HUBUNGAN ASUPAN SENG, VITAMIN A, DAN STADIUM KLINIS TERHADAP STATUS GIZI DAN JUMLAH CD4+ PADA ANAK TERINFEKSI HIV DI WILAYAH KOTA DAN KABUPATEN SEMARANG
Abstract
Latar Belakang. Peningkatan jumlah kasus infeksi HIV anak di Indonesia paralel dengan peningkatan persentase transmisi penularan AIDS dari ibu ke anaknya, dari 3 persen (2013) menjadi 4,6 persen (2015). Salah satu tujuan pemberian terapi antiretroviral (ARV) pada kasus HIV anak adalah untuk meningkatkan jumlah sel T-CD4+. Semakin berat stadium klinisnya akan menurunkan kadar CD4+. Pemberian suplementasi zat gizi mikro dapat meningkatkan status gizi penderita HIV anak yang menjalani pengobatan ARV. Tujuan. Penelitian ini bertujuan menganalisis hubungan asupan seng, vitamin A, dan stadium klinis infeksi HIV terhadap status gizi dan jumlah CD4+ pada kasus HIV anak di Kota dan Kabupaten Semarang. Metode. Penelitian ini menggunakan desain cross-sectional. Subjek penelitian adalah anak yang menderita HIV berumur 1-14 tahun sebanyak 31 subjek. Data yang dikumpulkan meliputi data tinggi badan (TB), berat badan (BB), asupan zat gizi yang diperoleh dengan metode food recall 2x24 jam. Jumlah CD4+ diukur melalui pemeriksaan darah subjek. Data dianalisis menggunakan uji chi-square dan regresi logistik untuk menghitung Prevalence Rasio (PR). Hasil. Hasil penelitian ini menunjukkan bahwa asupan seng memberikan risiko bermakna terhadap kejadian berat badan rendah (PR=3,020; p=0,029; CI=1,043-8,739). Asupan vitamin A memberikan risiko bermakna terhadap rendahnya kadar CD4+ (PR=3,036; p=0,021; CI=1,211-7,608 dan PR=2,8; p=0,018; CI=1,331-5,891). Stadium klinis tingkat sedang memberikan risiko bermakna terhadap rendahnya kadar CD4+ rendah (PR=8,211; p = 0,004; CI=1,227-54,962). Probabilitas jumlah CD4+ rendah ketika penderita pada stadium klinis infeksi HIV berat sebesar 14,3 persen. Kesimpulan. Stadium klinis sedang-berat meningkatkan risiko terjadinya penurunan jumlah CD4+ di dalam sel-T (<500sel/mm3).
References
Kementerian Kesehatan Republik Indonesia. Profil kesehatan Indonesia Tahun 2014. Jakarta: Kemenkes RI; 2015. p.138-42.
UNICEF Indonesia. Ringkasan Kajian: Kesehatan Ibu dan Anak. Jakarta: UNICEF Indonesia; 2012. p.1-6.
UNAIDS. Global Report : UNAIDS Report on the Global AIDS Epidemic. Switzerland: UNAIDS; 2013. p.4-20
UNAIDS. Fact Sheet: Children and HIV. Diunduh dari: http://www.unaids.org/sites/default/files/media_asset/FactSheet_Children_en.pdf.
Desmonde S, Goegthebuer T, Thome C, Leroy V. Health and Survival of HIV Perinatally Exposed but Uninfected Children Born to HIV-infected Mothers. Curr Opin HIV AIDS. 2016; 11 (5): 465-76.
Asnake S, Amsalu S. Clinical Manifestations of HIV/AIDS in Children in Northwest Ethiopia. Ethiop J Health Dev. 2005; 19(1): 24-8.
UNICEF Indonesia. Laporan Tahunan 2012. Jakarta: UNICEF; 2012. p.1-10.
Direktorat Jenderal Pengendalian Penyakit dan Penyehatan Lingkungan Kemenkes RI. Petunjuk Teknis Tata Laksana Klinis Ko-Infeksi TB-HIV. Jakarta: Kementerian Kesehatan RI; 2012. p.42-61.
