FAKTOR-FAKTOR YANG MEMPENGARUHI KENAIKAN JUMLAH SEL T CD4+ PADA PASIEN TERINFEKSI HIV YANG MENJALANI TERAPI ANTIRETROVIRAL
| Main Authors: | , Fara Silvia Yuliani, , dr. Yanri Wijayanti Subronto, Ph.D., Sp. PD |
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| Format: | Thesis NonPeerReviewed |
| Terbitan: |
[Yogyakarta] : Universitas Gadjah Mada
, 2014
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| Subjects: | |
| Online Access: |
https://repository.ugm.ac.id/133156/ http://etd.ugm.ac.id/index.php?mod=penelitian_detail&sub=PenelitianDetail&act=view&typ=html&buku_id=73714 |
Daftar Isi:
- The HIV epidemic in Indonesia continues to increase despite the widespread use of antiretroviral treatment (ART) nationwide. However, there is limited data assessing the impact of ART as well as host and environment factors on CD4+ T cell increase among HIV infected patients in Indonesia, particularly in Yogyakarta. CD4+ T cell counts is still used for ART response monitoring, instead of HIV-RNA viral load due to financial limitation. The aim of this study was to identify the predictors of immunologic response following ART within 12 months. A retrospective cohort study was carried out among HIV patients who started ART during 2008-2012 in Dr. Sardjito referral hospital at Yogyakarta, Indonesia. CD4+ T cell counts for each patient was observed within 12 months after starting ART. Immunologic success was defined by increasing CD4+ T cell counts â�¥ 200 cells/mm3 during 12 months after starting ART in this study. Kaplan- Meier and Cox Proportional Hazard analyses were performed to predict factors associated with time to achieve CD4+ T cell count â�¥ 200 cells/Î1⁄4l within 12 months. A total of 222 patients were included with median age of 32 years (IQR 28-40). Median CD4+ count at the time of ART initiation were 41 cells/mm3 (IQR 13-105). Eighty patients (36%) achieved a CD4+ T cell count â�¥ 200 cells/Î1⁄4l after 12 months of ART. The median time could not be estimated due to the low event of CD4+ count â�¥ 200 cells/mm3 within 12 months, however, 25% reached this outcome by 9 months. In multivariate analyses, CD4+ T cell count at baseline was the only significant independent predictor of CD4+ T cell count increase (HR: 2.78, 95% CI 1.55-4.98, p< 0.001). Higher CD4+ T count at start of ART was more likely to achieve CD4+ T cell counts â�¥ 200 cells/Î1⁄4l in the first year. More than fifty percent of patients had very low CD4+ count at baseline. Therefore, it is indispensable to develop strategies that increase HIV early testing, diagnosis and treatment to improve ART success.