tourists) travelling in groups to areas of likely

disease transmission/occurrence. Recognition of new (or old) disease agents

or emerging antimicrobial resistance requires a standardised study effort

with complementary advanced diagnostic capabilities. Collaborative research

involving NAMRU-2 includes surveillance of 01 and non-01 Vibrio cholerae

strains in epidemic and sporadic transmission, profiling regional patterns

of antimicrobial resistance associated with Mycobacterium tuberculosis,

describing the molecular epidemiology of HIV genotypic spread, and

investigating

foci of epidemic hepatitis E virus transmission.

Focused surveillance efforts, as described, provide for recognition of

emerging and/or re-emerging diseases, optimising the investment of generally

scarce public health resources.

Publication Types:

Review

Review, tutorial

PMID: 9494669, UI: 98155773

AIDS Care 1993;5(3):289-303

AIDS and STDs: risk behaviour patterns among female sex workers in Bali,

Indonesia.

Wirawan DN, Fajans P, Ford K

Faculty of Medicine, Udayana University, Bali, Indonesia.

This study investigated AIDS and STD knowledge, risk behaviour patterns and

condom use among three distinct groups of female commercial sex workers

(CSWs) in Bali, Indonesia. Individual in-depth interviews were conducted

with 71 female CSWs. These CSW groups differ in the prices they charge,

their places and modes of employment, educational backgrounds, levels of

AIDS and STD knowledge, number of clients served and levels of condom use.

Knowledge of the routes of transmission and appropriate prevention practices

is low among all groups, and despite significant differences in their number

of clients and their condom use, all groups report high levels of STD

symptoms. Although

HIV seroprevalence rates are currently low in Indonesia,

high risk sexual behaviour patterns place all three groups of CSWs and their

clients at great risk of infection. Interventions targeted to specific

groups of CSWs and clients should be undertaken as soon as possible,

including educational activities utilizing peer educators, condom promotion

and distribution, together with improved STD diagnosis and treatment for

CSWs and their clients.

PMID: 8218464, UI: 94032538

Soc Sci Med 1995 Aug;41(3):409-17

AIDS knowledge and risk behaviors among domestic clients of female sex

workers in Bali, Indonesia.

Fajans P, Ford K, Wirawan DN

Department of Population Planning and International Health School of Public

Health, University of Michigan, Ann Arbor 48109, USA.

This study investigated AIDS and STD knowledge, risk behaviors and condom

use among clients of female commercial sex workers in Bali, Indonesia.

Although these clients were varied in their socioeconomic status, they all

tended to have low levels of knowledge concerning HIV and STD transmission

and prevention, multiple sexual partners, low frequencies of condom use with

these partners, and experienced frequent STDs. Although

HIV sero-prevalence rates are currently low in Indonesia

, clients of CSWs are at high risk of HIV transmission. Given their high

mobility and frequent sexual encounters with CSWs in other parts of

Indonesia, these men could well be agents of rapid spread of the virus

throughout Indonesia. Interventions to prevent the spread of the HIV virus

must be targeted not only to CSWs, but also to their clients. These

interventions should include educational activities concerning AIDS and STD

transmission and prevention, condom promotion, efforts to improve condom

availability, and activities to strengthen the health sectors' STD diagnosis

and treatment capabilities for both CSWs and their clients.

PMID: 7481934, UI: 96083027

Southeast Asian J Trop Med Public Health 1997 Sep;28(3):525-9

Second report of AIDS related attitudes and sexual practices of the Jakarta

Waria (male transvestites) in 1995.

Lubis I, Master J, Munif A, Iskandar N, Bambang M, Papilaya A, Roesin R,

Manurung S, Graham R

AIDS and STD Prevention Program, Indonesian Public Health Association,

Indonesia.

