HUBUNGAN PENURUNAN KADAR CD4 DENGAN POLA KEPEKAAN MYCOBACTERIUM TUBERCULOSIS TERHADAP RIFAMPISIN PADA PASIEN KO-INFEKSI TB-HIV DI RSUD DR. SOETOMO SURABAYA
Abstract
Abstrak. Latar belakang Mycobacterium tuberculosis banyak menimbulkan masalah kesehatan yang kompleks. Salah satu penyakit yang ditimbulkan adalah Tuberkulosis (TB). Obat untuk mengatasi Tuberkulosis disebut Obat Anti Tuberkulosis (OAT). Namun, sudah banyak Mycobacterium tuberculosis yang mengalami resistensi ganda terhadap obat lini pertama tersebut yang disebut MDR-TB (Multi-drug Resistant TB). Peningkatan kasus MDR-TB kemungkinan disebabkan oleh salah satu faktor risiko TB yaitu infeksi HIV (ko-infeksi TB-HIV). Sayangnya, ada tidaknya hubungan dari infeksi HIV, yang menurunkan kadar CD4, dengan pola kepekaan dari Mycobacterium tuberculosis terhadap Rifampisin di Indonesia belum diketahui secara pasti.
Tujuan: Mengetahui hubungan penurunan kadar CD4 dengan pola kepekaan Mycobacterium tuberculosis terhadap Rifampisin pada pasien ko-infeksi TB-HIV di RSUD Dr. Soetomo Surabaya
Metode Penelitian: Penelitian ini menggunakan desain penelitian analitik observasional menggunakan studi analitik dengan rancangan cross-sectional. Diperoleh 32 sampel dari rekam medis pasien ko-infeksi TB-HIV di RSUD Dr. Soetomo Surabaya periode 1 Januari - 31 Desember 2016. Data dianalisis dengan uji Chi Square menggunakan aplikasi SPSS.
Hasil Penelitian dan Pembahasan: Hasil uji Chi Square antara penurunan kadar CD4 dan pola kepekaan Mycobacterium tuberculosis terhadap RIfampisin menunjukkan tidak adanya hubungan yang signifikan (p=0,544).
Kesimpulan: Diperoleh hubungan yang tidak signifikan antara penurunan kadar CD4 (<200 sel/mm3) dengan resistensi Mycobacterium tuberculosis terhadap Rifampisin pada pasien koinfeksi TB-HIV di RSUD Dr. Soetomo Surabaya periode Januari-Desember 2016.
Kata Kunci: ko-infeksi TB-HIV, Mycobacterium tuberculosis, resisten Rifampisin, CD4.
Abstract. Background: Rifampicin-resistance Tuberculosis (TB) case rate is increasing every year, particularly in Indonesia. It is probably caused by the infection of Human Immunodeficiency Virus (HIV) on Tuberculosis patient, called TB-HIV co-infection. However, the association between HIV infection, which can cause decreasing of CD4, and Rifampicin-resistance Mycobacterium tuberculosis in TB-HIV co-infection patients is still not clearly yet.
Objective: This study was undertaken to analyze the association between CD4 decreasing and Rifampicin resistance in TB-HIV co-infection patients of Dr. Soetomo General Hospital Surabaya.
Methods: A retrospective research with cross-sectional method of TB-HIV co-infection patients’ medical record at Medical Record Center of Dr. Soetomo General Hospital Surabaya from 1 January to 31 December 2016 with 32 samples.
Result: Chi Square test shows that there is no association (p=0,544) between CD4 decreasing and Rifampicin-resistance Mycobacterium tuberculosis in TB-HIV co-infection patients of Dr. Soetomo General Hospital Surabaya.
Conclusion: There is no association between CD4 decreasing and Rifampicin-resistance Mycobacterium tuberculosis in TB-HIV co-infection patients.Keywords: TB-HIV co-infection, Mycobacterium tuberculosis, Rifampicin resistance, CD4.
Keywords
References
Daftar Pustaka
WHO Indonesia. Indonesia TB Situation Update. 2014. 28 Mei 2016
U.S. Department of Health & Human Services (HHS). Tuberculosis (TB). 2016. 26 Juni 2016.
Wells, C. et al. HIV Infection and Multidrug‐Resistant Tuberculosis—The Perfect Storm. The Journal of Infectious Diseases. 2007. 196(s1), pp. S86-S107.
Damtie D et al. Common opportunistic infections and their CD4 cell correlates among HIV-infected patients attending at antiretroviral therapy clinic of Gondar University Hospital, Northwest Ethiopia. BMC Research Notes. 2013. 6. 534. 12.
Handel, A et al. Exploring the role of the immune response in preventing antibiotic resistance. Journal of Theoritical Biology 256. 2009. 655–662.
Rinanda, T. Kajian Molekuler Mekanisme Reistensi Mycobacterium tuberculosis. Jurnal Kedokteran Syiah Kuala. 2015. Vol. 15. No. 3. p. 162-167.
Eldholm, V et al. Impact of HIV co-infection on the evolution and transmission of multidrug-resistant tuberculosis. Jit M, ed. eLife. 2016;5:e16644.
McGrath, M et al. Mutation rate and the emergence of drug resistance in mycobacterium tuberculosis. Journal of Antimicrobial Chemotherapy. 2014;69:292–302.
Lawn, SD et al. Screening for HIV-Associated Tuberculosis and Rifampicin Resistance before Antiretroviral Therapy Using the Xpert MTB/RIF Assay: A Prospective Study. PLoS Med8(7). 2011: e1001067.
Nasarudin, J et al. Prevalensi Kejadian Resistensi Rifampisin pada Pasien TB-HIV dan Faktor-Faktor yang Mempengaruhi. Indonesian Journal of CHEST Critical and Emergency Medicine. 2016. Vol. 3, No. 1 Jan - Mar 2016
DOI: 10.24815/jks.v19i1.18044
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