Hubungan Hitung Sel CD4+ dengan Kejadian Pneumonia pada Anak Terinfeksi Human Immunodeficiency Virus

Abstract

Background : Pneumonia is a major cause of morbidity and mortality in infants and children who are infected with Human Immunodeficiency Children (HIV). For HIV-infected children, the risk for developing pneumonia has been closely related to an individual’s having a lower CD4 T-lymphocyte cell count. Objective :To evaluate association between CD4 T-lymphocyte cell count with pneumonia in HIV children. Method : A cross sectional study was conducted among all children diagnosed with and without pneumonia in HIV at Adam Malik Hospital Medan. Data taken from medical record patient between January 2008 and December 2015. We studied demographic, clinical, radiological and CD4 T-lymphocyte cell count. Result : A total of 174 HIV children were included in this study, pneumonia were found in 47 children, median age of onset 39 month. Mean difference CD4 levels was 0,912 (95% CI, -5,79 – 7,62). No significant association between nutritional status with incidence of pneumonia [p = 0,886, OR 1,050, 95% CI (0,537 – 2,053)]. No significant association between immunodeficient status HIV children and pneumonia, [p = 0,984, OR 0,986, 95% CI (0,25 – 3,885)]. The common opportunistic infection besides pneumonia are pulmonary TB, oral thrush, diarrhea, varicella, CMV. Conclusions : There is no significant association between CD4 T-lymphocyte cell count and pneumonia in HIV children.

Latar belakang : Pneumonia merupakan penyebab utama morbiditas dan mortalitas pada anak yang terinfeksi Human Immunodeficiency Children (HIV). Anak yang terinfeksi HIV memiliki risiko menderita pneumonia yang berkaitan dengan kadar sel T-limfosit CD4 yang rendah. Objektif : Untuk menilai hubungan antara sel T-limfosit CD4 dengan kejadian pneumonia pada anak yang terinfeksi HIV. Metode : Penelitian dengan metode cross sectional dilakukan pada semua anak yang terinfeksi HIV yang menderita pneumonia dan tanpa pneumonia di RS Adam Malik Medan. Data diambil dari rekam medis pasien sejak bulan January tahun 2008 hingga bulan Desember tahun 2015. Dilakuan penilaian karakteristik data, gejala klinis, radiologis dan kadar sel T-limfosit CD4 Hasil : Seluruh sampel berjumlah 174, dibagi menjadi dua kelompok yaitu penderita pneumonia sebanyak 40 anak, dengan rerata usia 39 bulan. Rerata kadar CD4 0,912 (95% CI, -5,79 – 7,62). Tidak terdapat hubungan bermakna antara status nutrisi dengan kejadian pneumonia [p = 0,886, OR 1,050, 95% CI (0,537 – 2,053)]. Tidak terdapat hubungan signifikan antara status imonudefisiensi penderita HIV dengan pneumonia, [p = 0,984, OR 0,986, 95% CI (0,25 – 3,885)]. Infeksi oportunistik selain pneumonia dialami oleh anak penderita HIV yaitu TB paru, kandidiasis oral, diare, varisela, CMV. Kesimpulan : Tidak terdapat hubungan bermakna antara kadar sel T-limfosit CD4 dengan pneumonia pada anak yang terinfeksi HIV.