FAKTOR RISIKO KEBERHASILAN PENGOBATAN TUBERKULOSIS PADA PASIEN DENGAN KOINFEKSI TB-HIV DI RSUP DR. SARDJITO, YOGYAKARTA

INTAN WAHYUNI TUKIYO, dr. Yanri Wijayanti S, Ph.D., Sp.PD-KPTI FINASIM;Dr. dr. Rizaldy T Pinzon, Sp.S, M.Kes

2022 | Tesis | MAGISTER ILMU KEDOKTERAN TROPIS

Latar belakang: Salah satu cara pengendalian pada pasien koinfeksi TB-HIV adalah dengan melakukan pengobatan rutin yang mana keberhasilannya dipengaruhi berbagai faktor, baik sosial demografi maupun klinis. Penelitian ini bertujuan untuk mengetahui faktor yang berhubungan dengan keberhasilan pengobatan pasien koinfeksi TB-HIV di RSUP Dr. Sardjito Yogyakarta. Metode: Penelitian menggunakan desain kohort retrospektif data pasien koinfeksi TBHIV yang diambil dari register TB03 di poliknilik paru infeksi RSUP Dr. Sardjito. Data yang dikumpulkan meliputi faktor sosial (sosial) demografi (jenis kelamin, usia, tingkat pendidikan, pekerjaan dan status pernikahan) dan faktor klinis pasien (stadium HIV, kadar CD4, regimen ARV, koinfeksi kandidiasis, koinfeksi hepatitis, kategori pengobatan, klasifikasi TB, kepatuhan pengobatan TB, lama pengobatan, paduan OAT, riwayat DM, pemeriksaan BTA) serta hasil akhir pengobatan pasien (sukses, pengobatan lengkap, lost to follow up,drop out, meninggal). Data pasien diolah dan dianalisis secara bivariat dengan p value <0,05 dan multivariat dengan hasil p value dari analisis bivariat p<0,25. Hasil penelitian: Terdapat 106 pasien koinfeksi TB-HIV dengan rata-rata umur 37 tahun, dan laki-laki 85 orang (80,19%%). Sebanyak 88 (83,02%) mengalami pengobatan yang berhasil. Analisis bivariat menunjukkan bahwa faktor lama pengobatan TB 9 bulan (p value:0,000) dan 12 bulan (p value:0,031) berhubungan dengan keberhasilan pengobatan pasien koinfeksi TB-HIV. Analisis multivariat menunjukkan faktor lama pengobatan 9 bulan (p value: 0,001) memiliki pengaruh secara signifikan dan berisiko tinggi sebesar 54,47 kali terhadap keberhasilan pengobatan pasien koinfeksi TB-HIV di RSUP Dr. Sardjito. Kesimpulan: pasien koinfeksi TB-HIV yang menyelesaikan pengobatan TB selama 9 bulan menunjukkan hasil pengobatan yang lebih baik. Perlunya dilakukan penelitian lebih lanjut menggunakan subyek TB dengan dan tanpa koinfeksi HIV.

Background: One way to control TB-HIV co-infected patients is to carry out routine treatment whose success is influenced by various factors, both sociodemographic and clinical. This study aims to determine the factors associated with the successful treatment of TB-HIV co-infected patients at RSUP Dr. Sardjito Yogyakarta. Methods: The study used a retrospective cohort design using secondary data of TB-HIVco- The study used a retrospective cohort design with data on TB-HIV coinfected patients taken from the TB03 register at the infectious pulmonary polyclinic of Dr. Sardjito. The data collected included social (social) demographic factors (gender, age, education level, occupation and marital status) and patient clinical factors (HIV stage, CD4 levels, ARV regimen, candidiasis coinfection, hepatitis coinfection, treatment category, TB classification, TB treatment adherence, duration of treatment, combination of OAT, history of DM, BTA examination) and the final outcome of patient treatment (success, complete treatment, lost to follow up, drop out, died). Patient data were processed and analyzed bivariately with p value <0.05 and multivariate with p value from bivariate analysis p<0.25. Results: There were 106 TB-HIV coinfected patients with an average age of 37 years, and 85 men (80.19%%). A total of 88 (83.02%) experienced successful treatment. Bivariate analysis showed that 9 months (p value: 0.000) and 12 months (p value: 0.031) TB treatment factors were associated with successful treatment of TB-HIV co-infected patients. Multivariate analysis showed that the factor of treatment duration of 9 months (p value: 0.001) had a significant and high risk effect of 54.47 times on the success of treatment for TB-HIV coinfected patients at Dr. Sardjito. Conclusion: In this study, TB-HIV coinfected patients who completed 9 months of TB treatment showed better treatment outcomes. There is a need for further research using TB subjects with and without HIV coinfection.

Kata Kunci : Lama pengobatan, Keberhasilan pengobatan, Koinfeksi TB-HIV/Duration of treatment, Successful treatment, TB-HIV coinfection