Hubungan Antara Jumlah Cluster of Differentiation 4 (CD4) dan Tipe Human Papilloma Virus (HPV) dengan Giant Condyloma Acuminata (GCA)

Abstract

Background: Condyloma acuminata (CA) is a sexually transmitted infection (STI) caused by the Human Papilloma Virus (HPV). HPV infection is increasing in immunosuppressed patients which causes the development of CA lesions to be longer, recurrent and larger (giant condyloma acuminata). CD4 count showed an association with the occurrence of GCA. Objective: To determinate the relationship between CD4 count and type of HPV with GCA. Methods: This study was an observational analytic study using the cross sectional study. The study subjects were 20 people who were selected using the consecutive sampling technique. CD4 examination using blood samples which were analyzed using fluorecense activated cell sorter (FACS) count. CA lesions were taken using a shave biopsy technique and then the HPV type was examined using the polymerase chain reaction (PCR) method. Results: The majority of the study subjects were male with GCA 7 people (41,2%). The most age group was 26-35 years old with GCA 6 people (66,7%). The education level of the subjects was mostly secondary education with GCA 9 people (56,2%). The employment of the subjects were mostly service and sales personnel with GCA 4 people (57,1%). The results of the analysis showed no significant relationship between of sex, age, education, and employment with GCA lesions. Based on the location of the GCA lesions, there were 4 people (57.1%) in the genital area and 6 people (46.2%) in the anal area. The results of the analysis showed that there was no significant relationship between lesion location and GCA (p = 1,000, Fisher's Exact test). A total of 9 people (90%) with GCA had severe immunosuppression. The results of the analysis showed that there was a significant relationship between CD4 count and GCA lesions (p < 0.001, Chi Square test). The Prevalence Ratio value is 9 (95% CI, 1,386-58,443). The most common of HPV type in GCA was HPV-11, amounting to 6 people (46.2%). The results of the analysis showed that there was no significant relationship between type of HPV and GCA lesions (p = 0.275, Kruskal Walis test). Conclusion: There is a significant relationship between CD4 count and GCA lesions, and there is no relationship between type of HPV and GCA lesions. Subjects with severe immunosuppression tend to be at risk of developing GCA lesions by 9 times greater than subjects with non severe immunosuppression.