Hubungan Antara Kadar Cluster Differentiation 4 (CD4) dan Viral Load dengan Manifestasi Okular pada Anak dengan Human Immunodeficiency Virus (HIV) yang Mendapatkan Terapi Antiretroviral (ARV)

Abstract

Background: Children infected with Human Immunodeficiency Virus (HIV) have exceptionally higher morbidity and mortality compared to adults. Nowadays the incidence are increasing rapidly in children throughout the world, in developing countries including Indonesia. It is the fourth cause of death and severe systemic complications in children. Ocular involvement in children differs from in adults. Objective: To determine the relationship between Cluster Differentiation 4 (CD4) and Viral Load (VL) with ocular manifestations among HIV possitive children who received antiretrovital therapy. Methods: A cross sectional study was done on 25 HIV possitive children at Yayasan Medan Plus, on December 2023. The data were collected not only by interview, anterior and posterior segment examinations but also Schirmer test and laboratory investigation from medical record no longer than 6 months ago. Results: A total of 25 children were retained for the study. The population consisted of 14 boys (56%), and 11 girls (44%). The mean age was 11,64 years. And 88% of children had normal immune status. The average duration of ARV was 9,56 years with 60% of the children on treatment for 5 to 10 years. The main eye complaints were blurred vision (24%), red eye and pruritus (16%), and watery eye (4%). None experienced dry eyes. The frequency of anterior segment was conjunctivitis 6%, blepharitis 8% and corneal cicatrix 4% and posterior segment was tigroid fundus and nasalization 4%, and retinal detachment 2%. The median VL value with ocular manifestations was 112 copies/mL and the median CD4 level was 885,5 cells/mm3. Conclusion: There was statistical significant between viral load and ocular manifestations, but no in CD4 count.