Gangguan fungsi kognitif pada pasien HIV/AIDS di layanan rawat jalan RSCM dan faktor yang memengaruhinya
DOI:
https://doi.org/10.25170/djm.v24i3.6647Keywords:
terapi antiretroviral, gangguan kognitif, HIV, meningitis, depresiAbstract
Pendahuluan: Kemajuan teknologi medis dan akses yang lebih luas terhadap terapi antiretroviral (ART) telah meningkatkan angka harapan hidup orang dengan HIV. Namun, gangguan neurokognitif masih sering ditemukan dan dapat berdampak negatif terhadap kualitas hidup. Penelitian ini bertujuan untuk mengidentifikasi faktor-faktor yang berhubungan dengan penurunan fungsi kognitif pada pasien HIV/AIDS di Rumah Sakit Cipto Mangunkusumo (RSCM).
Metode: Penelitian potong lintang dilakukan pada Mei 2022 hingga Januari 2024 di RSCM. Subjek penelitian adalah pasien HIV berusia 18–59 tahun, berbahasa Indonesia, dan sedang menjalani ART. Pasien dengan gangguan fisik atau mental berat dikecualikan. Sebanyak 121 subjek direkrut menggunakan metode pengambilan sampel acak sederhana. Data yang dikumpulkan meliputi karakteristik demografis, komorbiditas fisik, kondisi kesehatan mental, penggunaan zat, waktu inisiasi ART, durasi infeksi HIV, durasi penggunaan ART, kepatuhan pengobatan, dan dukungan sosial. Fungsi kognitif dinilai menggunakan Montreal Cognitive Assessment versi Indonesia (MoCA-INA). Analisis regresi linear dilakukan untuk mengidentifikasi faktor yang berhubungan dengan gangguan kognitif.
Hasil: Rerata usia subjek adalah 40,25 ± 8,42 tahun dan mayoritas berjenis kelamin laki-laki. Prevalensi gangguan kognitif sebesar 55,4%. Pada analisis multivariat, keterlambatan inisiasi ART dan riwayat meningitis berhubungan secara signifikan dengan penurunan skor MoCA-INA. Setiap keterlambatan satu tahun inisiasi ART berhubungan dengan penurunan skor MoCA-INA sebesar 0,3 poin (p<0,05), sedangkan riwayat meningitis berhubungan dengan penurunan skor sebesar 2,63 poin (p<0,05).
Simpulan: Keterlambatan inisiasi ART dan riwayat meningitis berhubungan dengan penurunan fungsi kognitif pada pasien HIV. Inisiasi ART sedini mungkin dan penapisan kognitif secara berkala perlu ditekankan untuk meningkatkan luaran jangka panjang.
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