JUMLAH CD4+ ABSOLUT IBU HAMIL YANG TERINFEKSI HUMAN IMMUNODEFICIENCY VIRUS PADA TRIMESTER III LEBIH RENDAH DIBANDINGKAN SAAT PASCA-PERSALINAN

Abstract

Human immunodeficiency virus (HIV) merupakan penyakit infeksi yang hingga saat ini masihmemiliki insidens yang cukup tinggi dikalangan wanita hamil. Wanita hamil yang terinfeksi HIVakan lebih rentan mengalami kematian langsung maupun kematian obstetric seperti perdarahan postpartum,sepsis puerpuralisdan komplikasi dari sectiocaesaria.Kematian yang disebabkan oleh karenaAIDSbisa terjadi secara langsung saat kehamilan maupun sebagai penyebab tidak langsung akibatdariinfeksi opportunistik. Penelitian ini bertujuan untuk membuktikan bahwa jumlah clusterofdiffrentiation+ (CD4+) absolut ibu hamil yang terinfeksi HIV saat trimester III lebih rendah dari padasaatpasca-persalinan. Metode penelitian ini adalah studi longitudinaldi Poliklinik PMTCT KebidanandanKandungan Rumah Sakit Umum Pusat (RSUP) Sanglah, Denpasar yang dilakukan mulai bulanAgustus2011 hingga Desember 2013 dengan sampel penelitian sebanyak 20 pasien. Sampel adalahibuhamil terinfeksi HIV saat trimester III. Kemudian dilakukan perhitungan kadar CD4+ absolut,dandilakukan pengukuran CD4+ absolut kembali saat 7 hari pasca-persalinan. Analisis data dilakukandenganuji t-paireddenganbantuan SPSSfor windows 17.0 versiondengan batas kemaknaan (P)<0,05.Ujit-pairedsaattrimester III mendapatkan rerata jumlah CD4+ absolut sebesar 357,90 (SB 238,81)dandibandingkan dengan saat 7 hari pasca-persalinan dengan rerata jumlah CD4+ absolut sebesar421,50(SB 213,57) [beda rerata -63,60 (IK 95% -122,8 sampai -4,4), P= 0,037]. Disimpulkan bahwajumlahCD4+ absolut pada wanita hamil terinfeksi HIV saat hamil trimester III lebih rendahdibandingkansaat pasca-persalinan. [MEDICINA2015;46:166-9].

Human immunodeficiency virus (HIV) is an infectious disease that still have high incidence amongpregnancy women. Pregnancy women with HIV infection are more vulnerable to direct mortality eitherobstetric mortality such as haemoragic post-parturition, septic puerpuralis and caesarean sectioncomplication. Mortality due to AIDS could become direct cause due to obstetric complication or indirectcause due to opportunistic infection. The aim of this study was to prove that CD4+ absolute level inpregnancy infected by HIV in third trimester is lower than on post-parturition. The study method waslongitudinal study that conducted in PMTCT Clinic Obstetrics and Gynecology, Sanglah Hospital,Denpasar, which was taken from August 2011 to December 2013 with a sample of 20 patients. Sampleswere pregnant women infected with HIV during the third trimester. Then calculate the absolute levelsof CD4 + and the measurements of CD4 + absolute were repeated at 7 days post-parturition. Dataanalysis was wearing paired t-test using SPSS for windows version 17.0 with significance value (P)<0.05.Analysis result showed that mean CD4+ absolute levels that were obtained on third trimester was357.90 (SD 238.81) and compared with the 7 days after delivery was 421.50 (SD 213.57) with meandifferences -63.60 (95% CI -122.8 to -4.4), P= 0.037. It was concluded that CD4+ absolute levels inpregnant women with HIV during the third trimester of pregnancy is lower than on post-parturition.[MEDICINA 2015;46:166-9].