Periode Waktu Inisiasi Anti-Retroviral Terapi (ART) Berhubungan dengan Perbedaan Outcome dan Tingkat Kadar CD4 pada Kasus HIV Positif

Wayan Citra Wulan Sucipta Putri, Anak Agung Sagung Sawitri, Komang Ayu Kartika Sari

Abstract


Pemberian ART (Anti Retroviral Therapy) lebih dini pada level CD4 yang lebih tinggi diyakini memberikan outcome yang lebih baik. Penelitian bertujuan mengetahui adanya perbedaan outcome dan tingkat kadar CD4 berdasarkan periode waktu inisiasi awal ART pada penderita HIV positif. Penelitian menggunakan rancangan kohort retrospektif, menggunakan data sekunder untuk melihat perbedaan outcome (CD4, status mortalitas, morbiditas, lost to follow up) pasien berdasarkan periode waktu inisiasi ART. Populasi penelitian adalah seluruh pasien HIV-positif yang sedang atau sudah menjalani ART di Kota Denpasar. Sebanyak 312 pasien diikutkan dalam penelitian ini sesuai kriteria. Hasil penelitian menunjukkan bahwa proporsi subjek yang mengalami kenaikan CD4 hanya 0-99sel/mm3 cenderung lebih besar pada kelompok yang memulai ART lebih dari 12 minggu dibandingkan pada kelompok yang memulai ART 12 minggu ke bawah (44.7% vs 36.7%). Begitu pula sebaliknya, proporsi subjek yang mengalami kenaikan CD4 ≥100 sel/mm3 lebih besar pada kelompok inisiasi ART ≤12 minggu (73.3% vs 55.3%) p=0.046. Proporsi subjek yang meninggal dan lost to follow up lebih besar pada kelompok subjek yang memulai ART lebih dari 12 minggu dari pada sebaliknya (berturut-turut 11% dan 24.2% vs 5% dan 12.7%, p=0.003). Perbedaan signifikan juga terlihat, proporsi subjek yang masih memakai ART lebih besar pada kelompok subjek yang melakukan inisiasi ART ≤12 minggu (64.8% vs 82.4%, p=0.003).


Keywords


HIV, CD4, ART, waktu inisiasi

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DOI: http://dx.doi.org/10.30597/mkmi.v14i3.4123

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