Profil Penggunaan Obat-Antituberkulosis dan Anti-Retroviral pada Pasien Tuberkulosis-HIV Periode 2024-2025

Authors

  • Dinda Shafa Nabila Prodi Farmasi, Fakultas Farmasi dan Sains, Universitas Islam Bandung, Indonesia
  • Bambang Tri Laksono Prodi Farmasi, Fakultas Farmasi dan Sains, Universitas Islam Bandung, Indonesia
  • Umi Yuniarni Prodi Farmasi, Fakultas Farmasi dan Sains, Universitas Islam Bandung, Indonesia

DOI:

https://doi.org/10.29313/bcsp.v6i2.25723

Keywords:

Tuberkulosis, HIV, Profil pengobatan

Abstract

Abstract. Tuberculosis (TB) is an opportunistic infection that frequently occurs in patients with Human Immunodeficiency Virus (HIV), requiring concurrent treatment with antituberculosis drugs (OAT) and antiretroviral drugs (ARV). This study aims to describe the characteristics of patients as well as the usage profiles of OAT, ARVs, and supportive medications among TB-HIV patients at Hospital X during the 2024–2025 period. The study employed a descriptive observational method with a retrospective approach based on medical record data. The sample was obtained using total sampling and included 75 patients who met the study criteria. Descriptive analysis was performed using frequency distributions and percentages. The results showed that the majority of patients were male (73.33%), aged 18–59 years (98.67%), and had extrapulmonary TB (61.33%). All patients received fixed-dose combination anti-tuberculosis therapy (2RHZE/4RH). The most commonly used ARV regimen was Tenofovir/Lamivudine/Efavirenz (TLE) (65.33%), followed by Tenofovir/Lamivudine/Dolutegravir (TLD) (29.33%). The most frequently administered adjunctive medications were vitamin B6 (74.67%) and co-trimoxazole (72.00%). The study results indicate that the use of OAT and ARVs was in accordance with national guidelines, with vitamin B6 and co-trimoxazole being the most commonly used adjunctive therapies.

Abstrak. Tuberkulosis (TB) merupakan infeksi oportunistik yang sering terjadi pada pasien Human Immunodeficiency Virus (HIV), sehingga memerlukan terapi obat anti-tuberkulosis (OAT) dan antiretroviral (ARV) secara bersamaan. Penelitian ini bertujuan menggambarkan karakteristik pasien serta profil penggunaan OAT, ARV, dan obat pendukung pada pasien TB-HIV di Rumah Sakit X periode 2024–2025. Penelitian menggunakan metode observasional deskriptif dengan pendekatan retrospektif berdasarkan data rekam medis. Sampel diperoleh menggunakan metode total sampling dan melibatkan 75 pasien yang memenuhi kriteria penelitian. Analisis dilakukan secara deskriptif menggunakan distribusi frekuensi dan persentase. Hasil penelitian menunjukkan bahwa mayoritas pasien berjenis kelamin laki-laki (73,33%), berusia 18–59 tahun (98,67%), dan mengalami TB ekstraparu (61,33%). Seluruh pasien menerima OAT kombinasi dosis tetap (2RHZE/4RH). Regimen ARV yang paling banyak digunakan adalah Tenofovir/Lamivudin/Efavirenz (TLE) (65,33%), diikuti Tenofovir/Lamivudin/Dolutegravir (TLD) (29,33%). Obat pendukung yang paling sering diberikan adalah vitamin B6 (74,67%) dan kotrimoksazol (72,00%). Hasil penelitian menunjukkan bahwa penggunaan OAT dan ARV telah sesuai dengan pedoman nasional, dengan vitamin B6 dan kotrimoksazol sebagai terapi pendukung yang paling banyak digunakan.

