Efek Proteksi Profilaksis Isoniazid terhadap Infeksi Tuberkulosis pada Pasien HIV di Rumah Sakit Pengayoman Cipinang

Abstract

Tuberkulosis (TB) merupakan infeksi oportunistik yang menjadi penyebab utama kematian pada pasien human immunodeficiency virus (HIV). Oleh karenanya, perlu upaya pencegahan infeksi TB melalui pemberian profilaksis isoniazid (INH) kepada pasien HIV. Penelitian ini bertujuan untuk memberikan gambaran karakteristik pasien yang mendapat profilaksis INH dan hasil pemberian profilaksis tersebut di RS Pengayoman Cipinang. Metode penelitian yang digunakan adalah desain kohort retrospektif pada pasien HIV yang mulai mendapat profilaksis INH pada tahun 2018–2019. Data diambil dari Ikhtisar Perawatan HIV. Hasil penelitian menunjukkan sebanyak 46 dari 57 (80,7%) subjek mendapat profilaksis INH lengkap, sementara subjek lainnya ada yang mengalami alergi, loss of follow up, pindah, atau meninggal. Subjek mulai mendapat profilaksis INH setelah 3 (0–13) tahun dikonfirmasi terinfeksi HIV.  Berdasarkan karakteristiknya, subjek yang mendapat profilaksis INH lengkap sebagian besar adalah laki-laki, berusia 36 (24–54) tahun, berpendidikan Sekolah Menengah Atas (SMA), dan belum menikah. Status kesehatan dan riwayat pengobatan subjek beragam. Sebanyak 71,1% subjek mendapat regimen antiretroviral fixed-dosed combination, 87% dengan adherence ≥95%, 39% stadium klinis III, 52,2%  dengan viral load detected, 15,2% mempunyai riwayat infeksi TB, dan 93,5% tidak mendapat profilaksis kotrimoksasol. Hasil observasi selama setahun menunjukkan tidak ada subjek dengan profilaksis INH lengkap yang terinfeksi TB. Dapat disimpulkan profilaksis INH efektif melindungi subjek dari infeksi TB.

Kata kunci: Pasien human immunodeficiency virus, profilaksis isoniazid, tuberkulosis  

The Protective Effect of Isoniazid Prophylactic Therapy against Tuberculosis Infection in HIV Patients at Pengayoman Cipinang Hospital 

Abstract

Tuberculosis (TB) is the most opportunistic infection and the leading cause of death in human immunodeficiency virus (HIV) patients. Consequently, TB infection must be prevented by providing these patients with isoniazid prophylactic therapy (IPT). This study, therefore, aimed to describe the characteristics of patients administered IPT and the results of this therapy at Pengayoman Cipinang Hospital, using a retrospective cohort design in HIV patients first administered IPT between 2018 and 2019. Data was collected through a review of medical records and a total of 57 participants were selected for the study. According to the results, 46 subjects (80.7%) received complete IPT, while others either experienced allergies, failed to follow-up, moved, or died. The subjects all began IPT after 3 (0 to 13) years of confirmed HIV infection, and based on the respondent characteristics, the majority of subjects administered complete IPT were unmarried men, aged 36 (24–54) years, and with high school education. However, the health status and treatment history of the subjects varied. A total of 71.1% of the subjects received a fixed-dose combination antiretroviral regimen, 87% received with adherence ≥95%, 39% with clinical stage III, 52.2% with viral load detected, 15.2% had a history of TB infection, while 93.5% did not receive cotrimoxazole prophylaxis. Observations for a year showed none of the subjects with complete IPT were infected with TB. Therefore, IPT was concluded to be effective in protecting HIV patients from TB infection.    

Keywords: Isoniazid prophylactic therapy, human immunodeficiency virus patients, tuberculosis