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CHAPTER VII
CONCLUSION AND SUGGESTIONS
A. ConclusionBased on the results of research on influence of epidemiological risk factors for occurrence of Hepatitis B virus (HBV) co-infection in HIV/AIDS patients: study in DR. Kariadi hospital, Semarang, Indonesia the following conclusions can be drawn:
a) The factors proven to be risk factor for the occurrence of Hepatitis B infection in HIV/AIDS patients is CD4≤100cells/mm3 and being MSM was also shown as risk factor for occurrence of Hepatitis B infection in HIV/AIDS
a. The probability for HIV/AIDS patients to be infected with Hepatitis B if they have CD4≤100 cells/mm3 is equal to 67.76%.
b. The probability for HIV/AIDS patients to be infected by Hepatitis B virus if they are MSM is 50.3%
c. The probability for HIV/AIDS patients to be infected by Hepatitis B virus if he has CD4≤100 and being men who do sex with other men (MSM), it’s probability if he has both these risk factors is equal to 88.18%.
b) Factors that were proven not to be risk factors for the occurrence of Hepatitis B virus in HIV/AIDS patients are Age, Gender, Marital Status, and Levels of Education.
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B.Suggestions
1. For Science Development
a. This research is expected to be used as a basis for further research such as a prospective cohort study in other to further understand the risk factors of Hepatitis B infection in HIV/AIDS patients.
a) The researcher suggest the Research using a cohort study design with a larger number of sample as well as indebt interview should be considered in searching for any other risk factors associated with the occurrence of Hepatitis B virus in HIV/AIDS patients.
b) The researcher suggests a research on the survival of HIV/AIDS patients who are co- infected with Hepatitis B virus infection, to know their survival.
2. For Health Services 2.1. Hospital
a) More comprehensive HIV tests and one on one counseling services should be made available.
b) All patients who become positive after taking a test for HIV/AIDS should be advised to test for Hepatitis B virus(HBsAg test) especially the ones that have low CD4 counts and the one that are MSM and in order to prevent the HIV/AIDS patients with being infected with Hepatitis virus.
c) HIV and Hepatitis B awareness should be strengthened in the hospital environment through the use of media such as posters, leaflets and billboards related to the importance of conducting HIV and HBV testing as early as possible.
81 d) Health promotion awareness about Hepatitis B virus such as reporting early to hospital for care, use of condom and consistency in taking ARV drugs amongst others should be given to HIV/AIDS patients at every follow up in the hospital.
e) Drugs that treat HIV and Hepatitis B virus infection at the same time for instance agents that have dual activity against HIV and HBV, this include-Tenofovir+ FTC ,FTC is also called the Emtricibine ,the use of 3TC also called Lamivudine or FTC alone against HBV is contraindicated due to low barrier to resistance should be prescribed and given to HIV/AIDS patients co-infected with Hepatitis B infection having CD4 counts < 100 cells/ul as well as those whose CD4 counts are less than 200cells/ul.
f) The researcher suggests that HIV/AIDS patients’ CD4 cells should be checked periodically to minimize their risk of being infected with other diseases.
3. Indonesian/Provincial Ministry of health
a. Providing vaccination of Hepatitis B infection among the unvaccinated population.
b. Providing test equipment for the diagnosis of Hepatitis B and at a subsidized rate in hospitals in other for patients to be able to access this service at an affordable rate.
3. For the Community
a) HIV/AIDS patients should get vaccination of Hepatitis B, so that they can prevent to be infected with two viruses.
b) The researcher suggests the use of condoms in HIV/AIDS patients who are MSM in other to prevent the infection with other diseases.
82 c) HIV and HBV routine tests should be carried out regularly in the community, at least once every 6 months in other to ascertain the HIV status of the community at a very early stage.
d) HIV/AIDS patients should ensure to go for regular control checkups and be compliant in the use of ARVs to avoid health deterioration.
