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Indonesian Journal of Critical and Emergency Medicine Vol 1 No.2 June-August 2014 / ISSN : 2355-4584

Clinical Profile of Extrapulmonary Tuberculosis Among TB-HIV Patients in Cipto Mangunkusumo Hospital


Gurmeet Singh
Anna Uyainah, Evy Yunihastuti, Darma Imran

ABSTRACT
Background:
In view of increase in incidence of EPTB after the epidemic of human immunodeficiency (HIV) virus infection, the clinical profile of EPTB in patients with HIV infection was studied.
Objective: To obtain the profile and to assess the distribution of EPTB in TB-HIV patients.
Methods: We conducted a descriptive cross-sectional study by browsing through the medical records of TB-HIV patients who received treatment in HIV referral center (POKDISUS) Cipto Mangunkusumo Hospital between July 2008-December 2010. Ethical clearance was obtained from the ethical committee of Faculty Medicine, Universitas
Indonesia and written on approval letter 135/PT02.FK/ETIK2010.
Results: EPTB prevalence was 32,95%. Overall, medical record of 522 HIV-positive TB patients were evaluated. The majority of the patients were males (84.3%), 18-40 years age group (91.9%), finished mid-level education (77.3%), and 31.4% belonged to Batavian ethnic group. Intravenous drug use were found to be the main transmission risk
factor, representing 60.5% of the subjects. Prolonged fever (63.4%) was the most common clinical manifestation. Negative Acid Fast Baciili (AFB) smears were found in 34.9% of the subjects, while CD4+ counts of <50 cells/μL was found in 34.9% of the subjects. The most frequent site of extrapulmonary TB was peripheral lymph node (18,0%).
Conclusion: Our study therefore gives some perspective of EPTB and HIV coinfection in Indonesia thereby setting a platform for more studies. Furthermore, our findings might help reinforce the need for integrated management of HIV and TB in Indonesia, which is mandatory for the global fight against TB.
Key words: Extrapulmonary Tuberculosis, HIV
 

ABSTRAK
Latar Belakang:
Dikarenakan terjadinya peningkatan insidensi tuberkulosis ekstra paru pasca epidemi infeksi human immunodeficiency virus (HIV), diperlukan penelitian mengenai profil klinis tuberkulosis ekstra paru (EPTB) pada pasien dengan infeksi HIV.
Tujuan: Untuk memperoleh profil dan menilai distribusi tuberkulosis ekstra paru pasien TB-HIV.
Metode: Studi merupakan penelitian potong lintang deskriptif dengan mempelajari rekam medis pasien TB-HIV di pusat rujukan HIV (POKDISUS) Rumah Sakit Cipto Mangunkusumo antara Juli 2008-Desember 2010. Lolos kaji etik diperoleh dari komite etik Fakultas Kedokteran, Universitas Indonesia dengan surat persetujuan nomor 135/
PT02.FK/ETIK2010.
Hasil: Prevalensi EPTB sebesar 32,95%. Mayoritas terdiri dari laki-laki (84,3%), usia 18-40 (91,9%), menyelesaikan pendidikan tingkat menengah (77,3%), dan 31,4% kelompok etnis Betawi. Penggunaan obat narkotika intravena menjadi faktor risiko transmisi utama (60,5%). Demam berkepanjangan (63,4%) menjadi manifestasi klinis yang paling sering ditemui. Apusan basil tahan asam (BTA) negatif ditemukan pada 34,9%, jumlah CD4 <50 sel/ul ditemukan pada 34,9% dari subyek. Lokasi terbanyak tuberkulosis ekstra paru adalah limfadenopati perifer (18,0%).
Kesimpulan: Penelitian in memberikan perspektif terhadap TB ekstra paru dan koinfeksi HIV di Indonesia, sehingga membuka peluang untuk penelitian lainnya. Selanjutnya, penelitian ini dapat membantu meningkatkan kebutuhan terhadap manajemen terintegrasi pada HIV dan TB di Indonesia, yang diperlukan untuk melawan TB
secara global.
Kata kunci: Tuberkulosisi ekstra paru, HIV


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