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ABSTRAK Retensi ARV Pada Pasien HIV Berdasarkan CD4 Awal Terapi ARV di RSPI Prof. Dr. Sulianti Saroso Jakarta Dari Tahun 2011 – 2014 Musa Rapang Perbedaan tingkatan imunodefesiensi memberikan kondisi klinis yang berbeda. Dampak perbedaan imunodefesiensi akan diperoleh retensi ARV yang berbeda pada tingkat imunodefesiensi berat dan sedang. Pasien dengan sistem imun yang baik (CD4 tinggi) kemungkinan akan memiliki retensi yang rendah. Tujuan penelitian ini adalah untuk melihat apakah perbedaan retensi ARV pada pasien HIV AIDS berdasarkan CD4 saat terapi ARV di RSPI Sulianti Saroso Jakarta. Penelitian ini menggunakan desain kohort retrospektif menggunakan 223 sampel yang diambil dari data rekam medik rumah sakit dari tahun 2011 – 2014 dengan waktu pengamatan selama satu tahun. Pasien yang retensi ada 70.85% dengan insident rate lost to follow up 2.9 per 100 orang bulan. Retensi ARV pada pasien dengan CD4 200-350 sel/mm lebih baik dengan HRadj lost to follow up sebesar 0.27 (CI 95% : 0.1 – 0.8) kali lebih rendah dibandingkan pasien dengan CD4 <200 sel/mm 3 . Selain itu pasien memiliki CD4 200350 sel/mm 3 pada stadium awal memiliki risiko lost to follow up yang lebih tinggi dengan HRadj 1.10 (CI 95% : 0.5 – 2.4) kali lebih tinggi dibandingkan dengan pasien yang memiliki CD4 < 200 sel/mm 3 pada stadium awal. Perlu dilakukan monitoring klinis, eduksi dan dukungan kepada pasien tentang manfaat ARV khususnya pada pasien dengan CD4 <200 sel/mm 3 . Kata kunci : Retensi ARV, CD4 Awal, lost to follow up
ABSTRACT ARV Retention HIV Patients Based On Early CD4 Therapy In Hospital Infection Disease of Prof. Dr. Sulianti Saroso Jakarta From Years 2011 - 2014 Musa Rapang The difference in the level of imunodefesiensi provide different clinical conditions. The impact will be acquired at different ARV retention rate of severe and moderate imunodefesiensi. HIV Patients with a good immune system (CD4 high) possibility have poor retention on antiretroviral drugs, so that the patient will tend to experience a lost to follow up. The purpose of this study was to see whether the difference in retention of antiretroviral drugs in HIV-AIDS patients by CD4 time ARV therapy in hospital Prof. Dr. Sulianti Saroso Jakarta. This research using retrospective cohort design using 223 samples taken from hospital medical records from the years 20112014 with the observation time for one year. The number of patients there was 70.85% retention with number incidents of lost to follow-up rate of 2.9 per 100 person-months. Retention ARV based on baseline CD4 200-350 cells / mm better with HRadj of lost to follow-up at 0.27 (CI 95% :0.1 – 0.8) times slower compared to patients with CD4 <200 cells / mm 3 in the early stages having lost to follow-up speed faster with HRadj 1.10 (CI 95% :0.5 – 2.4) times faster compared with patients with CD4 <200 cells/mm 3 . In addition patients had CD4 200-350 cells / mm 3 early stage. Needed to monitoring, education and supporting to patient for benfit to use ARV especially to patient with CD4 <200 cells/mm 3 . Keywords: Retention ARV, CD4 Earlier, Lost to follow up
Metode : Penelitian ini menggunakan metode penelitian kuantitatif dankualitatif. Penelitian kuantitatif menggunakan desain cross-sectional dengansampel 13 penderita TB. Sedangkan, penelitian kualitatif menggunakan wawancaramendalam.
Hasil : Hasil penelitian menemukan faktor pendukung pasien TB Paruputus berobat untuk memulai kembali pengobatannya adalah pengetahuan, sikappengobatan, jarak ke Puskesmas, kunjungan petugas TB, pendorong pengobatankembali, kebutuhan pengobatan, dukungan keluarga dan petugas TB Puskesmas.Sedangkan faktor penghambat pasien TB putus berobat adalah efek samping OATdan upaya pencarian pengobatan lain.
Kesimpulan : Pengobatan TB merupakansalah satu upaya paling efisien untuk mencegah penyebaran kuman TB. Maka, perludilakukan kerja sama lintas program terkait untuk mengoptimalkan pengobatan TBsekaligus mengatasi masalah pasien TB putus berobat di wilayah Kota Serang.
Kata kunci: Tuberkulosis, Putus Berobat, Faktor Pendukung, FaktorPenghambat, Pengobatan Kembali.
Background : Tuberculosis (TB) is a major global health problem, the first causeof two deaths of infectious diseases in worldwide. Some patients discontinuedtreatment before cured resulting the disease became severe, transmit diseases andeven death. Utilization of health services also have a role in the cases of TB, this isdue to prevent lost to follow-up cases. As many as 50% TB patients withouttreatment will die. One of death risk factor of TB are inadequate treatment. The aimof this study is to find out the supported and inhibited factors of lost to follow-upadult TB patients at Serang City in 2016.
Method : This study used quantitativeand qualitative research methods. In quantitative research, conducted by usingcross-sectional design with 13 patients TB as sample. Meanwhile, a qualitativestudy using in-depth interviews.
Result : The study found the factors supported lostto follow-up TB patients for restarting the treatment were knowledge, attitudes oftreatment, distance to reach public health center, health officers home visit,retreatment stimulus, needs of treatment, then the support of family and healthcenter officers. While the factors inhibited lost to follow-up patient to get theretreatment were the side effects of treatment and the search for another treatment.
Conclusion : TB Treatment is one of the most efficient efforts to prevent the furtherspread of Tuberculosis. Therefore, that is necessary to cooperate with variousprograms related to optimizing the treatment of TB as well as to overcome theproblem of lost to follow-up TB patients in the city of Serang.
Keywords: Tuberculosis, Lost to Follow-Up, Supported Factors, InhibitedFactors, Retreatment.