Hendaya Kognitif pada Penderita HIV

Oleh :

dr. Soeklola SpKJ MSi

Hendaya kognitif banyak dialami oleh pasien HIV. Hal ini merupakan bagian dari komplikasi sistem saraf pusat (SSP) yang disebut sebagai HIV-associated neurocognitive disorders (HAND).[1-3] Prevalensi HAND dari 35.513 kasus HIV yang dikumpulkan dari 32 negara, mencapai 42,6%; terdiri dari 23,5% asymptomatic neurocognitive impairment (ANI), 13,3% mild neurocognitive disorder (MND), dan 5% HIV-associated dementia (HAD).[4] Usia yang lebih tua dan jumlah sel CD4 < 200 sel/mm³ berasosiasi signifikan dengan peningkatan risiko HAD.[2,4]

Mekanisme Terjadinya Hendaya Kognitif pada Penderita HIV

Dahulu, sebelum penelitian terkait HIV semaju saat ini, pasien HIV sering mengalami berbagai masalah yang dapat menyebabkan efek jangka panjang pada otak, seperti infeksi sistem saraf pusat, kanker, dan toksisitas dari obat antiretroviral generasi awal. Selain itu, pada perjalanan penyakitnya, terdapat berbagai proses yang berhubungan dengan gangguan kognitif pada pasien HIV, termasuk neuroinflamasi, atrofi otak, dan cedera neuron. Walaupun proses ini dianggap mampu dikendalikan setelah terapi antiretroviral mulai dikonsumsi pasien dan supresi virus tercapai, panjangnya durasi infeksi HIV sebelum memulai terapi tetap dipercaya menyebabkan disfungsi neuron yang permanen.[5]

(Konten ini khusus untuk dokter. Registrasi untuk baca selengkapnya)

Referensi

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