COTRIMOXAZOLE PROPHYLAXIS INCREASE THE LEVEL OF HEMOGLOBIN IN HUMAN IMMUNODEFICIENCY VIRUS EXPOSED INFANT

TESIS

Abstract

By : Dr. Lourdes Maria Do Rego Leao

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Faculties : Fakultas Kedokteran

Department : PS. ILMU KESEHATAN ANAK

Pneumocystis jiroveci pneumonia (known as Pneumocystis carinii) has been reported as a leading cause of death in infants with HIV infection. In 2000, the World Health Organizatian (WHO) and Joint United Nations Programme on HIV/AIDS recommended the use of cotrimoxazole as prophylaxis against pneumocystis jiroveci for HIV exposed infant. Eventhough, it remains controversial regarding the risks and benefit including risk for anemia in HIV exposed-uninfected infants. This study was aimed to know the effect of 3 months cotrimoxazole prophylaxis on hemoglobin level. Thirty nine subjects were recruited consecutively in outpatient pediatric clinic of Sanglah Central General Hospital Denpasar from May 2016 until January 2017. It was an observational study (before and after). Full blood count was performed in all subjects at 6 week and 5 month old to collect the data of hemoglobin level. Shapiro-Wilk was performed to assess the data distribution then Wilcoxon was performed to record the mean difference of hemoglobin level since it was not distributed normally. There were 39 subjects whom underwent the full blood count investigation. The first median hemoglobin level was 9.2 g/dL (IQR 1) and the last was 11.3 g/dL (IQR 1). The hemoglobin level was significantly increased after three months of cotrimoxazole prophylaxis with the mean difference of 2,1 ( 95% CI 1,6-2,4). We concluded that it is save to use cotrimoxazole up to five months old as prophylaxis for PCP in HIV exposed infant.

Keyword : HIV exposed infant, cotrimoxazole prophylaxis, hemoglobin level

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