Determinan Kadar Cluster Diferensiasi 4 (CD4) pada Orang dengan HIV/AIDS
DOI:
https://doi.org/10.26630/jk.v12i1.2423Keywords:
CD4 levels, Duration of treatment, HIV-AIDS, Stigma, Side effects.Abstract
AIDS which is caused by the human immunodeficiency virus (HIV), is a global health crisis, with differentiated cluster 4 (CD4) cells being the main target so that it can affect the high morbidity and mortality rates. This study aimed to determine the determinants that affect CD4 levels in people with HIV/AIDS. The study population was all people with HIV/AIDS in care, support, and treatment (CST) services in Palembang City with a sample size of 118. The sampling technique was carried out using nonrandom, namely purposive sampling. Samples were taken when respondents took antiretroviral (ARV) treatment at a health facility. The research instrument used a structured questionnaire and medical records. To measure the determinant (independent variable) was done by interview, while to determine the CD4 count using data that has been recorded in the Medical Record. The results are the length of treatment was a factor that could reduce the risk of low CD4 levels in people with HIV/AIDS, with p-value=0,006; ORAdj 0,286 (0,117-0,697), whereas stigma and treatment side effects were proven as confounding variables. Increasing the CD4 in people living with HIV/AIDS requires appropriate and regular treatment. Regular treatment with a duration of therapy of more than 1 year has been shown to prevent low CD4 cells. The higher the CD4 cell count in people living with HIV/AIDS, the greater the chance of controlling opportunistic infections, reducing transmission and premature death. People with HIV/AIDS are advised to take regular medication at available health facilities and take medication regularly.
References
Ajong, A. B., Njotang, P. N., Nghoniji, N. E., Essi, M. J., Yakum, M. N., Agbor, V. N., & Kenfack, B. (2018). Quantification and factors associated with HIV-related stigma among persons living with HIV/AIDS on antiretroviral therapy at the HIV-day care unit of the Bamenda Regional Hospital, North West Region of Cameroon. Globalization and health, 14(1), 56.
Anglaret, X., Minga, A., Gabillard, D., Ouassa, T., Messou, E., Morris, B., Traore, M., Coulibaly, A., Freedberg, K. A., & Lewden, C. (2012). AIDS and non-AIDS morbidity and mortality across the spectrum of CD4 cell counts in HIV-infected adults before starting antiretroviral therapy in Cote d’Ivoire. Clinical infectious diseases, 54(5), 714–723.
Aubert, R. D., Kamphorst, A. O., Sarkar, S., Vezys, V., Ha, S.-J., Barber, D. L., Ye, L., Sharpe, A. H., Freeman, G. J., & Ahmed, R. (2011). Antigen-specific CD4 T-cell help rescues exhausted CD8 T cells during chronic viral infection. Proceedings of the National Academy of Sciences, 108(52), 21182–21187.
Bhatti, A. B., Usman, M., & Kandi, V. (2016). Current scenario of HIV/AIDS, treatment options, and major challenges with compliance to antiretroviral therapy. Cureus, 8(3).
Campbell, C., Nair, Y., Maimane, S., & Nicholson, J. (2007). Dying Twice’ A Multi-level Model of the Roots of AIDS Stigma in Two South African Communities. Journal of health psychology, 12(3), 403-416.
Edathodu, J., Ali, B., & Alrajhi, A. A. (2009). CD4 validation for the World Health Organization classification and clinical staging of HIV/AIDS in a developing country. International Journal of Infectious Diseases, 13(2), 243-246. https://doi.org/10.1016/j.ijid.2007.12.017
Famoroti, T. O., Fernandes, L., & Chima, S. C. (2013). Stigmatization of people living with HIV/AIDS by healthcare workers at a tertiary hospital in KwaZulu-Natal, South Africa: a cross-sectional descriptive study. BMC Medical Ethics, 14(1), S6. https://doi.org/10.1186/1472-6939-14-S1-S6
Gaolathe, T., Wirth, K. E., Holme, M. P., Makhema, J., Moyo, S., Chakalisa, U., Yankinda, E. K., Lei, Q., Mmalane, M., & Novitsky, V. (2016). Botswana’s progress toward achieving the 2020 UNAIDS 90-90-90 antiretroviral therapy and virological suppression goals: a population-based survey. The lancet HIV, 3(5), e221-e230.
Han, W. M., Ubolyam, S., Apornpong, T., Kerr, S. J., Hansasuta, P., Gatechompol, S., Maekanantawat, W., Ruxrungtham, K., Phanuphak, P., Ananworanich, J., & Avihingsanon, A. (2020). Characteristics of suboptimal immune response after initiating antiretroviral therapy among people living with HIV with a pre-treatment CD4 T cell count <200 cells/mm3 in Thailand. Journal of Virus Eradication, 6(3), 100005. https://doi.org/https://doi.org/10.1016/j.jve.2020.100005
Huo, H.-F., Chen, R., & Wang, X.-Y. (2016). Modelling and stability of HIV/AIDS epidemic model with treatment. Applied Mathematical Modelling, 40(13), 6550-6559. https://doi.org/https://doi.org/10.1016/j.apm.2016.01.054
Jagannath, V., Unnikrishnan, B., Hegde, S., Ramapuram, J. T., Rao, S., Achappa, B., Madi, D., & Kotian, M. S. (2011). Association of depression with social support and self-esteem among HIV positives. Asian Journal of Psychiatry, 4(4), 288-292. https://doi.org/https://doi.org/10.1016/j.ajp.2011.10.006
Jamil, K. F. (2014). Profil kadar CD4 terhadap infeksi oportunistik pada penderita human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) di RSUD dr. Zainoel Abidin Banda Aceh. Jurnal Kedokteran Syiah Kuala, 14(2), 76-80.