Ditjen PP dan PL Kemenkes RI. Statistik Kasus HIV/AIDS di Indonesia: Januari-September 2014. Jakarta: Ditjen PP dan PL Kemenkes RI; 2014. p. 1-3.
Komisi Penanggulangan AIDS Provinsi Jawa Tengah. Kondisi HIV dan AIDS di Jawa Tengah 1992 - 30 September 2015. Diunduh dari http://birohumas.jatengprov.go.id/ppid/wp-content/uploads/2016/01/Data-HIV-dan-AIDS-Prov.-Jateng-per-September-2015.pdf.
Dinas Kesehatan Kota Semarang. Laporan Bulanan Perawatan HIV dan ARV: Bulan Januari. Semarang: Dinkes Kota Semarang; 2015. p.1-2.
Nugroho AA, Hapsari MMDEAH, Farida H. Faktor Determinan Peningkatan Berat Badan dan Jumlah CD4+ Anak HIV/AIDS Setelah Enam Bulan Terapi Antiretroviral. Jurnal Media Medika Muda. 2014; 3(1): 1-9.
Swetha GK, Hemalatha R, Prasad UV, Murali V, Damayanti K, Bhaskar V. Health and Nutritional Status of HIV Infected Children in Hyderabad, India. Indian J Med Res. 2013; 141(1): 46-54.
Bobat R, Coovadia H, Stephen C, Naidoo KL, McKerrow N, Black RE et al. Safety and Efficacy of Zinc Supplementation for Children with HIV-1 Infection in South Africa: A Randomised Double-Blind Placebo-Controlled Trial. Lancet. 2005; 366(9500): 1862-7.
Siyazi M. Nutritional Supplementation in HIV-infected Children: A Review. J HIV Clin Scientific Res. 2015; 2 (2): 45-8.
Sjarif DR, Lestari ED, Mexitalia M, Nasar SS. Antropometri Anak dan Remaja. Dalam: Ikatan Dokter Anak Indonesia, editor. Buku Ajar Nutrisi Pediatrik dan Penyakit Metabolik Jilid 1. Jakarta: Badan Penerbit IDAI; 2011. p. 23-35.
Evalina R. Studi Deskriptif Infeksi HIV pada Anak di Rumah Sakit Umum Pusat Adam Malik Medan. Sari Pediatri. 2012; 14(2): 73-8.
Cotton MF, Violari A, Otwombe K, Panchia R, Dobbels E, Josipovic D et al. Early Time-limited Antiretroviral Therapy versus Deferred Therapy in South African Infants Infected with HIV: Results from the Children with HIV Early Antiretroviral (CHER) Randomised Trial. Lancet. 2013; 382(9904): 1555-63.
Dahlan MS. Statistik Untuk Kedokteran dan Kesehatan: Deskriptif, Bivariat, dan Multivariat Dilengkapi Aplikasi dengan Menggunakan SPSS. Jakarta: Salemba Medika; 2011.
Mulyaningsih TR. Kandungan Unsur Fe dan Zn dalam Bahan Pangan Produk Pertanian, Peternakan dan Perikanan Dengan Metode ko-AANI. JSTNI. 2009; X(2): 71-80.
Sulastini, Kurniawan A, Syamsu, Matulessy F, Christianto E, Prawitasari E et al. Pedoman Pelayanan Gizi Bagi ODHA. Jakarta: Direktorat Bina Gizi Masyarakat Kemenkes RI; 2010. p. 21-65.
Nelms MN, Frazier C. Cellular and Physiological Response to Injury : The Role of the Immune System. In: Nelms M, Sucher KP, Lacey K, Roth SL, editors. Nutrition Therapy and Pathophysiology 2nd ed. USA: Wadsworth; 2011. p.158-170.
Ndeezi G, Tumwine JK, Bolann BJ, Ndugwa CM, Tylleskar T. Zinc Status in HIV Infected Ugandan Children Aged 2-5 Years: A Cross Sectional Baseline Survey. BMC Pediatrics; 2010; 10(1): 68.
Irlam JH, Sregfried N, Visser ME, Rollins NC. Micronutrient Supplementations for Children with HIV Infection (Review). Cohrane Database of Systematic Reviews. 2013; Issue 10.
