ABSTRAK Latar belakang: Sejak dilaporkan pertama kali pada tahun 1981 di Amerika
Serikat, penyebaran Acquired Immune Deficiency Syndrome (AIDS) di seluruh
dunia termasuk Indonesia terjadi dengan pesat. Saluran pencernaan merupakan
target utama infeksi HIV. Enteropati terjadi pada 15-70% kasus anak. Enteropati
dapat terjadi walaupun tanpa gejala gastrointestinal. Kondisi enteropati dapat
menimbulkan perburukan gejala gastrointestinal, kegagalan pertumbuhan dan
menyebabkan pasien mengarah pada wasting. Enteropati dideteksi dengan
pemeriksaan alpha 1 antitripsin.
Tujuan: (1) Mengetahui proporsi enteropati yang terjadi pada anak dengan
AIDS stadium lanjut tanpa gejala gastrointestinal. (2) Mengetahui karakteristik
enteropati yang terjadi pada anak dengan AIDS stadium lanjut tanpa gejala
gastrointestinal. (3) Mengetahui hubungan antara enteropati dengan usia, status
gizi, status imunodefisiensi, jenis dan lama terapi ARV serta lama sakit anak
dengan AIDS stadium lanjut tanpa gejala gastrointestinal.
Metode: Penelitian potong lintang deskriptif dan analitik yang dilakukan di
Poliklinik Alergi Imunologi Departemen Ilmu Kesehatan Anak FKUI- RSCM
antara bulan Agustus sampai dengan November 2015 terhadap anak dengan
AIDS stadium lanjut berusia 0 - 18 tahun tanpa gejala gastrointestinal. Faktor
risiko dianalisis bivariat dan multivariat.
Hasil: Total subjek penelitian berjumlah 70 subjek (35 lelaki dan 35 perempuan).
Enteropati terjadi pada 31 subjek. Enteropati lebih banyak ditemukan pada anak
perempuan, usia >60 bulan, mengalami malnutrisi, tidak ada imunodefisiensi, obat
antiretroviral lini kedua dan ketiga, lama pengobatan 0-59 bulan dan lama sakit 059
bulan. Pada analisis bivariat tidak didapatkan faktor risiko yang bermakna.
Pada analisis multivariat didapatkan lama sakit 0-59 bulan dengan nilai OR 3,451
(IK95% 1,026-11,610) merupakan faktor risiko yang berperan dalam terjadinya
enteropati pada anak dengan AIDS stadium lanjut tanpa gejala gastrointestinal.
Simpulan : Proporsi enteropati pada anak dengan AIDS stadium lanjut tanpa
gejala gastrointestinal sebanyak 31 dari 70 subjek. Faktor risiko yang berperan
adalah lama sakit 0-59 bulan.
ABSTRACT Background: HIV/AIDS is a global pandemic. Digestive tract is a major target for
HIV infection. The digestive-absorptive functions are impaired, occurring in 1570%
of
children.
Enteropathy
contributes
to
gastrointestinal
manifestation,
growth
failure
and further immune derangement, leading to wasting. The diagnostic
approach includes alpha 1 antitrypsin fecal level.
Objective: (1) to describe frequency of enteropathy in advanced stages of AIDS
children without gastrointestinal manifestation, (2) to describe characteristic of
children with advanced stages of AIDS without gastrointestinal manifestation
who develop enteropathy, (3) to investigate the role of age, nutritional status,
immunodeficiency status, type and duration of antiretroviral therapy, and duration
of illness as risk for enteropathy in advanced stages of AIDS children without
gastrointestinal manifestation.
Methods: A descriptive and analytic cross-sectional study was conducted at
Pediatric Allergy-Immunology Outpatient Clinic RSCM between August to
November 2015. The inclusion criteria was advanced stages of AIDS children
age 0-18 years old without gastrointestinal manifestation. Risk factors were
analyzed with bivariate and multivariate analysis.
Results: Seventy children fulfilled the study criteria (35 males and 35 females).
Thirty-one subjects were diagnosed as enteropathy. Most subjects are female, age
>60 month-old, malnutritional status, no immunodeficiency, received second and
third line antiretroviral regimen with duration 0-59 months and duration of
illness 0-59 months. Bivariate analysis showed that no factor was significantly
associated with enteropathy. Based on multivariate analysis, duration of illness
0-59 months is a significant risk factor with OR 3.451 (CI 1.026-11.610).
