HUBUNGAN KADAR C-REACTIVE PROTEIN (CRP) DENGAN VIRAL LOAD HIV PADA PASIEN HIV YANG BELUM MENDAPAT TERAPI ANTIRETROVIRAL (ARV)

AGUS RIYADI, Agus Riyadi*, Umi S. Intansari**, Tri Ratnaningsih**

2020 | Tesis-Spesialis | PATOLOGI KLINIK

Latar belakang : Human Immunodeficiency Virus (HIV) merupakan virus yang menyerang sistem kekebalan tubuh dengan insidensi yang tinggi. Keparahan infeksi HIV dipengaruhi oleh jumlah virus HIV (Viral load) dan proses inflamasi akibat infeksi dan defisiensi sistem pertahanan tubuh. C-Reactive Protein (CRP) merupakan biomarker yang banyak digunakan sebagai penanda inflamasi, namun hubungannya dengan viral load HIV belum banyak diteliti. Tujuan: Tujuan penelitian ini adalah untuk menganalisis hubungan antara CRP dengan viral load pada pasien HIV sebelum terapi ARV Metode: Penelitian ini merupakan penelitian observasional analitik dengan desain potong lintang. Subjek adalah pasien terinfeksi HIV yang belum mendapatkan terapi ARV dan menjalani perawatan di Poliklinik Edelweis RSUP Dr. Sardjito. Viral load diukur dengan Real Time PCR, dan CRP diukur dengan metode immunoturbidimetric menggunakan sampel darah vena. Data karakteristik subjek dan data laboratorium disajikan dalam tabel dan grafik. Hubungan antara viral load dengan CRP dianalisis menggunakan uji korelasi Spearman. Dilakukan sub analisis perbedaan nilai antar kelompok berdasarkan stadium klinis dan jumlah sel CD4 dengan uji beda Mann-Whitney dan Kruskall Wallis. Hasil: Penelitian ini melibatkan 66 pasien HIV stadium klinis 1-4 yang belum mendapat terapi Anti Retroviral (ARV) dan memenuhi kriteria inklusi. Terdapat hubungan yang bermakna antara viral load HIV dengan kadar CRP (r=0,36 ; p=0,003). Terdapat perbedaan bermakna Viral load dan kadar CRP antar kelompok berdasarkan stadium klinis (p =0,002 dan p= 0,001) dan jumlah sel CD4 (p =0,0004 dan p=0,029). Simpulan: Terdapat hubungan positif yang bermakna antara kadar CRP dengan viral load HIV pada pasien HIV yang belum mendapat terapi ARV.

Background: Human Immunodeficiency Virus (HIV) is a virus that attacks the immune system with a high incidence. The severity of HIV infection is influenced by the amount of HIV virus (viral load) and the inflammatory process due to infection and deficiencies of the body's defense system. C-reactive protein (CRP) is a biomarker used as a marker of inflammation, but its relationship with HIV viral load before ARV therapy has not been widely studied. Objective: The aim of this study was to analyze the relationship between CRP and viral load in HIV patients before ARV therapy. Method: This research was an analytic observational study with a cross sectional design. Subjects were HIV-infected patients who had not received ARV therapy and were undergoing treatment at the Edelweis Polyclinic, Dr. Sardjito. Viral load was measured by the reverse transcription PCR method, and CRP was measured by the immunoturbidimetric method using venous blood samples. Subject characteristic data and laboratory data are presented in tables and graphs. The relationship between viral load and CRP was analyzed using the Spearman correlation test. Sub-analysis of differences in scores between groups based on clinical stage and CD4 cell count was carried out using the Mann-Whitney and Kruskall Wallis different test. Result: This study involved 66 HIV patients clinical stage 1-4 who had not received anti-retroviral (ARV) therapy and met the inclusion criteria. There was a significant relationship between HIV viral load and CRP levels (r = 0.36; p = 0.003). There were significant differences in viral load and CRP levels between groups based on clinical stage (p = 0.002 and p = 0.001) and CD4 cell count (p = 0.0004 and p = 0.029). Conclusion: There was a significant positive relationship between HIV viral load and CRP levels in HIV patients who had not received ARV therapy

Kata Kunci : HIV infection, CRP, viral load