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All Journal journal of internal medicine Majalah Kedokteran Bandung
Rudi Wicaksana
Departemen Ilmu Penyakit Dalam Fakultas Kedokteran Unpad/Rumah Sakit Dr. Hasan Sadikin, Bandung
Medicine & Pharmacology

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ANEMIA PADA PENDERITA HIV-AIDS DI POLIKLINIK TERATAI RS HASAN SADIKIN- BANDUNG Sumantri, Rachmat; Wicaksana, Rudi; Ariantan, Agnes R; Supandiman, Iman; Idjradinata, Ponpon; Creven, Reinout van-; der Ven, Andre van
journal of internal medicine Vol. 10, No. 3 September 2009
Publisher : journal of internal medicine

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Abstract

The prevalence of anemia in HIV-infection ranging between 1.3 ? 95% depend on the stadium of infection. Anemiamakes bad impact on morbidity and mortality, and anemia is an independent risk factor for death in HIV-infected patients. Across-sectional study has been done in Teratai Clinic Hasan Sadikin Hospital to evaluate the prevalence and the etiology ofanemia between 1 January to 30 June 2008. Inclusion criteria were all patients who signed the informed consent. There were534 patients, 222 were anemic, prevalence of anemia was 41.6% (95% CI: 37.4 ? 45.8%), men 167 (72.2%). 188 were mildanemia (Hb 10 ?12/14 g/dl), 26 moderate anemia (Hb 8 ? 10 g/dl), and severe anemia in 6 patients (Hb < 8 g/dl). Anemia ofchronic disease or anemia of in! ammation were found in 142 (64.5%) cases, zidovudine related anemia 32 (14.5%) cases, ironde" ciency 14 (6.4%), hemolytic anemia 15 (6.8%) cases, thallassemia 8 (3.6%) cases, and megaloblasic 9 (4.1%) cases. All ofanemic patients showed low (< 2) reticulocyt index, high ferritin, low sTfR, and high hs-CRP.
HUBUNGAN ANTARA INDEKS MASSA TUBUH DENGAN JUMLAH CD4 PADA PENDERITA HIV YANG MENDAPAT PENGOBATAN ARV Miftahrachman, -; Wicaksana, Rudi
Majalah Kedokteran Bandung Vol 47, No 4 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Efek merugikan obesitas pada populasi umum dalam hubungannya dengan mortalitas dan morbiditas untuk terjadi penyakit kardiovaskular telah diketahui dengan baik, namun pada penderita HIV hubungan berat badan dengan morbiditas dan mortalitas penyakit tersebut masih perlu dikaji lebih lanjut. Penelitian ini bertujuan mencari hubungan antara IMT dan CD4. Uji potong lintang dengan pendekatan deskriptif analitik dari data sekunder rekam medik penderita HIV yang berobat ke poliklinik Teratai RSUP Dr. Hasan Sadikin Bandung pada tahun 2007?2011. Variabel yang diteliti adalah IMT dan jumlah CD4 (p=0,0001) dengan uji korelasi Spearman dan uji Kruskal Wallis. Dari 936 penderita HIV rata-rata IMT 19,4 dan jumlah CD4 rata-rata 151 sel/mm3 . Terdapat hubungan positif antara IMT dengan nilai CD4, dengan kekuatan hubungan kategori sedang (r=0,409). Dengan mengkategorikan IMT, didapatkan perbedaan rata-rata CD4 antara keempat kategori IMT tersebut (p=0,0001), nilai CD4 rata-rata dan rentangnya dari yang terendah sampai yang tertinggi berturut-turut: underweight: 75 (1?1.329), normoweight: 229 (4?1.047), overweight: 259 (2?1.275), obese: 447 (71?654). Peningkatan IMT berhubungan dengan peningkatan jumlah CD4, menggambarkan penurunan morbiditas, mortalitas serta risiko progresivitas HIV. [MKB. 2015;47(4):237?41] Kata kunci: CD4, HIV, indeks massa tubuh (IMT)Correlation between Body Mass Index and CD4 Level in HIV Patients with Antiretroviral TherapyThe adverse consequence of overweight and obese condition in major population related to it?s mortality and morbidity of specific diseases like coronary heart disease has been well known. However, in immunocompromised patients, in the context of body weight with it?s morbidity and mortality needs further examination. The objective of this research was to find out the relationship between BMI and CD4 level, which describes disease progressivity from HIV patients whom already had antiretroviral (ARV) therapy. We conducted cross sectional method with descriptive analytic from secondary data of medical records from HIV patients who came to Teratai Polyclinic of Hasan Sadikin General Hospital Bandung from 2007 to 2011. From 936 HIV patients