Hubungan antara Kadar CD4+ dengan Angka Kejadian Infeksi Menular Seksual pada Pasien HIV/AIDS

Ancella Soenardi, Prasetyadi Mawardi

= http://dx.doi.org/10.20473/bikk.V31.2.2019.104-110
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Abstract


Latar Belakang: Infeksi menular seksual (IMS), termasuk infeksi Human immunodeficiency virus/ Acquired Immune Deficiency Syndrome (HIV/AIDS), merupakan masalah utama di negara berkembang. Koinfeksi IMS pada pasien HIV merupakan faktor komorbid peningkatan risiko transmisi HIV dan IMS. Kadar sel limfosit T CD4+ digunakan untuk menentukan imunitas pasien HIV/AIDS. Studi yang menghubungkan jumlah sel CD4+ dan angka kejadian IMS pada pasien HIV/AIDS hingga kini hanya sedikit. Tujuan: Mengevaluasi profil IMS pada pasien HIV/AIDS di RSUD dr. Moewardi dan mengevaluasi hubungan antara kadar sel limfosit CD4+ dengan angka kejadian IMS pada pasien HIV/AIDS. Metode: Penelitian retrospektif menggunakan data sekunder rekam medik klinik Voluntary Conseling and Testing (VCT) RSUD dr. Moewardi periode Januari 2014 - Maret 2016. Diagnosis IMS ditegakkan berdasarkan pendekatan sindrom. Data CD4+ pasien IMS dengan HIV/AIDS dicatat untuk diolah secara statistik. Hasil: Kasus terbanyak adalah kondiloma akuminata (44%), ulkus genital nonherpes (12%), dan herpes genitalis (12%). Pemeriksaan sel limfosit CD4+ berdasar data rekam medis,13 pasien memiliki nilai CD4+ ≤ 350 sel/mm3, 2 pasien memiliki nilai CD4+ >350 sel/mm3, dan nilai CD4+ pada 7 pasien lainnya tidak diketahui. Hasil analisis statistik menunjukkan tidak ada hubungan antara CD4+ dan angka kejadian IMS (p=0,562), tetapi kelompok nilai CD4+ rendah berisiko 1,16 kali untuk terkena IMS dibandingkan kelompok nilai CD4+ tinggi (0,67 kali). Simpulan: Hubungan bermakna antara kadar sel limfosit T CD4+ dan angka kejadian IMS belum dapat ditegakkan, meskipun kadar CD4+ rendah berisiko 1,16 kali untuk terkena IMS. Skrining kasus IMS pada pasien HIV/AIDS disertai perubahan perilaku dan pengobatan IMS yang tepat diharapkan dapat mencegah penularan HIV/AIDS.


Keywords


AIDS; HIV; infeksi menular seksual; kadar CD4+;

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References


Kimberly A. Workowski, Bolan GA. Sexually transmitted diseases treatment guideline 2015. MMWR Recomm Rep 2015;64(3).

Sharma S, Tiwari S, Paliwal V, Mathur DK, Bhargava P. Study of patterns of sexually transmitted diseases using a syndromic approach in the era of human immunodeficiency virus from a tertiary care hospital of the Northern India. Indian J Sex Transm Dis 2015;36(2):158-61.

Lee HC, Ko NY, Lee NY, Chang CM, Liu SY, Ko WC. Trends in sexually transmitted diseases and risky behaviors among HIV-infected patients at an outpatient clinic in southern Taiwan. Sex Transm Dis 2010;37(2):86-93.

UNAIDS. World AIDS Day 2015 Fact Sheet [10 Mei 2016]. Available from: http://www.unaids.org/en/resources/campaigns/HowAIDSchangedeverything/factsheet.

Statistik Kasus HIV/AIDS di Indonesia [Internet]. Ditjen PP dan PL Indonesia. 2014 [cited 26 April 2016]. Available from: http://spiritia.or.id/Stats/StatCurr.pdf.

Organization WH. Global incidence and prevalence of selected curable sexually transmitted infections 2008 Switzerland: WHO Press; [10 Mei 2016]. Available from: http://apps.who.int/iris/bitstream/10665/75181/1/9789241503839_eng.pdf.

Bhattar S, Bhalla P, Rawat D, Tripathi R, Kaur R, Sardana K. Correlation of CD4 T cell count and plasma viral load with reproductive tract infections/sexually transmitted infections in HIV infected females. J Clin Diagn Res 2014;8(10):DC12-4.

