Nilai Viral Load dan Cluster of Differentiation 4 (CD-4) pada Pasien Human Immunodeficiency Virus (HIV) sebagai Penanda Infeksi Menular Seksual
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Infeksi Human immunodeficiency virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) merupakan masalah utama di negara berkembang. Koinfeksi infeksi menular seksual (IMS) pada pasien HIV merupakan faktor komorbid risiko transmisi HIV dan IMS. Keberhasilan terapi dinilai dari kadar sel limfosit T CD4 dan viral load. Studi yang menghubungkan jumlah sel CD4, viral load dan angka kejadian IMS pada pasien HIV/AIDS hingga kini hanya sedikit dan hasil bervariasi. Penelitian ini bertujuan untuk mengevaluasi nilai CD4 dan viral load pada pasien HIV/AIDS di RSUD dr. Moewardi dengan angka kejadian IMS. Penelitian retrospektif menggunakan data sekunder rekam medik klinik Voluntary Conseling and Testing (VCT) RSUD dr. Moewardi periode Januari 2022 – Desember 2024. Diagnosis IMS ditegakkan berdasarkan pendekatan sindrom. Data CD4 pasien IMS dengan HIV/AIDS dicatat untuk diolah secara statistik menggunakan SPSS versi 26. Data numerik dilakukan uji normalitas menggunakan uji kolmogorov-smirnov (p>0.05). Data yang terdistribusi normal dilakukan uji t tidak berpasangan, data yang tidak terdistribusi normal dilanjutkan uji mann-whitney, data kategorik menggunakan uji chi-square dengan signifikansi p<0,05. Data CD4 kemudian dinilai untuk melihat sensitivitas, spesifisitas dan nilai cut-off. Kasus pasien HIV dengan IMS didominasi laki-laki dengan rerata usia 33,94 tahun. Analisis statistik menunjukkan jenis kelamin (p=<0.001), Pekerjaan (p=0.018) usia (p<0.001), dan lama ARV (p=0.037), sedangkan tingkat pendidikan (p=0.448) dan viral load (p=0.417). Hasil pemeriksaan CD4 (p=0.027) mendapatkan nilai p<0.05, AUC untuk CD 4 sebesar 0.648 dengan nilai p=0.030, cut-off 459,5, sensitivitas 66,7% dan spesifisitas 62,5%, OR=3,33 dan p=0,013. Terdapat hubungan antara kadar CD4 dengan kejadian IMS pada pasien HIV dengan sensitifitas sebesar 66,7%, spesifisitas 62,5% dan nilai cut-off 459,5, pasien HIV dengan CD4 <459,5 berpeluang risiko terjadi IMS sebesar 3,33 kali dibandingkan dengan pasien HIV yang memiliki CD 4 ≥459,5 (OR=3,33; p=0,013).
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