analyzed, median BMI was 19,4 with range between 12.1?36.2 kg/m2, median CD4 was 151 cells/mm3 with range between 1?1,329. The r value was 0.409, suggested positive correlation significance between BMI and CD4 value, CD4 value increased parallel with the increasing of BMI, with intermediate p value (p=0.0001). Since we categorized BMI, the median of CD4 between all categories (p=0.0001), range from the smallest to the highest was underweight:75 (1?1,329), normoweight: 229 (4?1,047), overweight: 259 (2?1,275), obese: 447 (71?654) cells/mm3, respectively. As conclusion, increasing of BMI related to enhancement of CD4 level, suggests reduction of HIV morbidity and mortality. [MKB. 2015;47(4):237?41]Key words: Body mass index (BMI), CD4, HIV DOI: 10.15395/mkb.v47n4.623
Prevalensi dan Faktor Risiko Anemia pada HIV-AIDS Sumantri, Rachmat; Wicaksana, Rudi; R. Ariantana, Agnes
Majalah Kedokteran Bandung Vol 41, No 4
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Anemia berperan dalam morbiditas dan mortalitas penderita HIV-AIDS. Penelitian mengenai anemia pada infeksiHIV di Indonesia belum banyak. Studi potong lintang dilakukan untuk mengetahui prevalensi dan faktor risikoanemia pada penderita HIV-AIDS di Poliklinik Teratai RS. Hasan Sadikin dari 1 Januari-30 Juni 2008. Hasilpenelitian: terdapat 534 penderita HIV-AIDS, anemia 222 penderita, prevalensinya 41,6%. Anemia ringan (Hb 10-14 g/dL laki-laki, 10-12 g/dL wanita) didapatkan pada 188 penderita (35%); anemia sedang (Hb 8-10 g/dL) pada 28penderita (5,2%), dan anemia berat (Hb &lt; 8 g/dL) terdapat pada 6 penderita (1,1%). Faktor risiko yaitu jenis kelamin,umur, indeks massa tubuh (BMI), intravenous drug user (IDU), stadium klinis WHO, kandidiasis oral, peradangankronik, pemberian kotrimoksazol, pemberian ARV, tuberkulosis, CD4, dan viral load. Uji statistik menunjukkanbahwa faktor risiko anemia yang penting adalah BMI antara 18,5-22,9 dengan OR 0,368 (95% CI 0,216-0,627).Kandidiasis oral dengan OR 1,793 (95% CI 0.99-3,248), pemberian ARV dengan OR 0,905 (95% CI 0,555-1,474),dan CD4 antara 1-50 dengan OR 8,66 (95% CI 4,407-13,522). Peluang kejadian terbesar untuk kejadian anemiaadalah kombinasi BMI yang rendah (&lt; 18,5) baik mendapat ARV ataupun tidak mendapat ARV dengan kandidiasisoral dan CD4 antara 1-50/mm3. Penelitian ini menunjukkan prevalensi anemia yang cukup tinggi (41,6%) dan faktorrisiko yang penting untuk kejadian anemia adalah BMI yang rendah, kandidiasis oral, ARV dan CD4 yang rendah. [MKB 2009;41(4):187-93].Kata kunci: HIV-AIDS, anemia, faktor risikoPrevalence and Risk Factors of Anemia in HIV-AIDSAnemia has an important role in morbidity and mortality among HIV-AIDS patients. The study of anemia amongHIV-AIDS patients in Indonesia was not much done. A cross-sectional study has been done in Teratai Clinic HasanSadikin Hospital Bandung to evaluate the prevalence and risk factors of anemia in HIV-AIDS patients between 1January to 30 June 2008. There were 534 HIV-AIDS patients, anemia occured in 222 patients, the prevalence was41.6%. Mild anemia or Hb level 10-14 g/dL in man or 10-12 g/dL in woman was found in 188 (35%), moderateanemia or Hb 8-10 g/dL in 28 (5,2%) and severe anemia or Hb less than 8 g/dL in 6 (1,1%) patients. Risk factors weregender, age, BMI, IDU, WHO staging, oral candidiasis, chronic inflammation, ARV, tuberculosis, CD4, and viralload. Statistical analysis showed that the important risk factors were BMI between 18.5-22.9 OR 0.368 (95% CI0.216-0.627), oral candidiasis OR 1.793 (95% CI 0.99-3.248), use of ARV OR 0.905 (95% CI 0.555-1.474), andCD4 1-50 OR 8.66 (95% CI 4.407-13.522). The chance of anemia was great in combination of BMI ≤ 18.5 with CD4≤ 50 , oral candidiasis with or without ARV. This study showed that the prevalence of anemia in HIV-AIDS patients isprominent and the important risk factors for anemia are BMI, oral candidiasis, ARV and CD4.[MKB. 2009;41(4):187-93]Key words: HIV-AIDS, anemia, risk factorsDOI: http://dx.doi.org/10.15395/mkb.v41n4.252
Co-Authors - Miftahrachman, - Agnes R Ariantan Andre van der Ven Iman Supandiman Ponpon Idjradinata R. Ariantana, Agnes Rachmat Sumantri Reinout van- Creven