ABSTRAK
Latar Belakang: Hingga saat ini belum ada panduan mengenai paduan terapiantiretroviral (antiretroviral therapy/ART) terpilih pada pasien HIV dewasadengan riwayat interupsi tidak terencana. Kondisi pasien pada saat reintroduksiART perlu dievaluasi sebagai dasar pemilihan paduan ART Tujuan: Mengetahui proporsi keberhasilan virologis pada reintroduksi ART linipertama pasca interupsi tidak terencana. Mengetahui hubungan antara berbagaifaktor klinis dan laboratoris dengan keberhasilan virologis pada reintroduksi tersebut. Metode: Penelitian kohort retrospektif dilakukan pada pasien HIV yangmendapatkan reintroduksi ART lini pertama pasca interupsi tidak terencanaselama minimal 1 bulan. Data didapatkan dari rekam medis RS dr. CiptoMangunkusumo di Jakarta. Viral load (VL) dinilai 6-18 bulan setelah reintroduksiART lini pertama, dinyatakan berhasil bila VL <400 kopi/ml. Dilakukan analisisterhadap faktor yang berhubungan dengan keberhasilan virologis tersebut.Hasil: Selama periode Januari 2005 s.d. Desember 2014 terdapat 100 subjek yangmendapatkan reintroduksi ART lini pertama dan memiliki data viral load 6-18bulan pasca reintroduksi. Pasca reintroduksi ART didapatkan keberhasilanvirologis pada 55 (55%) subjek. Pada analisis didapatkan dua faktor yangberhubungan dengan keberhasilan virologis pada reintroduksi ART lini pertama,yaitu frekuensi interupsi satu kali (adjusted OR/aOR 5,51; IK95% 1,82-16,68;p=0,003), nilai CD4 saat reintroduksi ≥200 sel/mmxi 3 (aOR 4,33; IK95% 1,1416,39,p=0,031).Simpulan:Proporsi keberhasilan virologis pada reintroduksi ART lini pertamapasca interupsi tidak terencana adalah 55%. Pasien dengan frekuensi interupsi 1kali dan pasien dengan nilai CD4 saat reintroduksi ≥200 sel/mm3 memiliki kecenderungan untuk mencapai keberhasilan virologis pada reintroduksi ART.ABSTRACT
There is no guideline concerning antiretroviral therapy (ART) ofchoice for adult HIV patients after unplanned interruption. Hence, patients?conditions at time of ART reintroduction need to be evaluated as a basis forselecting ART regiment. Objectives: To know the proportion of virological success of first line ARTreintroduction after unplanned interruption. To know the association betweeneither clinical or laboratory factors and virological success in reintroduction. Methods: We conducted a retrospective cohort study in HIV patients that werereintroduced to first line ART after having unplanned interruption for at least onemonth period. The data were collected from medical records of Dr. CiptoMangunkusumo Hospital in Jakarta. Viral load (VL) was evaluated at 6-18months after first line ART reintroduction, declared as a success if VL <400copies/mL. Analysis was done to factors associated with such virological success.Results: Between January 2005 and December 2014, 100 subjects werereintroduced to first line ART and having VL data in 6 to 18 months after thereintroduction. Virological success was achieved in 55 (55%) subjects. In theanalysis we found that virological success was associated with interrupted once(adjusted OR/aOR 5.51%, 95%CI 1.82-16.68, p=0.003) and CD4 ≥200 cell/mmxii Universitas Indonesia 3at the time of reintroduction (aOR 4.33, 95%CI 1.14-16.39, p=0.031).Conclusions: Proportion of virological success on first line ART reintroductionafter unplanned interruption was 55%. Patients who were having interrupted onceand patients with CD4 ≥200 cell/mm3 at the time of reintroduction would havehigher odds of virological success on first line ART reintroduction.;Background: There is no guideline concerning antiretroviral therapy (ART) ofchoice for adult HIV patients after unplanned interruption. Hence, patients?conditions at time of ART reintroduction need to be evaluated as a basis forselecting ART regiment. Objectives: To know the proportion of virological success of first line ARTreintroduction after unplanned interruption. To know the association betweeneither clinical or laboratory factors and virological success in reintroduction. Methods: We conducted a retrospective cohort study in HIV patients that werereintroduced to first line ART after having unplanned interruption for at least onemonth period. The data were collected from medical records of Dr. CiptoMangunkusumo Hospital in Jakarta. Viral load (VL) was evaluated at 6-18months after first line ART reintroduction, declared