Vol. 34 No. 4 September 2017
PERBEDAAN RERATA LIMFOSIT CD4 PADA PENDERITA HIV DENGAN DAN TANPA GANGGUAN MEMORI VERBAL
Ketut Widyastuti,* Ni Made Susilawathi,** I Made Susila Utama,*** Anak Agung Ayu Putri Laksmidewi**
DIFFERENCES IN MEAN CD4 LYMPHOCYTES OF HIV PATIENTS WITH AND WITHOUT VERBAL MEMORY IMPAIRMENT
ABSTRACT
Introduction: Neurocognitive complications in Human Immunodeficiency Virus (HIV) patients are approximately 51% with the most cognitive domains impaired is memory (63%). Verbal memory impairment in patients with HIV is still found active antiretroviral therapy (ARV) that it can increase the levels of lymphocytes cluster of differentiation 4 (CD4) has widely used. Immune suppression shown in CD4 level is a strong determinant for cognitive impairment.
Aims: To evaluate the differences in mean CD4 lymphocytes on HIV patients with and without verbal memory impairment.
Methods: This is an analytic observational cross sectional study on HIV patients of VCT outpatient clinic at Sanglah Hospital, Denpasar, during June until August 2016. The subjects were divided into 2 groups based on Rey Auditory Verbal Learning Test (RAVLT) as HIV patients with and without verbal memory impairment. Blood serum were taken to check the CD4 and MoCA-Ina was done to examine the cognitive impairment. Bivariate analysis using unpaired t test with significance level of p<0.05.
Results: There were 42 subjects, 21 for each group, mostly male between 17-34 years old. The mean number of CD4 lymphocytes were statistically significant between groups of HIV patients with and without impaired verbal memory on learning, immediate recall, delayed recall and recognition process. CD4 lymphocytes of HIV patients with verbal memory impairment lower than HIV patients without verbal memory impairment.
Discussion: There were significant difference of mean of CD4 lymphocytes between subject with and without verbal memory impairment. Subject with verbal memory impairment have lower CD4 level.
Keywords: CD4 lymphocytes, memory impairment, Rey Auditory-Verbal Learning Test
ABSTRAK
Pendahuluan: Komplikasi neurokognitif pada penderita human immunodeficiency virus (HIV) didapatkan sebesar 51% dengan domain kognitif yang paling sering terganggu adalah memori (63%). Gangguan memori verbal pada penderita HIV tetap ditemukan meskipun sudah digunakan terapi antiretroviral (ARV) untuk meningkatkan kadar limfosit cluster of differentiation 4 (CD4). Beratnya supresi imun yang dilihat dari rendahnya angka limfosit CD4 merupakan determinan kuat terjadinya penurunan fungsi kognitif.
Tujuan: Mengetahui perbedaan rerata angka limfosit CD4 pada penderita HIV dengan dan tanpa gangguan memori verbal.
Metode: Penelitian analitik observasional dengan metode potong lintang terhadap penderita HIV yang rawat jalan di Poliklinik Voluntary Counseling and Testing (VCT) RSUP Sanglah, Denpasar, periode Juni hingga Agustus 2016. Sub- jek dibagi menjadi 2 kelompok berdasarkan hasil pemeriksaan Rey Auditory Verbal Learning Test (RAVLT) yaitu subjek dengan dan tanpa gangguan memori verbal. Dilakukan pemeriksaan kadar CD4 serum dan penilaian gangguan kognitif menggunakan MoCa-Ina. Analisis bivariat menggunakan uji t tidak berpasangan dengan tingkat kemaknaan p<0,05.
Hasil: Didapatkan 42 subjek yang masing-masing terdiri dari 21 subjek pada kedua kelompok, mayoritas laki-laki berusia 17-34 tahun. Terdapat perbedaan rerata angka limfosit CD4 yang bermakna antara subjek yang mengalami ganggu- an memori verbal dan yang tidak mengalami gangguan memori verbal pada berbagai proses memori, antara lain learning, immediate recall, delayed recall, dan recognition. Limfosit CD4 subjek dengan gangguan memori verbal juga lebih rendah dibandingkan yang tanpa gangguan memori verbal.
Diskusi: Terdapat perbedaan rerata angka limfosit CD4 yang bermakna antara subjek yang mengalami gangguan memori verbal dan yang tidak mengalami gangguan. Kadar CD4 subjek dengan gangguan memori verbal lebih rendah dibandingkan yang tanpa gangguan memori verbal.
Kata kunci: Limfosit CD4, gangguan memori, Rey Auditory-Verbal Learning Test---------------------------------------------------
*Program Studi Doktoral Ilmu Kedokteran FK Universitas Udayana, Denpasar; **Bagian Neurologi FK Universitas Udayana RSUP Sanglah, Denpasar; ***Bagian Penyakit Dalam FK Universitas Udayana RSUP Sanglah, Denpasar.
Korespondensi: kt_widyastuti@ unud.ac.id
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Vol. 34 No. 4 September 2017 |
Terakreditasi DIKTI Nomor: 12/M/Kp/II/15
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