ABSTRAK
Latar Belakang: Pada ODHA didapatkan peningkatan inflamasi dan stresoksidatif. Puasa Ramadan dapat memperbaiki inflamasi dan stres oksidatif, namunpenelitian pada ODHA yang mendapat antiretroviral belum pernah dilakukan.Tujuan: Mengetahui pengaruh puasa Ramadan terhadap high sensitivity Creactiveprotein (hs-CRP) dan status antioksidan total (SAT) pada ODHA yangmengonsumsi antiretroviral.Metode: Penelitian ini merupakan penelitian prospektif pada 29 orang ODHAdengan ARV yang berpuasa dan 29 yang tidak berpuasa. Kriteria inklusi yaitupria, 20-40 tahun, mendapat ARV lini 1 minimal 6 bulan, serta tidak dalam faseinisiasi pengobatan untuk infeksi oportunistik. Pasien yang mendapat steroid atauimunosupresan lain atau pasien dengan adherens minum ARV kurang dari 95%dieksklusi. Pemeriksaan kadar hs-CRP dan SAT dilakukan sebelum dan saatpuasa Ramadan (setelah 14 hari puasa).Hasil: Karakteristik baseline usia, hitung CD4, HIV-RNA, kombinasi ARV,status hepatitis B dan C, serta kadar hs-CRP tidak berbeda antara kelompokberpuasa dengan kontrol. Setelah dua minggu, terdapat penurunan signifikan hs-CRP pada kelompok yang berpuasa dibandingkan kontrol (p=0,004). Medianperubahan hs-CRP pada kelompok puasa adalah -0,41 (IQR -1; 0,1) mg/L,sedangkan pada kelompok kontrol adalah 0,2 (IQR -0,3; 1,5) mg/L. Konsumsipolyunsaturated fatty acid, berat badan, jumlah rokok, dan jumlah jam tidur perhari menurun selama puasa Ramadan (berturut-turut p=0,029; p<0,001; p<0,001;dan p<0,001). Tidak ditemukan perbedaan bermakna perubahan SAT antarakelompok yang berpuasa dengan kontrol (p=0,405). Median perubahan SAT padakelompok puasa adalah 0,05 (IQR -0,03; 0,12) mmol/L, sedangkan padakelompok kontrol adalah 0,04 (IQR -0,13; 0,36) mmol/L.Simpulan: Puasa Ramadan menurunkan kadar hs-CRP pada ODHA yangmengosumsi antiretroviral. Puasa Ramadan belum meningkatkan kadar SAT padaODHA yang mengonsumsi antiretroviral.
ABSTRACT
Background: Inflamation and oxidative stress were increased among HIVpatients. Studies had showed Ramadan fasting could improve inflammation andoxidative stress, but not one of them had been conducted in HIV patients receivingantiretroviral therapy.Aim: to know the effect of Ramadan fasting on hs-CRP level and total antioxidantstatus among HIV patients on highly active antiretroviral therapy.Methods: A prospective cohort study comparing 29 HIV-infected patients onstable ART doing Ramadan fasting versus 29 non-fasting patients. Inclusioncriteria were male, 20-40 years old, receiving first line ART for at least sixmonths, and not on initial phase of opportunistic infection?s treatment. Patientswho consumed steroid or other immunosuppressant or patients with poor ARTadherence were excluded. Level of hs-CRP was obtained before and duringRamadan after at least 14 days fasting.Results: Baseline age, CD4 cell count, HIV-RNA, ART combination, hepatitis Band hepatitis C status, and hs-CRP level were similar for both fasting and controlgroups. After 2 weeks, a significant hs-CRP decrease was found in fasting groupcompared to non-fasting one (p=0.004). Median difference of hs-CRP in fastinggroup was -0.41 (IQR -1 and 0.1) mg/L, while in control group the mediandifference was 0.2 (IQR -0.3 and 1.5) mg/L. Polyunsaturated fatty acidconsumption, body weight, amount of cigarette smoking, and total sleep hours perday were decreased significantly during Ramadan fasting (p=0.029; p<0.001,p<0.001, p<0.001 respectively). There was no statistically significant changes intotal antioxidant status between the two groups (p=0.405). Median totalantioxidant status changes in fasting group was 0.05 (IQR -0.03;0.12) mmol/L.Median total antioxidant status changes in control group was 0.04 (IQR -0.13;0.36) mmol/LConclusion: Ramadan fasting decreased hs-CRP level among HIV patients onantiretroviral therapy. Ramadan fasting had not increased total antioxidant statusamong HIV patients on antiretroviral therapy. |
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