As the second part of a community based educational campaign to convey the

risk of HIV/AIDS to commercial sex workers in Jakarta, from May-July 1995, a

total of 253 male transvestites (WARIA) were questioned about their sexual

behavior patterns and their knowledge and attitude toward HIV/AIDS. In the

previous report, 1991-1993, there was one out of 830 WARIA found HIV

positive in November 1993. In this study, 1995, a total of two out of

253 WARIA were confirmed of HIV infection in July 1995.

Most of them still have incorrect knowledge on HIV/AIDS transmission mode,

they are still practicing high risk sexual attitudes such as an exchange

partner rate of 5 men per three weeks, low condom use (1.2 out of the last 5

sexual contacts). The reasons for not using condoms were forgetfulness 35.3%

and partner does not like condom 38.2% Most of WARIA know about condoms

(94.5%), but it is difficult to access condom use from small shops around

them. Therefore, to prevent further spread of HIV/AIDS in WARIA, condom

should be used constantly and properly. It has been shown from another

study, that more information, better availability and better promotion of

condoms can increase condom use. Thus, attention should be placed on various

ways of distributing condoms for WARIA in Jakarta, especially

community-based distribution by peer leaders, social marketing and

commercial sales.

PMID: 9561602, UI: 98222387

Southeast Asian J Trop Med Public Health 1993;24 Suppl 1:275-7

Anti-HIV, anti-HCV, syphilis, HBsAg serologic tests among high-risk groups

and blood donors in Yogyakarta, Indonesia.

Triwibowo

Department of Medicine, Faculty of Medicine University of Gadjah Mada,

Indonesia.

This report showed anti-HIV among high-risk groups and

blood donors in Yogyakarta were still negative.

The frequency of HBsAg among blood donor was 2% (RPHA), 3% (ELISA) positive.

Test for syphilis gave 0.3% positive.

PMID: 7886597, UI: 95192861

J Acquir Immune Defic Syndr Hum Retrovirol 1997 Jan 1;14(1):1-6

Genetic, antigenic and serologic characterization of human immunodeficiency

virus type 1 from Indonesia.

Porter KR, Mascola JR, Hupudio H, Ewing D, VanCott TC, RL, Corwin

AL, Widodo S, Ertono S, McCutchan FE, Burke DS, CG, Wignall FS, Graham

RR

Infectious Diseases Department,

Naval Medical Research Institute, Bethesda, land, USA.

To examine the genetic and antigenic characteristics of HIV-1 in Indonesia,

samples from 19 HIV-positive volunteers were studied. By a combination of

PCR typing and DNA sequence analysis, 12 of the 19 volunteers were

determined to be infected with HIV-1 clade B and seven with clade E. Six of

the seven Indonesian clade E isolates were from

volunteers associated with the Indonesian Military during a peacekeeping

mission in Cambodia.

Infectivity reduction neutralization assays showed that the Indonesian E

viruses were effectively neutralized by Thailand clade E HIV-1 antisera but

not by U.S. clade B antisera. The Indonesian clade B virus tested was

neutralized by U.S. clade B antisera and not by the Thailand E antisera.

Using a previously described serologic typing ELISA based on clade B and E

V3 peptides, genetic clade was accurately determined in eight of eight sera

tested. This is the first report of the genetic and antigenic analysis of

HIV-1 isolates from Indonesia. The data indicate that at least two genetic

and antigenic HIV-1 clades (clade E and circulate in Indonesia.

PMID: 8989203, UI: 97143192

Human immunodeficiency virus seroprevalence in children received multiple

transfusions or blood products in the Department of Child Health Faculty of

Medicine University of Indonesia/Dr. Cipto Mangunkusumo General Hospital,

Jakarta. Paediatr Indones. 1988 Nov-Dec;28(11-12):223-30. No abstract

available.

PMID: 3244449; UI: 89220088.

In 1997 and during the first quarter of 1998, UNAIDS and WHO worked closely

with national governments and research institutions to recalculate current

estimates on people living with HIV/AIDS. These calculations are based on

the previously published estimates for 1994 (WER 1995; 70:353-360) and

recent trends in HIV/AIDS surveillance in various populations.

Estimated number of AIDS cases 52000

The current estimates do not claim to be an exact count of infections.

Rather, they use a methodology that has thus far proved accurate in

producing estimates which give a good indication of the magnitude of the

epidemic in individual countries. However, these estimates are constantly

being revised as countries improve their surveillance systems and collect

more information. This includes information about infection levels in

different populations, and behaviours which facilitate or impede infection.

