Ko-Infeksi Tuberkulosis dan HIV pada Anak

Retno Widyaningsih, Amar Widhiani, Endah Citraresmi

Sari


Latar belakang.Tuberkulosis (TB) adalah infeksi oportunistik yang sering menjadi ko-infeksi HIV. Diagnosis
dan manajemen TB anak menimbulkan tantangan substansial dalam era epidemi HIV. Diagnosis TB pada
anak semakin dipersulit oleh adanya ko-infeksi HIV.
Tujuan penelitian.Penelitian ini bertujuan untuk mengetahui karakteristik TB pada anak dengan infeksi
HIV di RSAB Harapan Kita Jakarta.
Metode.Penelitian ini menggunakan desain potong lintang. Data berasal dari rekam medis pasien HIVTB di RSAB Harapan Kita tahun 2002-2010. Kriteria inklusi adalah anak yang berumur 0-12 tahun, HIV
positif dan menderita penyakit TB. Data meliputi faktor risiko infeksi dan sakit TB yaitu umur, parut BCG,
kontak dengan penderita TB, status gizi, dan status imunitas HIV. Data lain yang dicatat yaitu gejala klinis
HIV dan gejala klinis TB, pemeriksaan laboratorium, foto Rontgen toraks, pengobatan serta outcome.
Hasil.Sebanyak 50 anak terdiagnosis infeksi HIV. Dua puluh tujuh anak (54%) menderita penyakit TB,
dengan kelompok umur terbanyak usia 1-4 tahun (48%). Dari 27 anak TB-HIV, 20 anak mempunyai status
imunitas supresi berat dan 18 anak kategori C. Dua puluh anak menderita TB paru, 3 anak TB milier, 2 anak
limfadenitis TB, 1 anak TB diseminata, dan 1 anak perikarditis TB. Lima belas anak mendapat pengobatan
TB secara lengkap, 4 anak meninggal dunia, dengan penyebab kematian 1 orang karena pneumonia berat
tersangka PCP dan 3 orang tersangka sepsis.
Kesimpulan.Diagnosis TB paru ditemukan sebesar 54% pada penderita HIV, sehingga skrining rutin TB
harus menjadi bagian penting dari diagnostik hasil pemeriksaan HIV.


Kata Kunci


HIV; TB; anak

Teks Lengkap:

PDF

Referensi


Chintu C, Mudenda V, Lucas S. Lung diseases at

necropsy in African children dying from respiratory

illnesses: a descriptive necropsy study. Lancet 2002;

:985–90.

Palme IB, Gudetta B, Bruchfeld J, Muhe L, Giesecke J.

Impact of human immunodeficiency virus 1 infection on

clinical presentation, treatment outcome and survival in

a cohort of Ethiopian children with tuberculosis. Pediatr

Infect Dis J 2002; 21:1053–61.

Jeena PM, Pillay P, Pillay T, Coovadia HM. Impact of

HIV-1 coinfection on presentation and hospital-related

mortality in children with culture proven pulmonary

tuberculosis in Durban, South Africa. Int J Tuberc Lung

Dis 2002; 6:672–8.

Madhi SA, Petersen K, Madhi A, Khoosal M, Klugman

KP. Increased disease burden and antibiotic resistance

of bacteria causing severe community-acquired lower

respiratory tract infections in human immunodeficiency

virus type 1–infected children. Clin Infect Dis 2000;

:170–6.

Nastiti N Rahajoe, Darfioes Basir, Makmuri MS, Cissy

B Kartasasmita. Tuberkulosis dengan HIV. Pedoman

Nasional Tuberkulosis Anak Edisi-2 dengan Revisi, UKK

Pulmonologi PP IDAI, September 2008.

Chifumbe C. Tuberculosis and human immunodeficiency

virus co-infection in children: management challenges.

Pediatric Respiratory Reviews 2007; 8:142-7.

Van Rie A, Beyers N, Gie RP, Kunneke M, Zietsman

L, Donald PR.Childhood tuberculosis in an urban

population in South Africa: burdenand risk factor. Arch

Dis Child 1999; 80: 433–437.

Kabra SK, Lodha R, Seth V. Some current concepts on

childhood tuberculosis. Indian J Med Res 2004; 120:

–97.

