Ditemukan 33029 dokumen yang sesuai dengan query :: Simpan CSV
The survival of HIV/AIDS patients is strongly influenced by the timing of antiretroviral therapy (ART) initiation following diagnosis. This study aimed to analyze the relationship between the ART initiation period and three-year survival among HIV/AIDS patients in Bekasi District. A retrospective cohort design was used, based on secondary data from the HIV/AIDS Information System (SIHA) of Bekasi District, involving patients diagnosed with HIV/AIDS during the 2017–2022 period. A total of 1,554 patients met the inclusion criteria. Kaplan-Meier analysis was employed to estimate survival probability, while time-dependent Cox regression analysis was used to assess the effect of ART initiation timing on the risk of death, controlling for sociodemographic, clinical, treatment-related, and behavioral variables. The results showed that the highest survival was observed among patients who initiated ART within
ABSTRAK Latar Belakang: Terapi ARV pada ODHA diharapkan dapat menurunkan angka kematian dan kesakitan serta menekan penularan HIV. Untuk mencapai tujuan MDG’s tahun 2015, diharapkan 90% ODHA sudah mendapatkan terapi ARV secara teratur. RSUD Arifin Achmad Pekanbaru telah memberikan terapi ARV sejak tahun 2004 tetapi belum pernah diteliti pengaruh ARV terhadap survival pasiennya. Metode : Penelitian ini menggunakan desain studi kohort retrospektif dengan 319 sampel dan dilakukan selama Mei-Juni 2013. Data penelitian diperoleh melalui data rekam medis RS. Data dianalisis dengan menggunakan analisis survival metode Kaplan-Meier dan dilanjutkan dengan analisis multivariate Hasil: Penelitian menunjukkan bahwa pasien yang memakan ARV secara teratur memiliki survival yang lebih baik. Pasien yang tidak memakan ARV atau memakan ARV tetapi tidak teratur, memiliki risiko kematian sebesar 42,5 kali lebih besar jika dibandingkan dengan pasien yang memakam ARV secara teratur. (p=0,01, 95%CI: 13-138). Jumlah kematian selama pengamatan hanya 5,8% pada kelompok yang teratur memakan ARV, sedangkan pada kelompok yang tidak mencapai 28%. Faktor lain yang turut meningkatkan survival adalah jumlah CD4 pada awal pengobatan >100 sel/mm³(p=0,01, HR=4,39, 95% CI(1,8-10,5). Walaupun kurang bermakna secara statistik, perlu mempertimbangkan pemberian ARV pada stadium klinis awal sebagai faktor yang turut meningkatkan survival ODHA mengingat stadium klinis dapat diperiksa di semua layanan kesehatan. (p=0,07, HR=2.3, 95%CI 0,9-5.6). Faktor pendidikan secara statistik juga bermakna membedakan survival pasien. Dalam penelitian ini stadium klinis dibuktikan sebagai confounding. Hal yang disarankan adalah meningkatkan cakupan penemuan dan tatalaksana dini kasus HIV/AIDS dengan melakukan pelacakan pada semua kasus mangkir, meningkatkan kepatuhan memakan ARV dan mengupayakan pendampingan kasus secara maksimal.
ABSTRACT Background: ARV for HIV or AIDS patients is a hope to reduce the mortality, morbidity and to prevent the transmissions. To achieve the MDG the minister of health need to cover 90% AIDS people with ARV adherently. RSUD Arifin Achmad Pekanbaru have giving the therapy for AIDS patients since 2004, but have never studied the survival analysis and another factors that contribute to yet. Method: This study is a cohort retrospective design, with 319 samples. Take place in Arifin Achmad Hospital Of Pekanbaru, Riau Province in May-June 2013. The resource are medical record of HIV/AIDS patiens in VCT clinic. Was analyse by Kaplan-Meier survival analysis and then for further use multivariate analyses. Result: The study show that the survival of patiens who take ARV adherently is higher than the other one. The patients who no used ARV adherently will have mortality rate 42,5 times than the patients that used ARV addherently. (p=0,01, 95%CI: 13-138). The deaths amount only 5,8% on the adherently ARV patients, but at another side, the deaths amount increase by 28%. Another factor that contribute to increase the survival are CD4 amounts at the beginning of therapy that >100 sel/mm³(p=0,01, HR=4,39, 95% CI(1,8-10,5). We need to consider the clinical of AIDS stadium as one of factor that contribute to increase the survival too if use ARV at the beginner of clinical stadium. (p=0,07, HR=2.3, 95%CI 0,9-5.6). The educations level has the value statistically to distinguish the survival. In this study, the clinical stadium is a confounder. We sugest to improve the early detection and prompt treatment by tracking the lost of follow up patients, increase the adherent of ARV and by mentoring or”buddy” programe for all HIV cases.
IntroductionDramatically, Anti-Retroviral drug Therapy (ART) has reduced morbidity andmortality of People Living with HIV/AIDS (PLWHA). However, adherence toantiretroviral therapy has become a challenge because this therapy must beendured for a lifetime. Adherence to antiretroviral therapy is one of the factorsthat determine the success of treatment. Poor adherence to ARV therapy inIndonesia is arround 23-55%. The objective of this study was to determine theinfluence of medication non-adherence to the 3-years survival of patients withHIV/AIDS.MethodsThis study used a retrospective cohort design at RSPI Prof. Dr. Sulianti Saroso in2010-2012.ResultsThe cumulative survival probability of patients with HIV/AIDS at RSPI Prof. dr.Sulianti Saroso in the second year (24th month) was 95.6% and the third year (inthe 36th) was 91%. Multivariate analysis with Cox regression showed the factorsthat affected the 3-years survival of patients with HIV/AIDS are non-adherence toART, after controlled by initial CD4 count (aHR = 7.608; 95% CI: 1.664 to34.790), and non-compliance appointments, after controlled by opportunisticinfection, age and initial CD4 count (aHR = 2.456; 95% CI: 0.802 to 7.518).Among patient non-adherence to ART, non-compliance appointments affected the3-years survival of patients with HIV/AIDS, after controlled by initial CD4 count,sex, CPT, modes of HIV transmission, WHO clinical stage, opportunisticinfection, and age (aHR = 4.517 ; 95%CI : 0.729-27.987).DiscussionsNonadherence to ART may caused a failure of the suppression on HIV viral, thusincrease the possibility of HIV virus mutations that can lead to drug-resistant andultimately increase the risk of death. Poor adherence to appointments of takingdrugs in the first year also assumed the poor adherence of the next assignment totake drugs in the further, and show disobedience to ART, so it will increase therisk of death.RecomendationMonitoring coverage of medication adherence of patients with HIV/AIDS in aregular basis as the early warning on the risk of death among patients withHIV/AIDS.Keyword : non-adherence to ART, appointment keeping, retrospective cohort
