Articles
<![CDATA[Survival COVID-19 in Adult Patients with Liver Cirrhosis ]]>
<![CDATA[Gita Aprilicia]]>;
<![CDATA[Syahrizal Syarif]]>;
<![CDATA[Kemal Fariz Kalista]]>;
<![CDATA[Andri Sanityoso Sulaiman]]>;
<![CDATA[Irsan Hasan]]>;
<![CDATA[Cosmas Rinaldi A Lesmana]]>;
<![CDATA[Juferdy Kurniawan]]>;
<![CDATA[Chyntia Olivia Maurine Jasirwan]]>;
<![CDATA[Saut Horas Hatoguan Nababan]]>;
<![CDATA[Rino Alvani Gani]]>
<![CDATA[ The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 22, No 2 (2021): VOLUME 22, NUMBER 2, August 2021 ]]>
Publisher : <![CDATA[The Indonesian Society for Digestive Endoscopy ]]>
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DOI: 10.24871/2222021124-129
<![CDATA[Background: COVID-19 is a disease caused by infection of SARS-CoV-2 virus which leads to mortality due to respiratory failure. The progression of COVID-19 is more severe in patients with pre-existence morbidities, including liver disease. Recently, a few studie showed that liver cirrhosis patients with COVID-19 had a higher risk of mortality rather than liver cirrhosis patients without COVID-19 infection. Nevertheless, the study of survival COVID-19 in a patient with underlying liver cirrhosis is still limited. The aim of this study is to evaluate the survival of COVID-19 in adult patients with liver cirrhosisMethod: An observational study in Cipto Mangunkusumo Hospital was conducted. Patients with underlying liver cirrhosis between March 2020-January 2021 with positive confirmation of COVID-19 were enrolled in this study. Liver cirrhosis patients without COVID-19 were enrolled as a comparison. Both liver cirrhosis patients with and without COVID-19 were follow up at the time of hospital admission until 30 days outcome. Kaplan Meier and a log-rank test were conducted to evaluate the comparison of survival rate in liver cirrhosis patients with and without COVID-19. Multivariate Cox Proportional Hazard was conducted to identify the independent risk factors related to survival.Results: There were 22 liver cirrhosis patients with COVID-19 and 116 liver cirrhosis patients included in this study. Presentation of gender and age similar both of them. Predominantly males with average age were 57 years ± 13,60 for cirrhosis with COVID-19 patients and 53 years ± 12,75 for without COVID-19. The survival rate of liver cirrhosis patients with COVID-19 lower than liver cirrhosis patients without COVID-19 (35.8% vs. 67.2%, p-value 0.001). Median survival of liver cirrhosis patients with COVID-19 was 4 days (95% CI: 1-8 days), while median survival of liver cirrhosis patients without COVID-19 couldn’t be reached since the survival rate of this group above 50%. Final model Cox PH showed that liver cirrhosis with COVID-19 (HR: 8.99; CI 95%: 4.55 – 17.80, p-value 0.001) and Child-Pugh class C (HR: 5.61; 95% CI: 2.76 – 11.40, p-value 0.001) were the independent risk factors associated with poor survival.Conclusion: The survival rate of liver cirrhosis patients with COVID-19 lower than liver cirrhosis patients without COVID-19. Liver cirrhosis with COVID-19 and Child-Pugh class C were associated with poor survival.]]>
<![CDATA[Procalcitonin Level Differences in Patients with Liver Cirrhosis Without Bacterial Infection ]]>
<![CDATA[Oska Mesanti]]>;
<![CDATA[Rino Alvani Gani]]>;
<![CDATA[Marcellus Simadibrata]]>;
<![CDATA[Suhendro Suhendro]]>
<![CDATA[ The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 18, No 1 (2017): VOLUME 18, NUMBER 1, April 2017 ]]>
Publisher : <![CDATA[The Indonesian Society for Digestive Endoscopy ]]>
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DOI: 10.24871/181201715-19
<![CDATA[Background: Procalcitonin level can increase in patients with liver cirrhosis without bacterial infection. The aim of this study is to identify the role of procalcitonin in patients with liver cirrhosis without bacterial infection.Methods: Cross-sectional study was performed to patients with liver cirrhosis without bacterial infection. In patients, we performed procalcitonin level examination and bacterial infection identification. Further, we analysed them to know the procalcitonin level difference in patients with compensated and decompensated liver cirrhosis without bacterial infection.Results: We obtained 39 patients with liver cirrhosis without bacterial infection, male 61.5% with compensated condition found in 17 patients and decompensated in 22 patients. We found significant difference in the average of procalcitonin level in decompensated patients (0.738ng/mL ± 1.185) compared to compensated (0.065ng/mL ± 0.022).Conclusion: Procalcitonin level increased in patients with liver cirrhosis without bacterial infection. The level in decompensated patients were higher compared to compensated patients.]]>
