Penggunaan Panleucogating dalam penentuan jumlah absolut limfosit CD4 pada pasien terinfeksi Human Immunodefficiency Virus (HIV)

INTANSARI, Umi Solekhah, Prof.dr. Budi Mulyono, SpPK(K),MM

2007 | Tesis | PPDS I Patologi Klinik

Latar Belakang : Infeksi Human Immunodeficiency Virus (HIV) / Acquired Immunodedeficiency Syndrome (AIDS) merupakan penyakit serius yang bisa menyebabkan kematian. Pasien sebaiknya diterapi jika jumlah absolut limfosit CD4 < 200 sel/uL. Metode standar pengukuran limfosit CD4 adalah dengan analisis flow cytometer., namun karena tingginya biaya, diperlukan metode alternatif PanLeucogating yang sederhana dengan biaya lebih murah Tujuan: Penelitian ini bertujuan untuk mengetahui kesesuaian metode PanLeucogating dengan single platform dan untuk menguji proporsi pasien yang mempunyai limfosit CD4<200 sel/uL yang diperiksa dengan kedua metode tersebut. Metode: Penelitian ini menggunakan rancangan potong lintang yang dilakukan di Bagian Patologi Klinik Fakultas Kedokteran Universitas Gadjah Mada dan RSUP Dr. Sardjito. Kriteria inklusi subyek adalah pasien HIV yang melakukan pemeriksaan jumlah absolut CD4. Jumlah limfosit CD4 diukur dengan metode PanLeucogating dan single platform menggunakan FACS Calibur. Analisis Bland Altman dilakukan untuk mengetahui apakah kedua metode tersebut bisa saling menggantikan Hasil: Metode PanLeucogating berkorelasi sangat baik dengan metode single platform (r = 0,996 ; y = -0,906 + 0,0,987). Analisis Bland Altman menghasilkan bias = 5; simpang baku = 18,7; MPD = 2 ; Limit of agreement (LOA) = -31,6 – 40,75; dan %LOA = -7,96 – 12,5%. Kesimpulan: Metode PanLeucogating mempunyai kesesuaian baik dengan metode single platform dalam pengukuran jumlah absolut limfosit CD4. Metode PanLeucogating juga tidak mempengaruhi proporsi pasien yang diterapi berdasarkan jumlah limfosit absolut < 200 sel/uL

Background: Human Immunodeficiency Virus (HIV) or Acquired Immunodedeficiency Syndrome (AIDS) infection is a life threatening disease that leading cause to death. The patient should be treated when the absolute lymphocyte count of CD4 reach <200 sel/ul. The standard method for absolute lymphocyte CD4 count is flow cytometric analysis, but due to the high costly manner, we need a simpler method and less costly manner of PanLeucogating dual platform. Objectives: The aim of the study is to replace the single platform by PanLeucogating dual platform by determining the agreement between both methods and to test the proportion of patient who have CD4 <200 cell/ul measured by Panleucogating method and single platform. Methods: The study is a cross sectional study was carried out in Departement of Clinical Pathology Faculty of Medicine Gadjah Mada University Yogyakarta. The inclu sion criteria of the study are the HIV/AIDS patients who were measured of the CD4. Absolunt count of CD4 was measured with both PanLeucogating and single platform method using FACS Calibur. The bias, correlation, regression and limit of agreement between both methods were analyzed using Bland Altman analysis to decide whether the two methods interchangeable. Results: The result of the study revealed an excellent correlation between the two methods (r = 0,996 ; y = -0,906 + 0,0,987). Bland Altman analysis revealed bias = 5 cells/uL; standard deviation = 18,7 and Limit of agreement (LOA) = -31,6 – 40,75. The Mean Percentage Difference (MPD) = 2%; dan %LOA = -7,96 – 12,5%. The proportion of CD4 absolute count < 200 measured by the two method was not significantly different ( Chi square test) Conclusion: PanLeucogating method has a good agreement with single platform method and can be used interchangeable. There was no difference of the proportion of patient who have CD4 <200 cell/ul measured by Panleucogating method and single platform.

Kata Kunci : Infeksi HIV,Limfosit CD4,Panleucogating, Lymphocyte CD4 absolute count, PanLeucogating, single platform