References

Aceves-Sánchez, B., Rajme-López, S., Martínez-Guerra, B. A., Rivera-Villegas, H., Román-Montes, C. M., Tamez-Torres, K. M., González-Vázquez, L. E., Guadarrama-Torres, S., Lazcano-Delgadillo, O., Nares-López, R., Segura-Ortíz, Z., Tepo-Ponce, K. M., González-Lara, M. F., Chávez-Mazari, B., Bobadilla-Del-Valle, M., Sifuentes-Osornio, J., & Ponce-De-León, A. (2025). Distinct Clinical Features of Extrapulmonary and Disseminated Tuberculosis in HIV- and Non-HIV-Associated Immunosuppression: A Retrospective Cohort Study. Open Forum Infectious Diseases, 12(5). https://doi.org/10.1093/ofid/ofaf239
Bhatt, A., Quazi Syed, Z., & Singh, H. (2023). Converging Epidemics: A Narrative Review of Tuberculosis (TB) and Human Immunodeficiency Virus (HIV) Coinfection. Cureus. https://doi.org/10.7759/cureus.47624
Decloedt, E. H., Maartens, G., Smith, P., Merry, C., Bango, F., & McIlleron, H. (2012). The safety, effectiveness and concentrations of adjusted lopinavir/ritonavir in HIV-infected adults on rifampicin-based antitubercular therapy. PLoS ONE, 7(3). https://doi.org/10.1371/journal.pone.0032173
Hamada, Y., Getahun, H., Tadesse, B. T., & Ford, N. (2021). HIV-associated tuberculosis. In International Journal of STD and AIDS (Vol. 32, Number 9, pp. 780–790). SAGE Publications Ltd. https://doi.org/10.1177/0956462421992257
Kementerian Kesehatan Republik Indonesia. (2024). Strategi Nasional Penanggulangan Tuberkulosis di Indonesia 2020–2024 (Revisi). Kementerian Kesehatan Republik Indonesia
Kementrian Kesehatan Republik Indonesia. (2019). Pedoman Nasional Pelayanan Kedokteran Tata Laksana HIV. Kementerian Kesehatan Republik Indonesia
Kementrian Kesehatan Republik Indonesia. (2020). Pedoman Nasional Pelayanan Kedokteran Tata Laksana Tuberkulosis. Kementerian Kesehatan Republik Indonesia
Ki, M. S., Jeong, D., Kang, H. Y., Choi, H., Sohn, H., & Kang, Y. A. (2023). Real-world impact of the fixed-dose combination on improving treatment outcomes of drug-susceptible tuberculosis: A comparative study using multiyear national tuberculosis patient data. BMJ Open Respiratory Research, 10(1). https://doi.org/10.1136/bmjresp-2023-001758
Kumar, R. P., & N, H. G. (2024). EXTRA-PULMONARY MANIFESTATIONS OF TUBERCULOSIS AMONG HIV PATIENTS-A CLINICAL STUDY. 31(10), 423–430. https://doi.org/10.53555/qv2xwr63
Ledesma, J. R., Ma, J., Zhang, M., Basting, A. V. L., Chu, H. T., Vongpradith, A., Novotney, A., LeGrand, K. E., Xu, Y. Y., Dai, X., Nicholson, S. I., Stafford, L. K., Carter, A., Ross, J. M., Abbastabar, H., Abdoun, M., Abdulah, D. M., Aboagye, R. G., Abolhassani, H., … Kyu, H. H. (2024). Global, regional, and national age-specific progress towards the 2020 milestones of the WHO End TB Strategy: a systematic analysis for the Global Burden of Disease Study 2021. The Lancet Infectious Diseases, 24(7), 698–725. https://doi.org/10.1016/S1473-3099(24)00007-0
Maartens, G., Griesel, R., Hill, A., & Meintjes, G. (2021). Standard versus double dose dolutegravir in patients with HIV-associated tuberculosis: A phase 2 non-comparative randomised controlled (RADIANT-TB) trial. Wellcome Open Research, 6. https://doi.org/10.12688/wellcomeopenres.16473.1
Maartens, G., & Meintjes, G. (2020). Managing Human Immunodeficiency Virus-associated Tuberculosis in the Dolutegravir Era. In Clinical Infectious Diseases (Vol. 70, Number 4, pp. 557–558). Oxford University Press. https://doi.org/10.1093/cid/ciz259
Masita, M., Hairi, F. M., Bachtiar, A., Mulyana, N., & Andriani, H. (2025). Community-driven strategies and policies for drug-resistant tuberculosis control in Banyumas Regency, Indonesia: A comprehensive 2023 analysis. Journal of Public Health Research, 14(3). https://doi.org/10.1177/22799036251376872
Mokhtar, S., Wahid, S., Lestari, I., Kanang, D., Iskandar, D., & Yuniarizka, S. (2023). FAKTOR RISIKO YANG MEMENGARUHI KEJADIAN HIV (Human Immunodeficiency Virus) PADA LAKI-LAKI DI RSUP DR. WAHIDIN SUDIROHUSODO MAKASSAR TAHUN 2020-2021. PREPOTIF : Jurnal Kesehatan Masyarakat, 7(3), 16997–17004.