as a success if VL <400copies/mL. Analysis was done to factors associated with such virological success.Results: Between January 2005 and December 2014, 100 subjects werereintroduced to first line ART and having VL data in 6 to 18 months after thereintroduction. Virological success was achieved in 55 (55%) subjects. In theanalysis we found that virological success was associated with interrupted once(adjusted OR/aOR 5.51%, 95%CI 1.82-16.68, p=0.003) and CD4 ≥200 cell/mmxii Universitas Indonesia 3at the time of reintroduction (aOR 4.33, 95%CI 1.14-16.39, p=0.031).Conclusions: Proportion of virological success on first line ART reintroductionafter unplanned interruption was 55%. Patients who were having interrupted onceand patients with CD4 ≥200 cell/mm3 at the time of reintroduction would havehigher odds of virological success on first line ART reintroduction.;Background: There is no guideline concerning antiretroviral therapy (ART) ofchoice for adult HIV patients after unplanned interruption. Hence, patients?conditions at time of ART reintroduction need to be evaluated as a basis forselecting ART regiment. Objectives: To know the proportion of virological success of first line ARTreintroduction after unplanned interruption. To know the association betweeneither clinical or laboratory factors and virological success in reintroduction. Methods: We conducted a retrospective cohort study in HIV patients that werereintroduced to first line ART after having unplanned interruption for at least onemonth period. The data were collected from medical records of Dr. CiptoMangunkusumo Hospital in Jakarta. Viral load (VL) was evaluated at 6-18months after first line ART reintroduction, declared as a success if VL <400copies/mL. Analysis was done to factors associated with such virological success.Results: Between January 2005 and December 2014, 100 subjects werereintroduced to first line ART and having VL data in 6 to 18 months after thereintroduction. Virological success was achieved in 55 (55%) subjects. In theanalysis we found that virological success was associated with interrupted once(adjusted OR/aOR 5.51%, 95%CI 1.82-16.68, p=0.003) and CD4 ≥200 cell/mmxii Universitas Indonesia 3at the time of reintroduction (aOR 4.33, 95%CI 1.14-16.39, p=0.031).Conclusions: Proportion of virological success on first line ART reintroductionafter unplanned interruption was 55%. Patients who were having interrupted onceand patients with CD4 ≥200 cell/mm3 at the time of reintroduction would havehigher odds of virological success on first line ART reintroduction.;Background: There is no guideline concerning antiretroviral therapy (ART) ofchoice for adult HIV patients after unplanned interruption. Hence, patients?conditions at time of ART reintroduction need to be evaluated as a basis forselecting ART regiment. Objectives: To know the proportion of virological success of first line ARTreintroduction after unplanned interruption. To know the association betweeneither clinical or laboratory factors and virological success in reintroduction. Methods: We conducted a retrospective cohort study in HIV patients that werereintroduced to first line ART after having unplanned interruption for at least onemonth period. The data were collected from medical records of Dr. CiptoMangunkusumo Hospital in Jakarta. Viral load (VL) was evaluated at 6-18months after first line ART reintroduction, declared as a success if VL <400copies/mL. Analysis was done to factors associated with such virological success.Results: Between January 2005 and December 2014, 100 subjects werereintroduced to first line ART and having VL data in 6 to 18 months after thereintroduction. Virological success was achieved in 55 (55%) subjects. In theanalysis we found that virological success was associated with interrupted once(adjusted OR/aOR 5.51%, 95%CI 1.82-16.68, p=0.003) and CD4 ≥200 cell/mmxii Universitas Indonesia 3at the time of reintroduction (aOR 4.33, 95%CI 1.14-16.39, p=0.031).Conclusions: Proportion of virological success on first line ART reintroductionafter unplanned interruption was 55%. Patients who were having interrupted onceand patients with CD4 ≥200 cell/mm3 at the time of reintroduction would havehigher odds of virological success on first line ART reintroduction. |
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