Peranan Laboratorium dalam Prevention of Mother to Child Transmission (PMTCT) HIV
Abstract
Human Immunodeficiency Virus (HIV) adalah retrovirus RNA yang dapat menyebabkan penyakit klinis, yaitu Acquired Immunodeficiency Syndrome (AIDS). Transmisi virus dari ibu ke anak (mother to child transmission/MTCT) dapat terjadi melalui darah maternal, sekresi saluran genital, dan ASI. Risiko penularan HIV dari ibu ke bayi dapat ditekan hingga 2% dengan program PMTCT. Tulisan ini bertujuan untuk memaparkan tentang peran laboratorium dalam mendukung program PMTCT HIV. Dalam hal ini laboratorium memegang peranan yang penting dalam mendeteksi HIV secara dini dan diikuti dengan evaluasi. Untuk menentukan bayi tidak mengidap HIV, diperlukan minimal dua kali pemeriksaan polymerase chain reaction (PCR) RNA HIV dengan hasil negatif, yaitu pada usia 4-6 minggu dan pada usia 4-6 bulan. Pada saat bayi berusia 18 bulan dilakukan pemeriksaan antibodi terhadap HIV dengan cara Enzyme-linked Immunosorbent Assay (ELISA) untuk konfirmasi. Laboratorium memegang peranan penting dalam melakukan deteksi dini HIV serta membantu dalam proses follow up sehingga dapat mendukung program PMTCT.                                                                       Â
Kata kunci: PMTCT, HIV, PCR, ELISA
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 [Laboratory Role In The Prevention of Mother to Child Transmission (PMTCT) of HIV]
The Human Immunodeficiency Virus (HIV) is a RNA retrovirus which causes the clinical disease termed the acquired immunodeficiency syndrome (AIDS). Mother-to-child transmission (MTCT) may occurred because of the intrapartum maternal blood exposure, infected genital tract secretions and during breastfeeding. The aim of this paper is to explain the role of laboratory to support PMTCT program. Laboratory plays an important role in PMTCT, that given the starting point of PMTCT is early detection of HIV and followed by evaluation. To determine the baby does not have HIV, it takes at least two times the HIV RNA PCR with negative results, (at 4-6 weeks of age and at the age of 4-6 months). And then infants examined for HIV antibodies by Enzyme-linked Immunosorbent Assay (ELISA) for confirmation at 18-month-old. Laboratory has an important role to support diagnose of HIV and their follow up, so it can be support PMTCT program.
Keywords: PMTCT, HIV, PCR, ELISA
References
Global AIDS Up Date 2016. Diakses tanggal 1 Agustus 2017. Diunduh dari URL: http://www.unaids.org/sites/default/files/media_asset/global-AIDS-update-2016_en.pdf
2015 Progress Report on The Global Plan. Geneva: Joint United Nations Programme on HIV/AIDS (UNAIDS); 2015
How AIDS changed everything—MDG
: 15 years, 15 lessons of hope from the AIDS response. Geneva: UNAIDS; 2015.
