Data collection and management
NAFLD, fasting blood glucose, periodontitis, fibrosis, liver stiffness
PERIODONTITIS, FIBROSIS
Subjects who meet eligibility criteria are enrolled and have a baseline visit (week 0) within 6 weeks following the screening visit. Venous blood sample are collected for fasting blood glucose, ALT, CMV DNA, hsCRP, sCD14, VCAM, ICAM, and β2M examinations.Each patient has a CIMT and FMD evaluation performed by a trained cardiologist using B mode ultrasonography. CIMT is defined as a double-line pattern visualized by echo 2D on both walls of the common carotid artery (CCA) in a longitudinal view. Two parallel lines (leading edges of two anatomical boundaries) form it: the lumen-intima and media-adventitia interfaces. High-resolution B-mode ultrasound images of the right and left common carotid artery will be used to measure carotid intima-media thickness. The patient is scanned in the supine position using 7–12 MHz linear array transducer (Philips Affiniti 70C, Phillips, UK). CIMT is calculated using both manual and semi-automated (Automated; QLAB, Phillips, UK) methods. Manual CIMT measurements are recorded from the far wall at 1 cm, 1.5 cm, and 2 cm intervals proximal to the carotid bulb. Automated measurements are also recorded from the far wall, using the same image, from the identical 1 cm section proximal to the carotid bulb. The carotid bulb is defined as the point where the far wall deviated from the parallel plane of the distal CCA. Mean manual and automated cIMT measurements for the right and left CCA are calculated from three consecutive cardiac cycles.FMD is assessed in the brachial artery by ultrasonography. The participant has to abstain from exercise (≥12 hr), caffeine (≥12 hr), smoking or smoke exposure (≥12 hr), vitamin supplementation (>72 hr), and any medication (≥4 hr half-lives of the drug, non-steroidal anti-inflammatory agents for 1 day and aspirins for 3 days). We ensure that the participant is under fasting conditions or has only consumed low-fat meals. The measurements are performed on the right arm when the patient is in the supine position, after 10 to 20 minutes of rest in the supine position
Transient elastography with CAP will be done by trained hepatologist using Fibroscan (Echosens®) device. The criteria for successful examination are 10 shots and an interquartile range (IQR) for liver stiffness of less than 20% of the median value. The cut-off value for NAFLD diagnosis is CAP measurement of above 238 dB/m and/or fibrosis score higher than 7.1 kPa
A trained neurologist performs the neurocognitive evaluation. The cognitive tests are performed in week 0, week 24, and week 48. This study uses tests that are sensitive to domain most affected in HIV but can be delivered in relatively short time. This study uses Trail Making Test (TMT) A and B to measure executive function, Symbol Digit Modalities Test (SDMT) for speed of information processing, and Brief Visuospatial Memory Test Revised for learning and memory. These tests have already been validated in Indonesia and can be administered by non-neuropsychologists who have been trained
A trained dentist will assess periodontitis using CPI, which was modified by the World Health Organization (WHO). This assessment uses a 0.5 mm ball tip periodontal probe with black band markers at 3.5, 5.5, 8.5, and 11.5 mm, and involve 10 teeth (17, 16, 11, 26, 27, 37, 36, 31, 46, and 47). The score ranges from 0 for healthy periodontal to score 4 for periodontal pocket ≥6 mm