Adults in this report are defined as women and men aged 15 to 49. This age

range covers people in their most sexually active years. While the risk of

HIV infection obviously continues beyond the age of 50, the vast majority of

those who engage in substantial risk behaviours are likely to be infected by

this age. Since population structures differ greatly from one country to

another, especially for children and the upper adult ages, the restriction

of the term adult to 15-to-49-year-olds has the advantage of making

different populations more comparable. This age range was used as the

denominator in calculating adult HIV prevalence.– 3

UNAIDS/WHO Epidemiological Fact Sheet June 1998

http://www.who.int/emc-hiv/fact_sheets/asia.html

[Guest guest]

Indonesia

---------------

219 million people

4th Largest Nation

% of Population with a virus

-------------------------------------

HAV = 100%

HBV = 80%

HCV = 18%

HDV = 0

HEV = 7%

HGV = 3%

TTV = NL

-------

Hep = 208%

HIV = 0.05%

AIDS= 52,000 cases by 97

HAV

------

Am J Trop Med Hyg 1985 May;34(3):616-9

Serologic markers of hepatitis A and B in the population of Bali, Indonesia.

Brown P, Breguet G, Smallwood L, Ney R, Moerdowo RM, Gerety RJ

A total of 343 sera from Balinese subjects in different age groups and

geographic locations were tested by radioimmunoassay (RIA) for serum

antibodies to hepatitis B surface antigen (anti-HBs) and hepatitis B core

antigen (anti-HBc); most sera were also tested for hepatitis B surface

antigen (HBsAg), and for antibody to hepatitis A virus (anti-HAV).

One hundred percent [100%] of the adult population was found to have

anti-HAV,

with antibody acquisition beginning in early childhood and reaching a level

of 95% by the age of 10 years. Antibodies to hepatitis B virus were also

frequent in young children, rapidly peaking to near 80% in older children

and adolescents, then declining to a plateau that fluctuated between 40% and

60% throughout adult life. Overall, anti-HBc (49%) was detected slightly

more often than anti-HBs (45%), but the relative frequencies of the 2

antibodies varied considerably from group to group. Despite these high

antibody prevalences, HBsAg was detected in only 1.5% of the general

population, and in no woman of child-bearing age. In utero infection is thus

far less likely to account for the early acquisition of antibody to

hepatitis B virus than inapparent percutaneous transmission occurring under

conditions of close personal contact.

PMID: 2988352, UI: 85222868

HBV

------

Am J Trop Med Hyg 1985 May;34(3):616-9

Serologic markers of hepatitis A and B in the population of Bali, Indonesia.

Brown P, Breguet G, Smallwood L, Ney R, Moerdowo RM, Gerety RJ

A total of 343 sera from Balinese subjects in different age groups and

geographic locations were tested by radioimmunoassay (RIA) for serum

antibodies to hepatitis B surface antigen (anti-HBs) and hepatitis B core

antigen (anti-HBc); most sera were also tested for hepatitis B surface

antigen (HBsAg), and for antibody to hepatitis A virus (anti-HAV).

One hundred percent [100%] of the adult population was found to have

anti-HAV,

with antibody acquisition beginning in early childhood and reaching a level

of 95% by the age of 10 years. Antibodies to hepatitis B virus were also

frequent in young children, rapidly

peaking to near 80% in older children and adolescents,

then declining to a plateau that fluctuated between 40% and 60% throughout

adult life. Overall, anti-HBc (49%) was detected slightly more often than

anti-HBs (45%), but the relative frequencies of the 2 antibodies varied

considerably from group to group. Despite these high antibody prevalences,

HBsAg was detected in only 1.5% of the general population, and in no woman

of child-bearing age. In utero infection is thus far less likely to account

for the early acquisition of antibody to hepatitis B virus than inapparent

percutaneous transmission occurring under conditions of close personal

contact.

PMID: 2988352, UI: 85222868

HCV

-------

J Clin Microbiol 2000 Feb;38(2):662-8

Prevalence of GB virus C/Hepatitis G virus infection among various

populations in surabaya, indonesia, and identification of novel groups of

sequence variants.

Handajani R, Soetjipto, Lusida MI, Suryohudoyo P, Adi P, Setiawan PB, Nidom

CA, Soemarto R, Katayama Y, Fujii M, Hotta H

Departments of Biochemistry, Faculty of Medicine, Airlangga University,

Surabaya, Indonesia.

