Hubungan Waktu Inisiasi Antiretroviral dengan Luaran Klinis Pasien Ensefalitis Toksoplasma dengan HIV yang Mendapatkan Terapi Toksoplasma di Rumah Sakit Adam Malik Medan

Abstract

Background: Toxoplasma encephalitis (TE) is the most common opportunistic infection in patients with HIV/AIDS, especially in individuals with low CD4 counts. The timing of antiretroviral therapy (ARV) initiation in patients with opportunistic infections such as TE is still debated. Although early ARV initiation can improve immunity and reduce viral replication, it can also increase the risk of immune reconstruction inflammatory syndrome (IRIS). Objective: This study aims to evaluate the relationship between the timing of antiretroviral therapy (ARV) initiation and clinical outcomes in TE patients at Haji Adam Malik General Hospital, Medan. Methods: This study examined clinical outcomes using the Glasgow Outcome Scale (GOS) as a measure of neurological conditions in patients after treatment. Data were collected from TE patients with HIV who received toxoplasmosis therapy, then a comparative analysis of clinical outcomes was performed between early and delayed ARV initiation groups. Results: A significant relationship between the timing of antiretroviral initiation and clinical outcomes in toxoplasma encephalitis patients (p=0.002). There is a relationship between the two variables where the faster the timing of antiretroviral (ARV) administration, the better the clinical outcomes in toxoplasma encephalitis patients as measured using the Glasgow Outcome Scale (GOS). Keywords: Toxoplasma Encephalitis, HIV/AIDS, Antiretroviral Therapy, Early Initiation, Clinical Outcome, Glasgow Outcome Scale