Abstrak: Abstrak

Laporan Kemenkes RI mengenai angka kejadian HIV & AIDS di Indonesia sampai September menyatakan 92.251 kasus HIV dan 39.434 kasus AIDS. ODHA memerlukan ARV untuk menekan replikasi virus. Paduan pengobatan dimulai dari lini pertama yang terdiri atas 2 Nucleoside Reverse Transcriptase Inhibitor (NRTI) dan 1 Non-nucleoside Reverse Transcriptase Inhibitor (NNRTI). Nevirapin adalah ARV golongan NNRTI yang paling sering digunakan karena efektif dan efisien. Evaluasi pengobatan ARV dan data mengenai substitusi ARV masih kurang. Substitusi dapat menggambarkan isu penting berkaitan dengan keberhasilan program pengobatan HIV dan efek samping obat. Desain penelitian ini kasus kontrol dengan data berasal dari rekam medis. Kasus adalah mereka yang mengalami sustitusi nevirapin. Analisis univariat, bivariat dan multivariat logistik regresi dilakukan. Didapatkan faktor-faktor dominan yang berhubungan dengan substitusi nevirapin adalah tingkat pendidikan OR=3,31(CI95%=1,27-8,63) dan kondisi awal terapi yaitu stadium klinis OR=0,37 (CI95%=0,13-1,11), kadar SGOT OR=2,15 (CI95%=0,83-5,57), kadar SGPT dengan OR=1,41 (CI95%=0,61-3,26), dan CD4 dengan OR ==1,80 (CI95%=0,56-5,83). Edukasi kepada pasien dengan tingkat pendidikan rendah mengenai manfaat dan cara minum obat perlu lebih ditekankan dan monitoring keluhan efek samping secara teratur melalui pemeriksaan fisik dan pemeriksaan laborarium secara berkala kepada seluruh penderita HIV/AIDS yang mendapat ARV disertai CD4 dan enzim hati diawal terapi yang tinggi.

Indonesian Ministry of Health reported that there are 92.251 cases HIV and 39.434 cases AIDS until September 2012. Those people need ARV to suppress viral load dan enhaced their immunity. Based on guideline therapy, starting ARV should from first line which consisted of 2 NRTI (nucleoside reverse transcriptase inhibitor) dan 1 NNRTI (non-nucleoside reverse transcriptase inhibitor). Nevirapin is a NNRTI and more prescribe because its effectiveness and efficiency. In Indonesia, there are less data about antiretroviral evaluation, especially substitution. These data are important to identify some issues such as effectiveness antiretroviral therapy and toxicity. Toxicity that induced by antiretroviral effect nonadherence. This study is using case control design which source of data is medical records. Cases are those who experienced nevirapine substitution. Univariat, bivariat and multivariate logistic regression are using to analyze these data. Result shows that significant factors associated with nevirapine substitution are education level OR=3,31(CI95%=1,27-8,63), clinical staging OR=0,37 (CI95%=0,13-1,11), SGOT level at baseline OR=2,15 (CI95%=0,83-5,57), SGPT level at baseline OR=1,41 (CI95%=0,61-3,26), and CD4 at baseline OR ==1,80 (CI95%=0,56-5,83). This result recommend to educate those who are low education with comprehensive information about antiretroviral and monitoring regularly patients who have elevated level of liver enzime on baseline therapy.

Abstrak: Peningkatan jumlah kasus COVID-19 dan penyebarannya di berbagai negara terjadi berlangsung cukup cepat dan dalam waktu singkat. Hingga 4 Mei 2021, total kasus konfirmasi COVID-19 global adalah 152.534.452 dengan 3.198.528 kematian. Pemerintah Indonesia telah melaporkan 1.682.004 orang dengan COVID-19 yang dikonfirmasi, tertinggi di Asia Tenggara. Sebanyak 45.949 kematian terkait COVID-19 yang dilaporkan, dengan CFR sebesar 2,7%. Kematian akibat COVID-19 di Indonesia berada pada peringkat ke-2 di Asia dan ke-17 di dunia. Studi kasus-kontrol dilakukan menggunakan data rekam medis pasien COVID-19 di RSUP Haji Adam Malik Medan periode Maret 2020-Desember 2020. Penelitian ini mendeskripsikan karakteristik serta mengidentifikasi faktor-faktor yang berhubungan dengan kematian pada pasien COVID-19. Hasil penelitian melalui analisis multivariat logistik regresi menunjukkan bahwa, adanya peningkatan risiko terhadap kematian pada usia ≥ 60 tahun (OR=5.495, 95% CI: 2.398-12.591), demam (OR=4.441, 95% CI: 1.401-14.077), sesak napas (OR=8.310, 95% CI: 3.415-20.220), riwayat hipertensi (OR=2.454, 95% CI: 1.159-5.196), riwayat penyakit ginjal kronik (OR=10.460 kali, 95% CI: 3.282-33.331), riwayat penyakit kanker (OR=16.137, 95% CI: 2.798-96.147) pada pasien COVID-19 yang dirawat inap di RSUP Haji Adam Malik Medan Tahun 2020

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The increase in the number of cases of COVID-19 and its spread in various countries occurred quite quickly and in a short time. As of May 4, 2021, the total global confirmed cases of COVID-19 were 152,534,452 with 3,198,528 deaths. The Indonesian government has reported 1,682,004 people with confirmed COVID-19, the highest in Southeast Asia. A total of 45,949 COVID-19-related deaths were reported, with a CFR of 2.7%. Deaths from COVID-19 in Indonesia are ranked 2nd in Asia and 17th in the world. A case-control study was conducted using medical records of COVID-19 patients at Haji Adam Malik General Hospital in Medan for the period March 2020-December 2020. This study describes the characteristics and identifies factors associated with death in COVID-19 patients. The results of the study through multivariate logistic regression analysis showed that there was an increased risk of death at age 60 years (OR = 5,495, 95% CI: 2,398-12,591), fever (OR = 4,441, 95% CI: 1,401-14,077), shortness of breath. breath (OR=8,310, 95% CI: 3,415-20,220), history of hypertension (OR=2,454, 95% CI: 1.159-5,196), history of chronic kidney disease (OR=10,460 times, 95% CI: 3.282-33,331) history of cancer (OR=16,137, 95% CI: 2,798-96,147) in COVID-19 patients who were hospitalized at Haji Adam Malik General Hospital Medan in 2020