<![CDATA[Survival Analysis of Hospitalized Liver Cirrhotic Patients in Jakarta: 2 Years Follow Up Study ]]>
<![CDATA[Rino Alvani Gani]]>
<![CDATA[ The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 22, No 1 (2021): VOLUME 22, NUMBER 1, April 2021 ]]>
Publisher : <![CDATA[The Indonesian Society for Digestive Endoscopy ]]>
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DOI: 10.24871/22120219-15
<![CDATA[Background: The incidence of liver cirrhosis in Indonesia is increasing over time. In this study, we aim to present a 2-year survival analysis on liver cirrhotic patients using Child-Pugh and MELD score and also analyzing the most common cause of death among liver cirrhotic patients.Method: A retrospective cohort study was used by evaluating the medical records of patients who went to internal medicine ward of Cipto Mangunkusumo Hospital during the period between 2011-2016. The inclusion criteria were all cirrhotic patient registered with a completely filled medical record. The exclusion criteria were the presence of Hepatocellular carcinoma, cholangiocarcinoma, and other form of malignanciesResults: A total of 89 patients were included in this study. The total of 75.3% of the patients were dead during the 2 years follow up with the most prevalent cause of death (COD) being infection (45.5%). Survival analysis, showed that the survival of CP Class A were significantly better than B and C. The cut off value for 2-years mortality was CP score 7 and MELD score 9 in liver cirrhotic patientsConclusion: The mortality rate of liver cirrhotic patients is very high with infection as the main COD. Patients with Child-Pugh score B and C have worse prognosis than Child-Pugh score A.]]>
<![CDATA[Hepatitis B Virus Double Mutations is There any Role in Pathogenesis of Hepatocellular Carcinoma in Young Patients ]]>
<![CDATA[Andri Sanityoso Sulaiman]]>;
<![CDATA[Rino Alvani Gani]]>;
<![CDATA[Irsan Hasan]]>;
<![CDATA[Andi Utama]]>;
<![CDATA[Susan Tai]]>;
<![CDATA[Griscalia Christine]]>
<![CDATA[ The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 10, NUMBER 3, December 2009 ]]>
Publisher : <![CDATA[The Indonesian Society for Digestive Endoscopy ]]>
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DOI: 10.24871/103200996-98
<![CDATA[Background: The incidence of hepatocellular carcinoma (HCC) below age 40 years old in our institution were relatively high compared with other institutions in Asia. Hepatitis B virus (HBV) basal core promoter (BCP) double mutations correspond with increasing age. The aim of this study was to know if there was any role of HBV double mutations in young HCC patients. Method: A descriptive study was performed on HBV related HCC patients in Cipto Mangunkusumo Hospital in May 2006-November 2008. Patient were recruited consecutively and divided in to two groups, below 40 and above 40 years old. The genotypes were examined by polymerase chain reaction (PCR) method. The alpha feto protein (AFP) values were diagnosed based on ELISA method. The BCP A1762T/G1764A double mutations were examined by direct sequencing. Results: There were 49 HBV related HCC samples consist of 14 (28.5%) samples with age below 40 years old and 35 (71.5%) samples with age above 40 years old. We only found two genotype, genotype B was dominant in patients with HBV related HCC compare to genotype C, 43 (88%) and 6 (12%) respectively. The increasing of AFP level above 400 ng/mL was only found in about half of the samples, 7 (50%) 40 years old, 19 (54%) 40 years old. Double mutations of A1762T/G1764A in BCP occurred in 5 (36%) 40 years old, 15 (43%) 40 years old. Conclusion: The incidence of HBV related HCC in young patients were relatively high. The proportion of patients with AFP level 400 ng/mL in patients below 40 years old were higher compared to patients above 40 years. Keywords: hepatocellular carcinoma, BCP double mutation, HBV genotype]]>
<![CDATA[Relationship Between Vascular Endothelial Growth Factor and Severity of Hepatocellular Carcinoma ]]>
<![CDATA[Arles - -]]>;
<![CDATA[Rino Alvani Gani]]>;
<![CDATA[Ari Fahrial Syam]]>;
<![CDATA[Hamzah Shatri]]>
<![CDATA[ The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 16, No 2 (2015): VOLUME 16, NUMBER 2, August 2015 ]]>
Publisher : <![CDATA[The Indonesian Society for Digestive Endoscopy ]]>
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DOI: 10.24871/162201567-72