A molecular epidemiological study was performed to investigate the

prevalence of GB virus C/hepatitis G virus (GBV-C/HGV) infection among

various populations in Surabaya, Indonesia. The prevalence of GBV-C/HGV RNA,

determined by reverse transcription-PCR for a portion of the NS3 region of

the viral genome,

was 2.7% (4 of 150) among randomly collected blood donor sera,

which were all negative for both hepatitis B virus surface antigen and

antibodies against hepatitis C virus (HCV). On the other hand, the

prevalence among

anti-HCV-positive blood donors was 17.8% (13 of 73),

with the ratio being significantly higher than that observed with the

anti-HCV-negative blood donors (P < 0.001). A high prevalence of GBV-C/HGV

infection was also observed among patients with chronic liver disease, such

as chronic hepatitis (5.7%), liver cirrhosis (11. 5%), and hepatocellular

carcinoma (7.0%), and patients on maintenance hemodialysis (29.0%). No

correlation was observed between GBV-C/HGV viremia and serum alanine

aminotransferase levels in the populations tested, suggesting the

possibility that GBV-C/HGV does not cause apparent liver injury.

Phylogenetic analysis of sequences of a portion of the 5' untranslated

region and the E1 region of the viral genome identified, in addition to a

previously reported then novel group of GBV-C/HGV variants (group 4),

another novel group of variants (group 5). This result suggests that

GBV-C/HGV can be classified into at least five genetic groups. GBV-C/HGV

isolates of group 4 and group 5 were each shown to comprise approximately

40% of the total Indonesian isolates.

PMID: 10655364, UI: 20122441

HDV

------

Trop Geogr Med 1988 Jan;40(1):17-9

Prevalence of anti-delta antibodies in pregnant women in Bandung, Indonesia.

Vranckx R, Reniers J, Alisjahbana A, Ngantung W, Sugita E, Meheus A

Department of Microbiology, Institute of Hygiene and Epidemiology, Brussels,

Belgium.

Knowledge of the epidemiology of hepatitis D virus (HDV)-infection is very

scarce in many parts of the world. The endemicity of delta-infection is

believed to be maintained and spread through the network of hepatitis B

surface antigen (HBsAg) carriers in the community. In the Far East and the

Pacific area, the prevalence of chronic HBsAg carriers is mostly high.

Markers of HDV infection are very frequent in some regions (e.g. parts of

China, Fiji Isles, Samoa), in other regions they are almost absent (e.g.

Taiwan, Thailand, parts of China). In the Bandung region (West Java,

Indonesia) we found 26 (2.8%) HBsAg carriers

among 926 pregnant women. Most of them are chronic carriers (anti hepatitis

B core (HBc) IgM negative). Although HBsAg is frequent in this Indonesian

population, we

could not find any anti-HD positive.

This data warrants the conclusion that HDV infection has not yet been

introduced in that densely populated area of Indonesia.

PMID: 3381311, UI: 88249196

HEV

-------

Trop Med Int Health 1997 Sep;2(9):885-91

Emerging viral pathogens in long-term expatriates (I): Hepatitis E virus.

Janisch T, Preiser W, Berger A, Mikulicz U, Thoma B, Hampl H, Doerr HW

Institut fur Medizinische Virologie, Zentrum der Hygiene, Klinikum der J.

W.

Goethe-Universitat, furt am Main, Germany.

Hepatitis E virus (HEV) is one of the so-called 'emerging' viral pathogens,

whose role is increasingly being recognized. To estimate the risk of HEV

infection during long-term stays in HEV-endemic countries, 500 serum

samples

obtained from development aid workers and their family members who had

spent

on average 9 years in HEV-endemic regions were tested for antibodies

against

HEV by ELISA and Immunoblot.

We found seroprevalence rates of 5-6% with no significant differences

related to gender or area of upbringing (raised in an HEV-endemic vs.

nonendemic region). Seroprevalence rates did not increase with increasing

number of stays or number of expatriate years. None of 77 children and

adolescents tested was positive for anti-HEV.

The Indian subcontinent showed the highest seropositive rate with 10%.