World Health Organization Global Programme

on AIDS. Current and future dimensions of HIV/

AIDS Pandemic. A Capsule Summary Document.

GPA/RES/SF/92.1 1992a. Geneva: World Health

Organization.

Ahmed Y, Mwaba P, Chintu C, Grange JM, Ustianowski A,

Zumla A. A study of maternal mortality at the University

Teaching Hospital, Lusaka, Zambia: the emergency of

tuberculosis as a major nonobstetric cause of maternal

death. Int J Tuberc Lung Dis 1999; 3:675–80.

Pillay T, Khan M, Moodley J, Adhikari M, Coovadia

H. Perinatal tuberculosis and HIV-1: considerations

for resource-limited settings. Lancet Infect Dis 2004; 4:155–65.

Katumba-Lunyenya J, Joss V, Latham P, Abbatnan C.

Pulmonary tuberculosis and extreme prematurity. Arch

Dis Child Fetal Neonatal Ed 2005; 90: F179-83.

Hecht R, Alban A, Taylor K, Post S, Andersen BN,

Schwarz R. Putting it together: AIDS and the Millennium

Development Goals. PLoS Med 2006; 3: e455.

World Health Organization (WHO). Global Tuberculosis

Control Surveillance, planning, financing: WHO Report

WHO/HTM/TB/2006.362. Genewa: WHO,

Elizabeth LC, Catherine JW, Neff W, Dermot M,

Brian G. W, Mario C. Raviglione, Christopher D. The

Growing Burden of Tuberculosis, Global Trends and

Interactions With the HIV Epidemic. Arch Intern

Med 2003;163:1009-21.

M’Pemba LLAB, Mabiala B, Bantsimba T, Nzingoula S.

Tuberculosis and HIV/AIDS co-infection in children:

experience carried out in paediatric service of the teaching

hospital of Brazzaville, Republic of Congo (1995-2004).

Bull Soc Pathol Exot 2007;100:51-2.

Akib AAP. Infeksi HIV pada Bayi dan Anak. Sari Pediatri

; (Suplement); 1-14.

Dermot M, Anthony H, Haileyesus G. Tuberculosis

and HIV interaction in sub-Saharan Africa: impact on

patients and programmes; implications for policies.

Tropical Medicine and International Health volume 10

no 8 pp 734–742 august 2005.

Schaaf HS, Cotton MF. The diagnosis and management

of tuberculosis in HIV-infected children. The Southern

African Journal of Epidemiology and Infection 2006;

:9-13.

B. J. Marais, S. M. Graham, M. F. Cotton, and N. Beyers.

Diagnostic and Management Challenges for Childhood

Tuberculosis in the Era of HIV. The Journal of Infectious

Diseases 2007; 196:S76–85

B.J. Marais, H. Rabie, M.F. Cotton. Mini-symposium:

Childhood TB in 2010. TB and HIV in children –

advances in prevention and management. Paediatric

Respiratory Reviews 2011;12: 39–45.

S.K. Sharma and A. Mohan. Co-infection of Human

Immunodeficiency Virus(HIV) and Tuberculosis: Indian

Perspective. Indian J Tuberc 2004; 51:5-16.

Hesseling AC, Werschkul H, Westra A. The clinical

features and outcome of confirmed tuberculosis in

HIV-infected children. Int J Tuberc Lung Dis 2002;

(Suppl 1): S181.

Rheenen P. The use of paediatric tuberculosis score

chart in an HIV-endemic area. Tropical Medicine and

International Health,2002: 435-41.




DOI: http://dx.doi.org/10.14238/sp13.1.2011.55-61

Refbacks

  • Saat ini tidak ada refbacks.


##submission.copyrightStatement##

##submission.license.cc.by-nc-sa4.footer##

Informasi Editorial:
Badan Penerbit Ikatan Dokter Anak Indonesia
Jl. Salemba I No 5, Jakarta 10430, Indonesia
Phone/Fax: +62-21-3912577
Email: editorial [at] saripediatri.org

Lisensi Creative Commons
Sari Pediatri diterbitkan oleh Badan Penerbit Ikatan Dokter Anak Indonesia
Ciptaan disebarluaskan di bawah Lisensi Creative Commons Atribusi-NonKomersial-BerbagiSerupa 4.0 Internasional.