Peluang Kematian Penderita Human Immunodeficiency Virus-Acquired Immune Deficiency Syndrome berdasarkan Gabungan Derajat Anemia, Indeks Massa Tubuh, dan Jumlah Cluster Differentiation 4

Sumantri, Rachmat
Supandiman, Iman
Indjradinata, Ponpon
van der Ven, Andre
van Crevel, Reinout

Majalah Kedokteran Bandung
Vol 44, No 1 (2012)

Prevalensi anemia pada infeksi human immunodeficiency virus (HIV) cukup tinggi, berkisar antara 1,3% sampai 95% bergantung pada stadium penyakitnya. Anemia, cluster differentiation 4 (CD4), dan viral load (VL) merupakan faktor risiko independen untuk kematian. Indeks massa tubuh (IMT) merupakan faktor risiko yang penting untuk anemia dan progresivitas penyakit. Dilakukan penelitian kohor untuk mengevaluasi respons pengobatan selama follow-up 6 bulan dengan endpoint kematian, serta menghitung peluang kematian penderita acquired immunodeficiency syndrome (HIV-AIDS) berdasarkan gabungan derajat anemia, IMT, dan jumlah CD4. Subjek penelitian adalah penderita HIV-AIDS di klinik Teratai Rumah Sakit Dr. Hasan Sadikin (RSHS) Bandung, periode Januari−Juni 2008, studi kohor dilakukan pada periode Juli−Desember 2008. Tercatat 534 penderita HIVAIDS yang masuk dalam data di klinik Teratai RSHS, sampai akhir penelitian terdapat 458 penderita yang masih aktif berobat, 38 penderita drop-out, 8 penderita pindah ke tempat lain, dan 28 penderita meninggal. Prevalensi anemia kelompok yang sama pada penelitian sebelumnya yaitu 41,6%. Dalam follow-up selama 6 bulan terdapat 26 kematian pada kelompok anemia dan hanya 2 kematian pada kelompok nonanemia. Gabungan antara derajat anemia sedang-berat, dengan CD4 ≤50/mm3, dan IMT <18,5 menunjukkan peluang kematian terbesar, dalam penelitian ini sebesar 80%. Simpulan, faktor risiko yang penting untuk kematian pada penderita HIV-AIDS yaitu jumlah CD4, derajat anemia, dan IMT. [MKB. 2012;44(1):50–6].Kata kunci: Anemia, CD4, indeks massa tubuhOpportunity of Death in Human Immunodeficiency Virus-Acquired Immunodeficiency Syndrome Patients by Combining Degree of Anemia, Body Mass Index, and Cluster Differentiation 4 CountThe prevalence of anemia in human immunodeficiency syndrome (HIV) infection was quite high, ranging from 1.3 to 95% depending on the stadium of HIV infection. Anemia, cluster differentiation 4 (CD4), and viral load were known as the independent risk factors for death. Body mass index (BMI) is an important risk factor for anemia and progression of the HIV infection. A cohort study had been conducted to evaluate the response of therapy, and deaths as the end point, and to calculate the opportunity of death  by combining the degree of anemia, BMI, and CD4 in HIV-AIDS patients. The subjects were patients in Teratai Clinic Dr. Hasan Sadikin General Hospital-Bandung from  January to June 2008. During 6 months of follow-up from  July−December 2008, there were 534 patients in the database of Teratai Clinic, with only 458 continuing the therapy, thirty eight  patients were dropped-out, eight patients moved to other hospital and 28 patients died. The prevalence of anemia from previous study of those 534 patients was 41.6%. After 6 months of follow-up, there were 26 deaths among anemic patients and 2 deaths in non-anemic patients. The combination of moderate-severe anemia, CD4 ≤50/mm3 and BMI <18.5 showing the highest opportunity of death in this study was 80%. In conclusion, the important risk factors of deaths in HIV-AIDS patients were CD4, grade of anemia, and BMI. [MKB. 2012;44(1):50–6].Key words: Anemia, body mass index, CD4DOI: http://dx.doi.org/10.15395/mkb.v44n1.212