In subjects returning from West and Central Africa, East Africa,

South-east Asia and Latin America seroprevalence rates were around 7%.

We found a comparatively low seroprevalence rate of 2.1% for the Arab

countries and the Middle East.

Our results show that there definitely is a risk for long-term expatriates

to acquire HEV infection; however, in most of our cases infection seems to

have been non- or oligo-symptomatic.

PMID: 9315047, UI: 97460665

HGV

-------

J Clin Microbiol 2000 Feb;38(2):662-8

Prevalence of GB virus C/Hepatitis G virus infection among various

populations in surabaya, indonesia, and identification of novel groups of

sequence variants.

Handajani R, Soetjipto, Lusida MI, Suryohudoyo P, Adi P, Setiawan PB, Nidom

CA, Soemarto R, Katayama Y, Fujii M, Hotta H

Departments of Biochemistry, Faculty of Medicine, Airlangga University,

Surabaya, Indonesia.

A molecular epidemiological study was performed to investigate the

prevalence of GB virus C/hepatitis G virus (GBV-C/HGV) infection among

various populations in Surabaya, Indonesia. The prevalence of GBV-C/HGV RNA,

determined by reverse transcription-PCR for a portion of the NS3 region of

the viral genome,

was 2.7% (4 of 150) among randomly collected blood donor sera,

which were all negative for both hepatitis B virus surface antigen and

antibodies against hepatitis C virus (HCV). On the other hand, the

prevalence among

anti-HCV-positive blood donors was 17.8% (13 of 73),

with the ratio being significantly higher than that observed with the

anti-HCV-negative blood donors (P < 0.001). A high prevalence of GBV-C/HGV

infection was also observed among patients with chronic liver disease, such

as chronic hepatitis (5.7%), liver cirrhosis (11. 5%), and hepatocellular

carcinoma (7.0%), and patients on maintenance hemodialysis (29.0%). No

correlation was observed between GBV-C/HGV viremia and serum alanine

aminotransferase levels in the populations tested, suggesting the

possibility that GBV-C/HGV does not cause apparent liver injury.

Phylogenetic analysis of sequences of a portion of the 5' untranslated

region and the E1 region of the viral genome identified, in addition to a

previously reported then novel group of GBV-C/HGV variants (group 4),

another novel group of variants (group 5). This result suggests that

GBV-C/HGV can be classified into at least five genetic groups. GBV-C/HGV

isolates of group 4 and group 5 were each shown to comprise approximately

40% of the total Indonesian isolates.

PMID: 10655364, UI: 20122441

Am J Trop Med Hyg 1997 Oct;57(4):455-6

Short report: evidence of worldwide transmission of hepatitis G virus.

Corwin AL, Hyams KC, Kim JP, Wages J, Doss R, Sulaiman A, B, Arthur

R, Bassily S, Punjabi NH, Laras K, Duc DD, Watts D

U.S. Naval Medical Research Unit No. 2, Jakarta, Indonesia.

Hepatitis G virus (HGV) has been recently documented in the Americas,

Europe, and Australia. Distinct risk populations from North Africa, South

America, and Southeast Asia were screened for HGV, in addition to hepatitis

B and C viruses. First time recognition of HGV is described from Egypt and

Indonesia. Notable is the high proportion of

HGV positive individuals among multiply transfused children, ranging from

24% of those sampled from Egypt to 32% in Indonesia.

Also, data from Peru suggest the likely association of HGV infection with

progressive liver disease. Hepatitis G virus should be considered a

world-wide health concern.

PMID: 9347963, UI: 98006186

TTV

------

Arch Virol 2000 Jan 25;145(1):63-72

TT virus (TTV) genotypes in native and non-native prostitutes of Irian Jaya,

Indonesia: implication for non-occupational transmission.