Rismiati. Hubungan Asupan Mikronutrien dan Status Gizi Anak Usia 2-5 Tahun di Wilayah Posyandu Gonilan. Naskah Publikasi. Surakarta: Fakultas Kedokteran Universitas Muhammadiyah Surakarta; 2016. p.1-17.
Suiraoka IP, Kusumajaya AAN, Larasati N. Perbedaan Konsumsi Energi, Protein, Vitamin A dan Frekuensi Sakit Karena Infeksi pada Anak Balita Status Gizi Pendek (Stunted) dan Normal di Wilayah Kerja Puskesmas Karangasem I. JIG. 2011; 2(1): 74-82.
Gardner, Fields C, Sucher K. HIV and AIDS. In: Nelms M, Sucher KP, Lacey K, Roth SL, editors. Nutrition Therapy and Pathophysiology 2nd ed. USA: Wadsworth; 2011. p. 735-65.
Fiteau S, Manno D. Nutritional for HIV/AIDS. In: Benjamin Caballero, editors. Encyclopedia of Human Nutrition 3th ed. USA: Elsevier; 2013. p. 303-8.
Gallagher ML. The Nutrient and their Metabolism. In: Mahan LK, Escottt-Stump S, editors. Krause’s Food and the Nutrition Care Process. USA: Elsevier; 2008. p.39-114.
Nugroho, Andy A. Faktor Determinan Peningkatan Berat Badan dan Jumlah CD4 Anak HIV/AIDS Setelah Enam Bulan Terapi Antiretroviral. Karya Tulis Ilmiah. Semarang: Universitas Diponegoro; 2014.
Murage EWK, Norris SA, Pettifor JM, Tollman SM, Grobusch KK, Olive XFG et al. Nutritional Status and HIV in Rural South African. BMC Pediatrics. 2011; 11(23): 1-13.
Dong, Kimberly R, Imai CM. Medical Nutrition Therapy for HIV and AIDS. In: Mahan LK, Escottt-Stump K, Raymond JL, editors. Krause’s Food & the Nutrition Care Process. USA: Elsevier; 2012. p.864-81.
Baratawidjaja, Garna K, Renggaris I. Imunologi Dasar. Jakarta: FK UI; 2009. p. 499-513.
Fenton M, Silverman EC. Medical Nutrition Therapy for Human Immunodeficiency Virus (HIV) Disease. In: Mahan LK, Escottt-Stump S, editors. Krause’s Food & the Nutrition Care Process. USA: Elsevier; 2012. p. 991-1015.
Silva MTN, Centeville M, Tani SM, Toro AADC, Rossi C, Vilela MM. Serum Imunoglobulin in Children Perinatally Exposed to Human Immunodeficiency Virus. J Pediatr. 2001; 77(2): 2009-18.
Kapavarapu PK, Bari O, Perumpii M, Duggan C, Dinakar C, Krishnamurthy S et al. Growth Pattern and Anaemia Status of HIV-infected Children Living in an Institutional Facility in India. Trop Med Int Health. 2012; 17(8): 962-71.
Rajkumar P, Arti R, Simran P, Sangeeta W, Satpal Y. Evaluation of the Most Probable Mode of Transmission, Correlation of WHO Staging and CD4 T-Lymphocyte Count and the Effect of Anti Retro Viral Therapy in HIV Infected Children Under 15 Years-A 12 Month Clinical Trial. International Journal of Clinical Dentistry. 2014; 7(2): 131-8.
O’hare B, Milner DA, Newberry L, Pelani I, Malisita K. Discordance Between Clinical and Immulogical ART Eligibility Criteria for Children in Malawi. BioMed Central. 2014; 7 (666): 1-6.
WHO, Ikatan Dokter Anak Indonesia, Kemenkes RI. Pedoman Penerapan Terapi HIV pada Anak. Jakarta: Kemenkes RI; 2004. p.1-40.
WHO. Antiretroviral Therapy for HIV Infection in Infant and Children: Towards Universal Access Recommendations for a Public Health Approach 2010 Revision. Austria: WHO; 2010.
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