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. |
T38679-Bryany Titi Santi.pdf :: Unduh