Mulyanto, Hijikata M, Matsushita M, Ingkokusmo G, Widjaya A, Sumarsidi D,

Kanai K, Ohta Y, Mishiro S

West Nusa Tenggara Hepatitis Laboratory, Mataram, Indonesia

We investigated prostitutes in Irian Jaya, an Indonesian territory of New

Guinea, to know whether TT virus (TTV) is sexually transmitted and what

genotypes of TTV exist there. An ORF2 region of the TTV genome was analyzed

for 44 isolates from prostitutes (19 were Irian Jaya natives but 25 were

immigrants from Java or other islands of Indonesia) and 26 isolates from

women of child-bearing age in Surabaya as a control. The

WX(7)HX(3)CX(1)CX(5)H motif sequence of the ORF2 was compared across the 70

Indonesian isolates with a reference of 47 Japanese isolates (filed in

databases) and the prototype TTV isolate TA278. A total of 77 different

sequences were generated from the comparison, but a phylogenetic analysis

suggested that they could be divided into three categories: group A, group B

and others (the third group was highly diverse). Interestingly, most of the

Indonesian isolates belonged to group B (74%): this rate was considerably

higher than that observed previously in Japanese isolates. Group B isolates

were further compared for the N-terminal 95 amino acids of the ORF2, with a

result that the natives of Irian Jaya had a different pattern of genotype

distribution from other groups. In particular, 9 out of 19 isolates from the

Irian Jaya-natives were co-classified under a distinct branch, to which none

of the other Indonesian and Japanese isolates belonged. Our data indicate

that

TTV genotypes reflect the birth place

of the infected prostitutes rather than their work environment, and thus

suggest that an infection is more likely during the early period of life

than through sexual transmission.

In addition, the presence of an Irian Jaya-specific genotype is intriguing

from an anthropological and viral evolutionary point of view, because Irian

Jaya has been isolated from contact with other areas for a long time.

PMID: 10664406

AIDS

-------

Soc Sci Med 1999 Oct;49(8):1101-14

Female commercial sex workers in Kramat Tunggak, Jakarta, Indonesia.

Sedyaningsih-Mamahit ER

Communicable Disease Research Center, Ministry of Health, Jakarta,

Indonesia. esedyani@...

Indonesia is predicted to face a severe AIDS epidemic in the near future.

More than 60% of the reported HIV-positive cases in Indonesia can be

attributed to heterosexual transmission; therefore, by the nature of their

work, female commercial sex workers (FCSWs) constitute one of the

communities at risk. No meaningful or effective STD/HIV prevention programs

for FCSWs can be planned if there is no contextual understanding of these

women as persons, the nature and the risks of their job and their relations

with their clients and managers. Just as it is incorrect to assume that all

women enter prostitution for the same reasons, educational approaches that

are modeled on shallow stereotypes will be ineffective. Interweaving

qualitative and quantitative methods, this research investigates the FCSWs

in an 'official' brothel complex in Jakarta, Indonesia. Results of this

study give insights of four typologies of FCSWs observed in Kramat Tunggak.

The personal, professional, social and other differences which influenced

the women into full-time sex work and affected their willingness and ability

to engage in healthy and protective behaviors, are presented. Finally, based

on those findings a recommendation on how to deliver health messages to the

FCSWs is offered.

PMID: 10475673, UI: 99402658

Ann Acad Med Singapore 1997 Sep;26(5):628-31

Emerging disease surveillance in Southeast Asia.

Corwin A, Simanjuntak CH, Ansari A

Emerging Disease Program, US Naval Medical Research Unit No. 2, Jakarta,

Indonesia.

The emergence of infectious disease causing agents/pathogens necessitates a

rational surveillance approach leading to early detection and appropriate

intervention. Surveillance activities with

support from the US Naval Medical Research Unit No. 2 (NAMRU-2),

targeting susceptible populations/areas in Southeast Asia, have been

organised using a multi-design strategy: 1) systematic multi-size (usually

hospital-based) study; 2) investigation of (suspected) outbreak events

involving significant case populations (and associated fatalities); and 3)

monitoring of unique " risk opportunities " that include pre- and

post-screening of immunologically naive (susceptible) persons (including

military personnel and tourists) travelling in groups to areas of likely

disease transmission/occurrence. Recognition of new (or old) disease agents

or emerging antimicrobial resistance requires a standardised study effort

with complementary advanced diagnostic capabilities. Collaborative research

involving NAMRU-2 includes surveillance of 01 and non-01 Vibrio cholerae

strains in epidemic and sporadic transmission, profiling regional patterns

of antimicrobial resistance associated with Mycobacterium tuberculosis,

describing the molecular epidemiology of HIV genotypic spread, and

investigating

foci of epidemic hepatitis E virus transmission.