Joint United Nations Programme on HIV/AIDS. (2014). Fast-track: ending the AIDS epidemic by 2030. Geneva. Switzerland: UNAIDS.
Joint, U. N. (2014). Programme on HIV/AIDS. The gap report. Geneva: Joint UN Programme on HIV.
Maartens, G., Celum, C., & Lewin, S. R. (2014). HIV infection: epidemiology, pathogenesis, treatment, and prevention. The Lancet, 384(9939), 258–271.
Malaza, A., Mossong, J., Bärnighausen, T., Viljoen, J., & Newell, M.-L. (2013). Population-based CD4 counts in a rural area in South Africa with high HIV prevalence and high antiretroviral treatment coverage. PloS one, 8(7), e70126.
Mirzaei, M., Poorolajal, J., Khazaei, S., & Saatchi, M. (2013). Survival rate of AIDS disease and mortality in HIV-infected patients in Hamadan, Iran: a registry-based retrospective cohort study (1997–2011). International journal of STD & AIDS, 24(11), 859–866.
Montaner, J. S. G., Lima, V. D., Harrigan, P. R., Lourenço, L., Yip, B., Nosyk, B., Wood, E., Kerr, T., Shannon, K., & Moore, D. (2014). Expansion of HAART coverage is associated with sustained decreases in HIV/AIDS morbidity, mortality and HIV transmission: the “HIV Treatment as Prevention†experience in a Canadian setting. PloS one, 9(2), e87872.
Olem, D., Sharp, K. M., Taylor, J. M., & Johnson, M. O. (2014). Overcoming barriers to HIV treatment adherence: A brief cognitive behavioral intervention for HIV-positive adults on antiretroviral treatment. Cognitive and behavioral practice, 21(2), 206-223.
Rusconi, S. (2017). The impact of adherence to HIV/AIDS antiretroviral therapy on the development of drug resistance. Future Medicine.
Sidibé, M., Loures, L., & Samb, B. (2016). The UNAIDS 90–90–90 target: a clear choice for ending AIDS and for sustainable health and development. Journal of the International AIDS Society, 19(1).
Turan, B., Smith, W., Cohen, M. H., Wilson, T. E., Adimora, A. A., Merenstein, D., Adedimeji, A., Wentz, E. L., Foster, A. G., & Metsch, L. (2016). Mechanisms for the negative effects of internalized HIV-related stigma on antiretroviral therapy adherence in women: the mediating roles of social isolation and depression. Journal of acquired immune deficiency syndromes (1999), 72(2), 198.
Turan, B., Rice, W. S., Crockett, K. B., Johnson, M., Neilands, T. B., Ross, S. N., Kempf, M.-C., Konkle-Parker, D., Wingood, G., & Tien, P. C. (2019). Longitudinal association between internalized HIV stigma and antiretroviral therapy adherence for women living with HIV: the mediating role of depression. AIDS (London, England), 33(3), 571.
UNAIDS. (2020). HIV Prevention 2020 Road Map. https://www.unaids.org/sites/default/files/media_asset/hiv-prevention-2020-road-map_en.pdf
WHO. (2013). Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection: summary of key features and recommendations, June 2013. World Health Organization.
WHO. (2013). Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection: recommendations for a public health approach. Geneva: World Health Organization, 1-272.
WHO. (2015). Guideline on when to start antiretroviral therapy and on pre-exposure prophylaxis for HIV. World Health Organization.
WHO. (2016). Consolidated guidelines on HIV prevention, diagnosis, treatment and care for key populations. World Health Organization.
WHO. (2017). Kajian Nasional Respon HIV DI Bidang Kesehatan Republik Indonesia. https://www.who.int/docs/default-source/searo/indonesia/non-who-publications/2017-hiv-country-review-indonesia-bahasa.pdf?sfvrsn=76ccal118_2
WHO. (2020). HIV/AIDS. https://www.who.int/news-room/fact-sheets/detail/hiv-aids.
Yogani, I., Karyadi, T. H., Uyainah, A., & Koesnoe, S. (2015). Faktor-faktor yang Berhubungan dengan kenaikan CD4 pada pasien HIV yang mendapat highly active antiretroviral therapy dalam 6 bulan pertama. Jurnal penyakit dalam Indonesia, 2(4), 217-222.
Young, J., Psichogiou, M., Meyer, L., Ayayi, S., & Grabar, S. (2012). Opportunistic Infections Project Team of COHERE. CD4 cell count and the risk of AIDS or death in HIV-infected adults on combination antiretroviral therapy with a suppressed viral load: a longitudinal cohort study from COHERE. PLoS Med, 9, e1001194.
Downloads
Additional Files
Published
Issue
Section
License
Authors who publish in this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License (CC BY-SA 4.0) that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.
- Authors can enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.