Pedoman Nasional Pencegahan Penularan HIV dari Ibu ke Bayi. Jakarta: Kementerian Kesehatan Republik Indonesia; 2011
Havens PL, Mofenson LM. Evaluation and management of the infant exposed to HIV-1 in the United States. Pediatrics. 2009;123:175-87
Kilewo C, Karlsson K, Massawe A, Lyamuya E, Swai A, Mhalu F, dkk. Prevention of mother-to-child transmission of HIV-1 through breast-feeding by treating infants prophylactically with lamivudine in Tanzania. J Acquir Immune Defic Syndr. 2008;48:315-23
Yayasan spiritia. Pencegahan penularan dari ibu-ke-bayi (PMTCT). Yayasan spiritia, Jakarta; 2008. Diakses tanggal 5 Januari 2014 Diunduh dari URL: http://spiritia.or.id/cst/bacacst.php
De Cock KM, Fowler MG, Mercier E, de Vincenzi I, Saba J, Hoff E, dkk. Prevention of mother-to child HIV transmission in resource-poor countries translating research into policy and practice. JAMA 2000;283:1175-81
WHO. PMTCT strategic vision 2010–2015: preventing mother-to-child transmission of HIV to reach the UNGASS and millennium development goals: moving owards the elimination of pediatric HIV. December 2009. WHO, Geneva; 2010
Kementerian Kesehatan Republik Indonesia. Pedoman Nasional Pencegahan Penularan HIV dari Ibu ke Anak (PPIA) Departemen Kesehatan RI, Jakarta; 2012
Adjorlolo-Johnson G, De Cock KM, Ekpini E, et al. Prospective comparison of mother-to-child transmission of HIV-1 and HIV-2 in Abidjan, Ivory Coast. JAMA 1994;272:462-466
Tovo PA, De Martino M, Caramia G, et al. Epidemiology, clinical features, and prognostic factors of paediatric HIV infection. Lancet 1988; ii:1043 -1046
Msellati P., Newell M-L., Dabis F., Rates of mother-to-child transmission of HIV-1 in Africa, America and Europe: Results from 13 perinatal studies Journal of Acquired Immune Deficiency Syndromes 1995;8:506-510
Kind C, Rudin C, Siegrist CA, et al. Prevention of vertical HIV transmission: additive protective effect of elective caesarean section and zidovudine prophylaxis. AIDS 1998;12:205-210
Maguire A, Sanchez E, Fortuny C, et al. Potential risk factors for vertical HIV-1 transmission in Catalonia, Spain: the protective role of caesarean section. AIDS 1997;11:1852-7
The Working Group on Mother-to-Child Transmission of HIV. Rates of mother-to-child transmission of HIV-1 in Africa, America and Europe: Results from 13 perinatal studies. J Acquir Immune Defic Syndr Human Retrovirol 1995;8:506-510
Bryson YJ, Luzuriaga K, Wara DW. Proposed definitions for in utero versus intrapartum transmission of HIV-1. N Engl J Med 1992;327:1246-1247
Rouzioux C, Costalgliola D, Burgand M, et al. Estimated timing of mother-to-child human immunodeficiency virus type 1 (HIV-1) transmission by use of a Markov model. Am J Epidemiol 1995;142:1330-1337
Newell ML. Mechanisms and timing of mother-to-child transmission of HIV-1. AIDS 1998;12:831-837
Zorilla CD, Tamayo-Agrait V. Pharmacologic and Non-Pharmacologic Options for The Management of HIV Infection During Pregnancy. HIV/AIDS Research and Palliative Care in Review. 2009;1:41-53.
James DK, Steer PJ, Weiner CP, Gonik B. Human Immunodeficiency Virus. Dalam: High Risk Pregnancy: Management Options. Edisi ke-1. London: W. B. Saunders Company Ltd, 1994; h. 498-502
Gareth TW, Diana G. HIV infection in children. Dalam: ABC of AIDS. Edisi ke-5. London: BMJ Publishing Group, 2001; h. 73-81
Andreasson PA, Dias F, Naucler A, Andersson S, Biberfeld G. A prospective study of vertical transmission of HIV-2 in Bissau, Guinea-Bissau. AIDS 1993;7:989-993
Morgan G, Wilkins HA, Pepin J, Ousman J, Brewster D, Whittle H, et al. AIDS following mother-to-child transmission of HIV-2. AIDS 1990;4:879-882
MAP. Monitoring the AIDS epidemic (MAP) network. The status and trends of the HIV/AIDS/STD epidemics in the world. Provisional report, June 1998
Marino T. HIV in Pregnancy. Emedicine, 2010
Green-top Guideline No.39. Management of HIV in Pregnancy. Royal College of Obstetricians and Gynecologists. 2010; h. 1-28
Direktorat Jenderal Pengendalian Penyakit menular dan Penyehatan Lingkungan Departemen Kesehatan RI, Pedoman Tatalaksana Infeksi HIV dan Terapi Antiretroviral Pada Anak Indonesia.Jakarta, 2008, 1-20