Chen Y-C, Hsiao-Ying Liu, Chung-Yi Li, Nan-Yao Lee, Chia-Wen Li, Wen-Chien Ko, et al. The rising trend of sexually transmitted infections among HIV-infected persons: a population-based cohort study in Taiwan, 2000 Through 2010. J Acquir Immune Defic Syndr 2015;68(4):432-8.

Chun HM, Carpenter RJ, Macalino GE, Crum-Cianflone NF. The role of sexually transmitted infections in HIV-1 progression: a comprehensive review of the literature. J Sex Transm Dis 2013;2013:176459.

Niode NJ, Ferbiansyah JPE. Interaksi infeksi menular seksual dan infeksi Human immunodeficiency virus. MDVI 2015;42(3):148-53.

Pao D, Fisher M, Hue S, Gillian Dean, Murphy G, Cane PA, et al. Transmission of HIV-1 during primary infection: relationship to sexual risk and sexually transmitted infections. AIDS 2005;19:85-90.

Kalichman SC, Pellowski J, Turner C. Prevalence of sexually transmitted co-infections in people living with HIV/AIDS: systematic review with implications for using HIV treatments for prevention. Sex Transm Infect 2011;87(3):183-90.

M. Osinde, O. Kakaire, D. Kaye. Sexually transmitted infections in HIV-infected patients in Kabale Hospital, Uganda. J Infect Dev Ctries 2012;6(3):276-82.

Sterling JC. Viral Infections. Griffiths CEM, Barker J, Bleiker T, Chalmers R, Creamer D, editors. Rook's Textbook of Dermatology. 9th edition. India Blackwell Publishing; 2016. p.25.43-25.63.

Meys R, Gotch FM, Bunker CB. Human papillomavirus in the era of highly active antiretroviral therapy for Human immunodeficiency virus: an immune reconstitution-associated disease? Br J Dermatol 2010;162(1):6-11.

Smith JS, Moses S, Hudgens MG, Parker CB, Agot K, Maclean I, et al. Increased risk of HIV acquisition among Kenyan men with human papillomavirus infection. J Infect Dis 2010;201(11):1677-85.

Abu-Raddad LJ, Magaret AS, Celum C, Wald A, Ira M. Longini J, Self SG, et al. Genital Herpes Has Played a More Important Role than Any Other Sexually Transmitted Infection in Driving HIV Prevalence in Africa. PLoS ONE 2008;3(5):e2230.

Jeanne S. Sheffield, George D. Wendel J, Donald D. McIntire, Norgard aMV. Effect of Genital Ulcer Disease on HIV-1 Coreceptor Expression in the Female Genital Tract. J Infect Dis 2007;196(1509-16).

Harindra V. Sexually Transmitted Infections in HIV patients. Gupta S, Kumar B, editors. Sexually Transmitted Infections. 2nd edition. India: Elsevier; 2012. p.1003-15.

Gomes Naveca F, Sabido M, Amaral Pires de Almeida T, Araujo Veras E, Contreras Mejia Mdel C, Galban E, et al. Etiology of genital ulcer disease in a sexually transmitted infection reference center in Manaus, Brazilian Amazon. PLoS One 2013;8(5):e63953.

Phiri S, Zadrozny S, Weiss HA, Martinson F, Nyirenda N, Chen CY, et al. Etiology of genital ulcer disease and association with HIV infection in Malawi. Sex Transm Dis 2013;40(12):923-8.

Atashili J, Poole C, Ndumbe PM, Adimora AA, Smith JS. Bacterial vaginosis and HIV acquisition: a meta-analysis of published studies. AIDS 2008;22(12):1493-501.

Goel V, Bhalla P, Sharma A, Mala YM. Lower genital tract infections in HIV-seropositive women in India. Indian J Sex Transm Dis 2011;32(2):103-7.

Gitau RW, Graham SM, Masese LN, Overbaugh J, Chohan V, Peshu N, et al. Effect of acquisition and treatment of cervical infections on HIV-1 shedding in women on antiretroviral therapy. AIDS 2010;24(17):2733-7.

Pedoman Nasional Tatalaksana Klinis Infeksi HIV dan Terapi Antiretroviral Pada Orang Dewasa. In: Indonesia KKR, editor. Indonesia: Direktorat Jenderal Pengendalian Penyakit dan Penyehatan Lingkungan; 2011.


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