ANEMIA, NUMBER OF T CD4 LYMPHOCYTE, OPPORTUNISTIC INFECTIONS AS MORTALITY PREDICTOR FACTORS IN PATIENTS INFECTED OF HUMAN IMMUNODEFICIENCY VIRUS (HIV) IN HAJI ADAM MALIK GENERAL HOSPITAL MEDAN

Abstract

Introduction: HIV (Human Immunodeficiency Virus) infection or commonly called AIDS (Acquired Immunodeficiency Syndrome) is currently one of the biggest health problem in the world. Anemia is one of the most frequent hematological complications in people with HIV infection which one of the anemia biomarker is Hb. HIV causes person’s ability to figth infection decreases by decreasing levels of CD4 T lymphocytes that are responsible for one's immune response to fight infectious pathogens. A state of ongoing immunodeficiency will be related to the entry of various opportunistic infections that the risk of death will increase. The simple/economic examination of Hb level and examination of CD4 count are compulsory tests before starting ARV therapy and monitoring therapy that makes researchers are interested in examining anemia, CD4 T lymphocyte counts,opportunistic infections as predictors factor of mortality in HIV-infected patients in RSUP HAM Medan.

Aim: To determine anemia, CD4 T lymphocyte counts, opportunistic infections as predictors of mortality in patients infected with HIV (Human Immunodeficiency Virus) treated at RSUP HAM Medan.

Method: This retrospective cohort study was conducted on 100 adult patients diagnosed with HIV who were treated in the integrated ward of RSUP HAM Medan from January 2018 to December 2018. Patients were divided into two groups based on the status of the patient's outcome ie the living group (outpatients / outpatients / PBJ) and the group were edited (edited during their stay).

Result: Out of 100 HIV patients with 50 survivors and 50 receiving, 4 variables were associated with patient outcomes, namely: CD4 <200 (p: 0.001), anemia status (p: 0.006), PCP (p: 0.012 ) and TE (p: 0.046). TE is a dominant risk factor for mortality [p: 0.061 OR: 3.25: 95% IK (0.945-11.190).

Conclusion: The dominant risk factor for mortality was Toxoplasmosis Encephalopathy (TE) where HIV-infected patients with TE coinfection were at 3.25 times the risk of patient mortality [p: 0.061 OR: 3.25; 95% IK (0.945 - 11,190)].