Conclusions: The proportion enteropathy in advanced stages of AIDS children
without gastrointestinal manifestation is 31/70. Patients who had been diagnosed
as advanced stage of HIV/AIDS for 0-59 months are more likely to develop
enteropathy.;Background: HIV/AIDS is a global pandemic. Digestive tract is a major target for
HIV infection. The digestive-absorptive functions are impaired, occurring in 1570%
of
children.
Enteropathy
contributes
to
gastrointestinal
manifestation,
growth
failure
and further immune derangement, leading to wasting. The diagnostic
approach includes alpha 1 antitrypsin fecal level.
Objective: (1) to describe frequency of enteropathy in advanced stages of AIDS
children without gastrointestinal manifestation, (2) to describe characteristic of
children with advanced stages of AIDS without gastrointestinal manifestation
who develop enteropathy, (3) to investigate the role of age, nutritional status,
immunodeficiency status, type and duration of antiretroviral therapy, and duration
of illness as risk for enteropathy in advanced stages of AIDS children without
gastrointestinal manifestation.
Methods: A descriptive and analytic cross-sectional study was conducted at
Pediatric Allergy-Immunology Outpatient Clinic RSCM between August to
November 2015. The inclusion criteria was advanced stages of AIDS children
age 0-18 years old without gastrointestinal manifestation. Risk factors were
analyzed with bivariate and multivariate analysis.
Results: Seventy children fulfilled the study criteria (35 males and 35 females).
Thirty-one subjects were diagnosed as enteropathy. Most subjects are female, age
>60 month-old, malnutritional status, no immunodeficiency, received second and
third line antiretroviral regimen with duration 0-59 months and duration of
illness 0-59 months. Bivariate analysis showed that no factor was significantly
associated with enteropathy. Based on multivariate analysis, duration of illness
0-59 months is a significant risk factor with OR 3.451 (CI 1.026-11.610).
Conclusions: The proportion enteropathy in advanced stages of AIDS children
without gastrointestinal manifestation is 31/70. Patients who had been diagnosed
as advanced stage of HIV/AIDS for 0-59 months are more likely to develop
enteropathy.;Background: HIV/AIDS is a global pandemic. Digestive tract is a major target for
HIV infection. The digestive-absorptive functions are impaired, occurring in 1570%
of
children.
Enteropathy
contributes
to
gastrointestinal
manifestation,
growth
failure
and further immune derangement, leading to wasting. The diagnostic
approach includes alpha 1 antitrypsin fecal level.
Objective: (1) to describe frequency of enteropathy in advanced stages of AIDS
children without gastrointestinal manifestation, (2) to describe characteristic of
children with advanced stages of AIDS without gastrointestinal manifestation
who develop enteropathy, (3) to investigate the role of age, nutritional status,
immunodeficiency status, type and duration of antiretroviral therapy, and duration
of illness as risk for enteropathy in advanced stages of AIDS children without
gastrointestinal manifestation.
Methods: A descriptive and analytic cross-sectional study was conducted at
Pediatric Allergy-Immunology Outpatient Clinic RSCM between August to
November 2015. The inclusion criteria was advanced stages of AIDS children
age 0-18 years old without gastrointestinal manifestation. Risk factors were
analyzed with bivariate and multivariate analysis.
Results: Seventy children fulfilled the study criteria (35 males and 35 females).
Thirty-one subjects were diagnosed as enteropathy. Most subjects are female, age
>60 month-old, malnutritional status, no immunodeficiency, received second and
third line antiretroviral regimen with duration 0-59 months and duration of
illness 0-59 months. Bivariate analysis showed that no factor was significantly
associated with enteropathy. Based on multivariate analysis, duration of illness
0-59 months is a significant risk factor with OR 3.451 (CI 1.026-11.610).
Conclusions: The proportion enteropathy in advanced stages of AIDS children
without gastrointestinal manifestation is 31/70. Patients who had been diagnosed
as advanced stage of HIV/AIDS for 0-59 months are more likely to develop
enteropathy.
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