Montales, M. T., Chaudhury, A., Beebe, A., Patil, S., & Patil, N. (2015). HIV-Associated TB Syndemic: A Growing Clinical Challenge Worldwide. In Frontiers in Public Health (Vol. 3). Frontiers Media S.A. https://doi.org/10.3389/fpubh.2015.00281
Nahid, P., Dorman, S. E., Alipanah, N., Barry, P. M., Brozek, J. L., Cattamanchi, A., Chaisson, L. H., Chaisson, R. E., Daley, C. L., Grzemska, M., Higashi, J. M., Ho, C. S., Hopewell, P. C., Keshavjee, S. A., Lienhardt, C., Menzies, R., Merrifield, C., Narita, M., O’Brien, R., … Vernon, A. (2016). Official American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America Clinical Practice Guidelines: Treatment of Drug-Susceptible Tuberculosis. In Clinical Infectious Diseases (Vol. 63, Number 7, pp. e147–e195). Oxford University Press. https://doi.org/10.1093/cid/ciw376
Ngari, M. M., Rashid, M. A., Sanga, D., Mathenge, H., Agoro, O., Mberia, J. K., Katana, G. G., Vaillant, M., & Abdullahi, O. A. (2023). Burden of HIV and treatment outcomes among TB patients in rural Kenya: a 9-year longitudinal study. BMC Infectious Diseases, 23(1). https://doi.org/10.1186/s12879-023-08347-0
Nguyen, H. V., Brals, D., Tiemersma, E., Gasior, R., Nguyen, N. V., Nguyen, H. B., Van Nguyen, H., Thi, N. A. Le, & Cobelens, F. (2023). Influence of Sex and Sex-Based Disparities on Prevalent Tuberculosis, Vietnam, 2017–2018. Emerging Infectious Diseases, 29(5), 967–976. https://doi.org/10.3201/eid2905.221476
Salma, K., Hartantri, Y., Wisaksana, R., Pradini, G. W., & Fauziah, N. (2025). Infeksi Oportunistik pada Pasien HIV yang Dirawat Inap di RSUP Dr. Hasan Sadikin Bandung Tahun 2019-2022. Jurnal Penyakit Dalam Indonesia, 12(1). https://doi.org/10.7454/jpdi.v12i1.1722
Sankar, J., Chauhan, A., Singh, R., & Mahajan, D. (2024). Isoniazid-historical development, metabolism associated toxicity and a perspective on its pharmacological improvement. In Frontiers in Pharmacology (Vol. 15). Frontiers Media SA. https://doi.org/10.3389/fphar.2024.1441147
Semengue, E. N. J., Fokam, J., Etame, N. K., Molimbou, E., Chenwi, C. A., Takou, D., Mossiang, L., Meledie, A. P., Yagai, B., Nka, A. D., Dambaya, B., Teto, G., Ka’e, A. C., Beloumou, G. A., Djupsa Ndjeyep, S. C., Abba, A., Kengni, A. M. N., Tommo Tchouaket, M. C., Bouba, N. P., … Ndjolo, A. (2023). Dolutegravir-Based Regimen Ensures High Virological Success despite Prior Exposure to Efavirenz-Based First-LINE ART in Cameroon: An Evidence of a Successful Transition Model. Viruses, 15(1). https://doi.org/10.3390/v15010018
Shin, H. J., Chang, J. S., Kim, M. S., Koh, B. G., Park, H. Y., Kim, T. O., Park, C. K., Oh, I. J., Kim, Y. Il, Lim, S. C., Kim, Y. C., Koh, Y. Il, & Kwon, Y. S. (2021). Hypersensitivity reactions to multiple antituberculosis drugs. PLoS ONE, 16(2 February). https://doi.org/10.1371/journal.pone.0246291
Swartwood, N. A., Singh, N., Mortazavi, S. A., Can, M. H., Cui, H., Ryuk, D. K., MacPherson, P., Horton, K. C., & Menzies, N. A. (2026). Differences in tuberculosis prevalence by sex in low- and middle-income countries over 1993–2025: A systematic review and meta-analysis. PLOS Medicine, 23(5), e1005114. https://doi.org/10.1371/journal.pmed.1005114
Wen-Wei Ku, S., Jiamsakul, A., Joshi, K., Kristoffer Ungos Pasayan, M., Widhani, A., Chaiwarith, R., Kiertiburanakul, S., Avihingsanon, A., Sun Ly, P., Kumarasamy, N., Do, C. D., Merati, T. P., Van Nguyen, K., Kamarulzaman, A., Zhang, F., Po Lee, M., Yong Choi, J., Tanuma, J., Khusuwan, S., … Wong, W.-W. (2017). Cotrimoxazole prophylaxis decreases tuberculosis risk among Asian patients with HIV TREAT Asia HIV Observational Database (TAHOD) of IeDEA Asia-Pacific* §. 13. https://doi.org/10.1002/jia2.25264/full
World Health Organization. (2021). Antiretoviral Therapy. Consolidated Guidelines on HIV Prevention, Testing, Treatment, Service Delivery and Monitoring: Recommendations for a Public Health Approach-NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK572730
World Health Organization. (2024). WHO consolidated guidelines on tuberculosis. Module 6: tuberculosis and comorbidities. Geneva: World Health Organization. Licence: CC BY-NC-SA 3.0 IGO.

Published

2026-08-03