Efektivitas Terapi Antiretroviral pada Ibu Hamil Penderita Human Immunodeficiency Virus (HIV) di Kota Jayapura Periode 2021 – 2023

Wanggai, Xena Alysia (2024) Efektivitas Terapi Antiretroviral pada Ibu Hamil Penderita Human Immunodeficiency Virus (HIV) di Kota Jayapura Periode 2021 – 2023. S1 thesis, Universitas Kristen Indonesia.

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Abstract

Latar Belakang: Human Immunodeficiency Virus (HIV) adalah retrovirus golongan ribonucleic acid (RNA) yang menyerang sistem kekebalan tubuh manusia secara spesifik. Provinsi Papua menjadi salah satu dari lima provinsi dengan kasus HIV/AIDS tertinggi di Indonesia. Mayoritas kasus HIV/AIDS terjadi pada wanita dan risiko penularan dari ibu ke anak menempati posisi ketiga terbanyak di Provinsi Papua. Tanpa terapi antiretroviral (ART), risiko penularan ibu ke anak sebesar 20 – 50%. Tujuan penelitian: untuk mengetahui mengetahui efektifitas terapi antiretroviral pada ibu hamil penderita Human Immunodeficiency Virus (HIV) di Kota Jayapura. Metode: Metode penelitian analitik cross sectional dengan pengumpulan data secara retrospektif, yaitu data sekunder yang diperoleh dari pencatatan dan pelaporan Dinas Kesehatan Kota Jayapura pada tiga Rumah Sakit dan tiga belas Puskesmas di wilayah Kota Jayapura periode 1 Januari 2021 – 31 Desember 2023. Sampel dalam penelitian ini adalah semua ibu hamil penderita HIV yang mendapat terapi antiretroviral dan bersalin di Kota Jayapura dalam rentang periode 1 Januari 2021 – 31 Desember 2023 diambil dengan menggunakan teknik purposive sampling. Uji statistik yang digunakan adalah uji Pearson Chi-Squaere dan Paired T-Test. Hasil: Total 170 ibu hamil penderita HIV, 72 di antaranya mendapat terapi antiretroviral dan bersalin di Kota Jayapura didapatkan usia 21-35 tahun (77,8%), primipara (79%), underweight (69,4%) kasus terbanyak; hubungan antara durasi minum ARV sebelum hamil dengan luaran bayi (p-Value -); hubungan antara durasi minum ARV saat hamil dengan luaran bayi (p-Value 0,008); hubungan antara durasi minum ARV sebelum hamil dengan kadar viral load ibu sebelum dan sesudah menjalani ART (p-Value 0,046); hubungan antara durasi minum ARV saat hamil dengan kadar viral load ibu sebelum dan sesudah menjalani ART (p-Value 0,156). Kesimpulan: Tidak ditemukan infeksi vertikal pada bayi dari kelompok ibu hamil yang telah mendapatkan ART sebelum kehamilan. Kejadian infeksi vertikal pada kelompok ibu yang mendapatkan ART pada trimester III lebih tinggi dibandingkan trimester I dan II. Ditemukan adanya hubungan signifikan antara kadar VL sebelum terapi dan sesudah terapi pada kelompok ibu yang menjalani ART sebelum kehamilan. Tidak ditemukan adanya hubungan signifikan antara kadar VL sebelum dan sesudah terapi pada ibu hamil yang baru memulai ART selama kehamilan. / Background: Human Immunodeficiency Virus (HIV) is a retrovirus classified as ribonucleic acid (RNA) that specifically attacks the human immune system. Papua Province ranks as one of the top five provinces with the highest HIV/AIDS cases in Indonesia. The majority of HIV/AIDS cases occur in women, with mother-to-child transmission being the third most common transmission route in Papua Province. Without antiretroviral therapy (ART), the risk of mother-to-child transmission ranges from 20% to 50%. Objective: To evaluate the effectiveness of antiretroviral therapy in pregnant women with Human Immunodeficiency Virus (HIV) in Jayapura City. Methods: This study used an analytical cross-sectional design with retrospective data collection. Secondary data were obtained from records and reports from the Jayapura City Health Office across three hospitals and thirteen primary health centers (Puskesmas) in Jayapura City between January 1, 2021, and December 31, 2023. The study sample consisted of all HIV-positive pregnant women who received antiretroviral therapy and gave birth in Jayapura City during this period. Samples were selected using purposive sampling. Statistical analyses were performed using Pearson Chi-Square and Paired T-Test. Results: Out of 170 HIV-positive pregnant women, 72 received antiretroviral therapy and delivered in Jayapura City. The majority were aged 21–35 years (77.8%), primiparous (79%), and underweight (69.4%). The analysis revealed the following: The relationship between the duration of ART use before pregnancy and neonatal outcomes (p-Value: -). The relationship between the duration of ART use during pregnancy and neonatal outcomes (p-Value: 0.008). The relationship between the duration of ART use before pregnancy and maternal viral load before and after therapy (p-Value: 0.046). The relationship between the duration of ART use during pregnancy and maternal viral load before and after therapy (p-Value: 0.156). Conclusion: No vertical transmission was observed in the group of mothers who received ART before pregnancy. The incidence of vertical transmission was higher in mothers who initiated ART in the third trimester compared to the first and second trimesters. A significant relationship was found between maternal viral load before and after therapy in mothers who received ART prior to pregnancy. However, no significant relationship was observed in mothers who started ART during pregnancy.

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