Focused surveillance efforts, as described, provide for recognition of

emerging and/or re-emerging diseases, optimising the investment of generally

scarce public health resources.

Publication Types:

Review

Review, tutorial

PMID: 9494669, UI: 98155773

AIDS Care 1993;5(3):289-303

AIDS and STDs: risk behaviour patterns among female sex workers in Bali,

Indonesia.

Wirawan DN, Fajans P, Ford K

Faculty of Medicine, Udayana University, Bali, Indonesia.

This study investigated AIDS and STD knowledge, risk behaviour patterns and

condom use among three distinct groups of female commercial sex workers

(CSWs) in Bali, Indonesia. Individual in-depth interviews were conducted

with 71 female CSWs. These CSW groups differ in the prices they charge,

their places and modes of employment, educational backgrounds, levels of

AIDS and STD knowledge, number of clients served and levels of condom use.

Knowledge of the routes of transmission and appropriate prevention practices

is low among all groups, and despite significant differences in their number

of clients and their condom use, all groups report high levels of STD

symptoms. Although

HIV seroprevalence rates are currently low in Indonesia,

high risk sexual behaviour patterns place all three groups of CSWs and their

clients at great risk of infection. Interventions targeted to specific

groups of CSWs and clients should be undertaken as soon as possible,

including educational activities utilizing peer educators, condom promotion

and distribution, together with improved STD diagnosis and treatment for

CSWs and their clients.

PMID: 8218464, UI: 94032538

Soc Sci Med 1995 Aug;41(3):409-17

AIDS knowledge and risk behaviors among domestic clients of female sex

workers in Bali, Indonesia.

Fajans P, Ford K, Wirawan DN

Department of Population Planning and International Health School of Public

Health, University of Michigan, Ann Arbor 48109, USA.

This study investigated AIDS and STD knowledge, risk behaviors and condom

use among clients of female commercial sex workers in Bali, Indonesia.

Although these clients were varied in their socioeconomic status, they all

tended to have low levels of knowledge concerning HIV and STD transmission

and prevention, multiple sexual partners, low frequencies of condom use with

these partners, and experienced frequent STDs. Although

HIV sero-prevalence rates are currently low in Indonesia

, clients of CSWs are at high risk of HIV transmission. Given their high

mobility and frequent sexual encounters with CSWs in other parts of

Indonesia, these men could well be agents of rapid spread of the virus

throughout Indonesia. Interventions to prevent the spread of the HIV virus

must be targeted not only to CSWs, but also to their clients. These

interventions should include educational activities concerning AIDS and STD

transmission and prevention, condom promotion, efforts to improve condom

availability, and activities to strengthen the health sectors' STD diagnosis

and treatment capabilities for both CSWs and their clients.

PMID: 7481934, UI: 96083027

Southeast Asian J Trop Med Public Health 1997 Sep;28(3):525-9

Second report of AIDS related attitudes and sexual practices of the Jakarta

Waria (male transvestites) in 1995.

Lubis I, Master J, Munif A, Iskandar N, Bambang M, Papilaya A, Roesin R,

Manurung S, Graham R

AIDS and STD Prevention Program, Indonesian Public Health Association,

Indonesia.

As the second part of a community based educational campaign to convey the

risk of HIV/AIDS to commercial sex workers in Jakarta, from May-July 1995, a

total of 253 male transvestites (WARIA) were questioned about their sexual

behavior patterns and their knowledge and attitude toward HIV/AIDS. In the

previous report, 1991-1993, there was one out of 830 WARIA found HIV

positive in November 1993. In this study, 1995, a total of two out of

253 WARIA were confirmed of HIV infection in July 1995.

Most of them still have incorrect knowledge on HIV/AIDS transmission mode,

they are still practicing high risk sexual attitudes such as an exchange

partner rate of 5 men per three weeks, low condom use (1.2 out of the last 5

sexual contacts). The reasons for not using condoms were forgetfulness 35.3%

and partner does not like condom 38.2% Most of WARIA know about condoms

(94.5%), but it is difficult to access condom use from small shops around

them. Therefore, to prevent further spread of HIV/AIDS in WARIA, condom

should be used constantly and properly. It has been shown from another

study, that more information, better availability and better promotion of

condoms can increase condom use. Thus, attention should be placed on various

ways of distributing condoms for WARIA in Jakarta, especially

community-based distribution by peer leaders, social marketing and

commercial sales.

