ABSTRAK
Latar belakang: Sejak dilaporkan pertama kali pada tahun 1981 di AmerikaSerikat, penyebaran Acquired Immune Deficiency Syndrome (AIDS) di seluruhdunia termasuk Indonesia terjadi dengan pesat. Saluran pencernaan merupakantarget utama infeksi HIV. Enteropati terjadi pada 15-70% kasus anak. Enteropatidapat terjadi walaupun tanpa gejala gastrointestinal. Kondisi enteropati dapatmenimbulkan perburukan gejala gastrointestinal, kegagalan pertumbuhan danmenyebabkan pasien mengarah pada wasting. Enteropati dideteksi denganpemeriksaan alpha 1 antitripsin.Tujuan: (1) Mengetahui proporsi enteropati yang terjadi pada anak denganAIDS stadium lanjut tanpa gejala gastrointestinal. (2) Mengetahui karakteristikenteropati yang terjadi pada anak dengan AIDS stadium lanjut tanpa gejalagastrointestinal. (3) Mengetahui hubungan antara enteropati dengan usia, statusgizi, status imunodefisiensi, jenis dan lama terapi ARV serta lama sakit anakdengan AIDS stadium lanjut tanpa gejala gastrointestinal. Metode: Penelitian potong lintang deskriptif dan analitik yang dilakukan diPoliklinik Alergi Imunologi Departemen Ilmu Kesehatan Anak FKUI- RSCMantara bulan Agustus sampai dengan November 2015 terhadap anak denganAIDS stadium lanjut berusia 0 - 18 tahun tanpa gejala gastrointestinal. Faktorrisiko 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 anakperempuan, usia >60 bulan, mengalami malnutrisi, tidak ada imunodefisiensi, obatantiretroviral lini kedua dan ketiga, lama pengobatan 0-59 bulan dan lama sakit 059bulan. 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 terjadinyaenteropati pada anak dengan AIDS stadium lanjut tanpa gejala gastrointestinal. Simpulan : Proporsi enteropati pada anak dengan AIDS stadium lanjut tanpagejala gastrointestinal sebanyak 31 dari 70 subjek. Faktor risiko yang berperanadalah lama sakit 0-59 bulan. ABSTRACT
Background: HIV/AIDS is a global pandemic. Digestive tract is a major target forHIV infection. The digestive-absorptive functions are impaired, occurring in 1570%ofchildren.Enteropathycontributestogastrointestinalmanifestation,growthfailureand further immune derangement, leading to wasting. The diagnosticapproach includes alpha 1 antitrypsin fecal level. Objective: (1) to describe frequency of enteropathy in advanced stages of AIDSchildren without gastrointestinal manifestation, (2) to describe characteristic ofchildren with advanced stages of AIDS without gastrointestinal manifestationwho develop enteropathy, (3) to investigate the role of age, nutritional status,immunodeficiency status, type and duration of antiretroviral therapy, and durationof illness as risk for enteropathy in advanced stages of AIDS children withoutgastrointestinal manifestation. Methods: A descriptive and analytic cross-sectional study was conducted at Pediatric Allergy-Immunology Outpatient Clinic RSCM between August toNovember 2015. The inclusion criteria was advanced stages of AIDS childrenage 0-18 years old without gastrointestinal manifestation. Risk factors wereanalyzed 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 andthird line antiretroviral regimen with duration 0-59 months and duration ofillness 0-59 months. Bivariate analysis showed that no factor was significantly associated with enteropathy. Based on multivariate analysis, duration of illness0-59 months is a significant risk factor with OR 3.451 (CI 1.026-11.610). Conclusions: The proportion enteropathy in advanced stages of AIDS childrenwithout gastrointestinal manifestation is 31/70. Patients who had been diagnosedas advanced stage of HIV/AIDS for 0-59 months are more likely to developenteropathy.;Background: HIV/AIDS is a global pandemic. Digestive tract is a major target forHIV infection. The digestive-absorptive functions are impaired, occurring in 1570%ofchildren.Enteropathycontributestogastrointestinalmanifestation,growthfailureand further immune derangement, leading to wasting. The diagnosticapproach includes alpha 1 antitrypsin fecal level. Objective: (1) to describe frequency of enteropathy in advanced stages of AIDSchildren without gastrointestinal manifestation, (2) to describe characteristic ofchildren with advanced stages of AIDS without gastrointestinal manifestationwho develop enteropathy, (3) to investigate the role of age, nutritional status,immunodeficiency status, type and duration of antiretroviral therapy, and durationof illness as risk for enteropathy in advanced stages of AIDS children withoutgastrointestinal manifestation. Methods: A descriptive and analytic cross-sectional study was conducted at Pediatric Allergy-Immunology Outpatient Clinic RSCM between August toNovember 2015. The inclusion criteria was advanced stages of AIDS childrenage 0-18 years old without gastrointestinal manifestation. Risk factors wereanalyzed 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 andthird line antiretroviral regimen with duration 0-59 months and duration ofillness 0-59 months. Bivariate analysis showed that no factor was significantly associated with enteropathy. Based on multivariate analysis, duration of illness0-59 months is a significant risk factor with OR 3.451 (CI 1.026-11.610). Conclusions: The proportion enteropathy in advanced stages of AIDS childrenwithout gastrointestinal manifestation is 31/70. Patients who had been diagnosedas advanced stage of HIV/AIDS for 0-59 months are more likely to developenteropathy.;Background: HIV/AIDS is a global pandemic. Digestive tract is a major target forHIV infection. The digestive-absorptive functions are impaired, occurring in 1570%ofchildren.Enteropathycontributestogastrointestinalmanifestation,growthfailureand further immune derangement, leading to wasting. The diagnosticapproach includes alpha 1 antitrypsin fecal level. Objective: (1) to describe frequency of enteropathy in advanced stages of AIDSchildren without gastrointestinal manifestation, (2) to describe characteristic ofchildren with advanced stages of AIDS without gastrointestinal manifestationwho develop enteropathy, (3) to investigate the role of age, nutritional status,immunodeficiency status, type and duration of antiretroviral therapy, and durationof illness as risk for enteropathy in advanced stages of AIDS children withoutgastrointestinal manifestation. Methods: A descriptive and analytic cross-sectional study was conducted at Pediatric Allergy-Immunology Outpatient Clinic RSCM between August toNovember 2015. The inclusion criteria was advanced stages of AIDS childrenage 0-18 years old without gastrointestinal manifestation. Risk factors wereanalyzed 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 andthird line antiretroviral regimen with duration 0-59 months and duration ofillness 0-59 months. Bivariate analysis showed that no factor was significantly associated with enteropathy. Based on multivariate analysis, duration of illness0-59 months is a significant risk factor with OR 3.451 (CI 1.026-11.610). Conclusions: The proportion enteropathy in advanced stages of AIDS childrenwithout gastrointestinal manifestation is 31/70. Patients who had been diagnosedas advanced stage of HIV/AIDS for 0-59 months are more likely to developenteropathy. |
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