Hubungan Kadar Vitamin D Terhadap Hemostasis Penderita Hiv/Aids Dengan Dan Tanpa Koinfeksi Tuberkulosis Paru Di Rsup Haji Adam Malik Medan

Abstract

Background. Low levels of vitamin D may contribute to hemostasis disorders. Vitamin D deficiency and hemostasis disorders are still frequently reported in Human Immunodeficiency Virus (HIV)/ Acquired Immunodeficiency Syndrome (AIDS) infection due to its progressiveness and complications, thus in tuberculosis (TB) coinfection in HIV/AIDS patients. Aim: to compare vitamin D level as well as prothrombin time (PT) and platelet indices and investigate any association between vitamin D and PT as well as platelet indices in HIV/AIDS patients with and without pulmonary TB coinfection treated with Efavirenz (EFV)-based Antiretroviral Therapy (ART) with and without rifampicin-based antituberculosis. Methods. This is a cross-sectional study including 70 subjects who were HIV/AIDS patients with and without pulmonary TB in Medan, North Sumatera, Indonesia between August and October 2019. The variables were 25(OH)D concentration, PT, and platelet indices. Result. About 75.7% and 89.1% of HIV/AIDS patients with and without pulmonary TB had 25(OH)D <30 ng/mL, respectively (p>0.05). There were statistically significant difference in terms of platelet count between the vitamin D insufficiency and sufficiency groups (p=0.036) and in terms of PDW between the vitamin D deficiency and insufficiency groups (p=0.020). Conclusion. Vitamin D level significantly correlated with platelet indices

Latar Belakang. Kadar vitamin D yang rendah berkontribusi terhadap gangguan hemostasis. Defisiensi vitamin D dan gangguan hemostasis masih sering dilaporkan terkait progresivitas dan komplikasi pada infeksi Human Immunodeficiency Virus (HIV)/ Acquired Immunodeficiency Syndrome (AIDS), begitu pula pada koinfeksi tuberkulosis (TB) pada pasien HIV/AIDS. Tujuan. Untuk membandingkan kadar vitamin D, Prothrombin Time (PT) dan indeks platelet serta mencari hubungan antara kadar vitamin D dengan PT dan indeks platelet pada pasien HIV/AIDS dengan dan tanpa koinfeksi TB paru yang mengonsumsi Obat Antiretroviral (ART) berbasis efavirenz (EFV) dengan dan tanpa Obat Antituberkulosis (OAT) berbasis rifampisin. Metode. Studi ini merupakan studi cross-sectional dengan 70 subjek penelitian pasien HIV/AIDS dengan dan tanpa koinfeksi TB Paru di Kota Medan, Sumatera Utara, Indonesia antara bulan Agustus dan Oktober 2019. Variabel penelitian ini yaitu kadar 25(OH)D, PT, dan indeks platelet. Hasil. Sekitar 75,9% dan 89,1% pasien HIV/AIDS dengan dan tanpa koinfeksi TB paru memiliki kadar 25(OH)D <30 ng/mL, masing-masing (p>0,05). Secara statistik tidak terdapat perbedaan kadar 25(OH)D, PT, dan indeks platelet pada kedua kelompok studi, kecuali kadar Platelet Distribution Width (PDW) (p=0,026). Terdapat perbedaan signifikan kadar platelet pada kelompok insufisiensi dan sufisiensi vitamin D (p=0,036) dan PDW pada kelompok defisiensi dan insufisiensi vitamin D (p=0,020). Kesimpulan. Kadar vitamin D signifikan berhubungan dengan indeks platelet.