HUBUNGAN NILAI CD4 DENGAN INTERNATIONAL HIV DEMENTIA SCALE

ADE MAYASHITA, dr. Sekar Satiti, Sp.S(K)/dr. Astuti, Sp.S(K)

2019 | Tesis-Spesialis | NEUROLOGI

Perkembangan infeksi Human Immunodeficiency Virus-I (HIV-I) dan AIDS di dunia dalam tahap mengkhawatirkan. Infeksi HIV dapat menyebabkan morbiditas sampai dengan mortalitas. Gangguan kognitif sering terjadi pada HIV. Penelitian menggunakan International HIV Dementia Scale (IHDS) dalam penapisan gangguan kognitif terkait HIV telah banyak digunakan di beberapa Negara. Sampai saat ini belum didapatkan penelitian tentang hubungan antara kadar CD4 dengan International HIV Dementia Scale di RSUP Dr. Sardjito, Yogyakarta. Penelitian ini bertujuan untuk mencari hubungan antara nilai CD4 dengan IHDS pasien HIV di RSUP Dr. Sardjito. Penelitian dilakukan pada 67 subjek penderita HIV dengan rancangan cross-sectional (potong lintang). Rerata subjek berumur 32,4. Nilai tengah lama menderita atau konsumsi obat ARV yaitu 2 tahun dengan rentang 2 minggu sampai 10 tahun. Sebanyak 26 (39,4%) berpendidikan sarjana dan 25 (37,9%) adalah SMA. Sebagian besar subjek adalah laki-laki 55 (82,1%) dengan status belum menikah 44 (65,7%) namun telah bekerja 47 (70,1%). Rerata skor IHDS 10,67 dengan median 11,00 menunjukkan bahwa rata-rata subjek memiliki fungsi kognitif kategori normal yaitu skor >10. Hasil uji korelasi diperoleh nilai p=0,012 (p<0,05) yang berarti ada hubungan bermakna nilai CD4 dengan IHDS. Koefisien korelasi sebesar 0,306 (positif) artinya semakin rendah nilai CD4 maka semakin rendah skor IHDS. Berdasarkan analisis multivariat diketahui bahwa variabel yang berpengaruh signifikan terhadap IHDS adalah CD4, umur, dan pendidikan (p<0,05). Koefisien regresi (B) CD4 dan pendidikan bernilai positif yang berarti semakin rendah CD4 maupun pendidikan maka semakin rendah pula IHDS, sedangkan koefisien regresi (B) umur bernilai negatif yang berarti semakin tinggi umur maka semakin rendah IHDS. Koefisien determinasi (R2) pada model 5 sebesar 0,466 yang berarti bahwa CD4, umur, dan pendidikan memberikan kontribusi pengaruh terhadap IHDS sebesar 46,6%.

The development of Human Immunodeficiency Virus-I infection (HIV-I) and AIDS in the world is at an alarming stage. HIV infection can cause morbidity up to mortality. Cognitive disorders often occur in HIV. Research using the International HIV Dementia Scale (IHDS) in screening for HIV-related cognitive disorders has been widely used in several countries. Until now no research has been found on the relationship between CD4 levels and the International HIV Dementia Scale at Dr. RSUP. Sardjito, Yogyakarta. This study aims to find the relationship between CD4 scores and IHDS HIV patients in Dr. RSUP. Sardjito. The study was conducted on 67 HIV-infected subjects with a cross-sectional design (cross section). The average subject was 32.4. Long median suffering or consumption of ARV drugs is 2 years with a range of 2 weeks to 10 years. A total of 26 (39.4%) had undergraduate education and 25 (37.9%) were high school. Most of the subjects were 55 men (82.1%) with unmarried status 44 (65.7%) but had worked 47 (70.1%). The average IHDS score is 10.67 with a median of 11.00 indicating that the average subject has a normal cognitive function which is a score of> 10. Correlation test results obtained a value of p = 0.012 (p <0.05) which means there is a significant relationship between CD4 values and IHDS. The correlation coefficient of 0.306 (positive) means that the lower the CD4 value, the lower the IHDS score. Based on multivariate analysis, it is known that the variables that significantly influence IHDS are CD4, age, and education (p <0.05). The regression coefficient (B) CD4 and education is positive, which means that the lower the CD4 and education, the lower the IHDS, while the regression coefficient (B) age is negative, which means that the higher the age the lower the IHDS. The coefficient of determination (R2) in model 5 is 0.466, which means that CD4, age, and education contribute 46.6% to the IHDS.

Kata Kunci : HIV, AIDS, IHDS, kognitif