PMID: 9561602, UI: 98222387

Southeast Asian J Trop Med Public Health 1993;24 Suppl 1:275-7

Anti-HIV, anti-HCV, syphilis, HBsAg serologic tests among high-risk groups

and blood donors in Yogyakarta, Indonesia.

Triwibowo

Department of Medicine, Faculty of Medicine University of Gadjah Mada,

Indonesia.

This report showed anti-HIV among high-risk groups and

blood donors in Yogyakarta were still negative.

The frequency of HBsAg among blood donor was 2% (RPHA), 3% (ELISA) positive.

Test for syphilis gave 0.3% positive.

PMID: 7886597, UI: 95192861

J Acquir Immune Defic Syndr Hum Retrovirol 1997 Jan 1;14(1):1-6

Genetic, antigenic and serologic characterization of human immunodeficiency

virus type 1 from Indonesia.

Porter KR, Mascola JR, Hupudio H, Ewing D, VanCott TC, RL, Corwin

AL, Widodo S, Ertono S, McCutchan FE, Burke DS, CG, Wignall FS, Graham

RR

Infectious Diseases Department,

Naval Medical Research Institute, Bethesda, land, USA.

To examine the genetic and antigenic characteristics of HIV-1 in Indonesia,

samples from 19 HIV-positive volunteers were studied. By a combination of

PCR typing and DNA sequence analysis, 12 of the 19 volunteers were

determined to be infected with HIV-1 clade B and seven with clade E. Six of

the seven Indonesian clade E isolates were from

volunteers associated with the Indonesian Military during a peacekeeping

mission in Cambodia.

Infectivity reduction neutralization assays showed that the Indonesian E

viruses were effectively neutralized by Thailand clade E HIV-1 antisera but

not by U.S. clade B antisera. The Indonesian clade B virus tested was

neutralized by U.S. clade B antisera and not by the Thailand E antisera.

Using a previously described serologic typing ELISA based on clade B and E

V3 peptides, genetic clade was accurately determined in eight of eight sera

tested. This is the first report of the genetic and antigenic analysis of

HIV-1 isolates from Indonesia. The data indicate that at least two genetic

and antigenic HIV-1 clades (clade E and circulate in Indonesia.

PMID: 8989203, UI: 97143192

Human immunodeficiency virus seroprevalence in children received multiple

transfusions or blood products in the Department of Child Health Faculty of

Medicine University of Indonesia/Dr. Cipto Mangunkusumo General Hospital,

Jakarta. Paediatr Indones. 1988 Nov-Dec;28(11-12):223-30. No abstract

available.

PMID: 3244449; UI: 89220088.

In 1997 and during the first quarter of 1998, UNAIDS and WHO worked closely

with national governments and research institutions to recalculate current

estimates on people living with HIV/AIDS. These calculations are based on

the previously published estimates for 1994 (WER 1995; 70:353-360) and

recent trends in HIV/AIDS surveillance in various populations.

Estimated number of AIDS cases 52000

The current estimates do not claim to be an exact count of infections.

Rather, they use a methodology that has thus far proved accurate in

producing estimates which give a good indication of the magnitude of the

epidemic in individual countries. However, these estimates are constantly

being revised as countries improve their surveillance systems and collect

more information. This includes information about infection levels in

different populations, and behaviours which facilitate or impede infection.

Adults in this report are defined as women and men aged 15 to 49. This age

range covers people in their most sexually active years. While the risk of

HIV infection obviously continues beyond the age of 50, the vast majority of

those who engage in substantial risk behaviours are likely to be infected by

this age. Since population structures differ greatly from one country to

another, especially for children and the upper adult ages, the restriction

of the term adult to 15-to-49-year-olds has the advantage of making

different populations more comparable. This age range was used as the

denominator in calculating adult HIV prevalence.– 3

UNAIDS/WHO Epidemiological Fact Sheet June 1998

http://www.who.int/emc-hiv/fact_sheets/asia.html