<![CDATA[Background: Severity of hepatocellular carcinoma (HCC) that is assessed using Barcelona Clinic Liver Cancer (BCLC) classification is a main prognostic factor of hepatocellular carcinoma. Assessment of the serum level of Vascular Endothelial Growth Factor (VEGF) is considered to reflect the severity of HCC. However, there is still no fundamental basis of the association of severity of HCC with the serum VEGF level. The objective of this study is to know the relationship between serum VEGF levels with the severity of HCC by assessing the average difference of serum VEGF level in various severity of HCC.Method: This study was a cross sectional study to identify the association between serum VEGF levels with the severity of HCC based on BCLC classification. This study was performed in Cipto Mangunkusumo Hospital between January and May 2015. Statistical tests used to evaluate the association between serum VEGF level with BCLC classification was one-way ANOVA analysis, and continued with post hoc Tukey Schaffe analysis.Results: A total of 61 subjects with HCC were included into this study. In this study, we did not find subjects with stage 0 BCLC. The average of serum VEGF level in stage A BCLC was 288.26 ± 156.6 pg/mL; stage B BCLC: 434 ± 164.8 pg/mL; stage C BCLC: 785.57 ± 194.25 pg/mL; stage D BCLC: 1537.97 ± 660.62 pg/mL. One-way ANOVA analysis showed significant difference (P 0.001) between serum VEGF level and HCC severity based on BCLC classification. Post hoc Tukey Schaffe analysis showed the presence of significant difference between stage A and C BCLC (p 0.05) and stage A and D BCLC (p 0.001), stage B and D BCLC (p 0.001), and stage C and D BCLC (p 0.001). There was no significant difference between stage A and B BCLC, and between stage B and C BCLC.Conclusion: It was found that serum VEGF level increased in accordance to the HCC severity based on BCLC classification, particularly for stage B BCLC and above.]]>
<![CDATA[Impact of Endoscopic Ultrasound (EUS) Procedure in Pancreatico-biliary Disorders in Indonesia ]]>
<![CDATA[Cosmas Rinaldi A Lesmana]]>;
<![CDATA[Rino Alvani Gani]]>;
<![CDATA[Irsan Hasan]]>;
<![CDATA[Andri Sanityoso Sulaeman]]>;
<![CDATA[Laurentius A Lesmana]]>
<![CDATA[ The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 18, No 1 (2017): VOLUME 18, NUMBER 1, April 2017 ]]>
Publisher : <![CDATA[The Indonesian Society for Digestive Endoscopy ]]>
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DOI: 10.24871/181201743-46
<![CDATA[Pancreato-biliary disorders are the challenging disorders in gastroenterology practice. It is well-known that endoscopic retrograde cholangiopancreatography (ERCP) is a common procedure in managing pancreato-biliary disorders. However, imaging modalities such as abdominal CT scan and MRI has been successfully reduced the unnecessary ERCP to avoid several potential complications. Recently, endoscopic ultrasound (EUS) procedure has become an important tool due to the limitation of imaging modalities in pancreato-biliary disorders. Its ability which is not only for diagnostic, but also for therapeutic purpose has given a new insight for most gastroenterologists in their daily practice. However, the investment, cost, and the proper training curriculum are still debatable in most developing countries, especially in Indonesia.]]>
<![CDATA[Treatment of Chronic Hepatitis B ]]>
<![CDATA[Prasna Pramita]]>;
<![CDATA[Rino A Gani]]>;
<![CDATA[Ali Sulaiman]]>
<![CDATA[ The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 6, ISSUE 1, April 2005 ]]>
Publisher : <![CDATA[The Indonesian Society for Digestive Endoscopy ]]>
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DOI: 10.24871/6120059-15
<![CDATA[Chronic hepatitis B is still a major health problem in Indonesia. Unfortunately, to date, treatment of chronic HBV (Hepatitis B virus) infection had not shown satisfactory Result. Monotherapy with alpha interferon or lamivudine have been widely used as treatment of chronic HBV. However, treatment response to Alpha interferon in Asian people was not satisfactory (15% - 20%), while monotherapy with lamivudine was not sufficient to eradicate HBV in chronically infected patients and commonly induce drug resistance. The occurrence of chronic hepatitis B resistant to lamivudine had encouraged development of newer agents such as adefovir, entecavir, emtricitabine and nucleoside analog. New therapeutic strategy using combination therapy should be considered if there is no sufficient response to monotherapy. Keywords: Treatment, chronic hepatitis B, combination therapy]]>
<![CDATA[Primary Tupaia Javanica Hepatocyte Culture as an In Vitro Model for Human Hepatitis B Virus Infection ]]>
<![CDATA[Kemal Fariz Kalista]]>;
<![CDATA[Maryati Surya]]>;
<![CDATA[Silmi Mariya]]>;
<![CDATA[Diah Iskandriati]]>;
<![CDATA[Irsan Hasan]]>;
<![CDATA[Rino Alvani Gani]]>
<![CDATA[ The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 22, No 3 (2021): VOLUME 22, NUMBER 3, December 2021 ]]>
Publisher : <![CDATA[The Indonesian Society for Digestive Endoscopy ]]>
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DOI: 10.24871/2232021203-209
<![CDATA[Background: Hepatitis B virus (HBV) infection is still one of the biggest health problems in the world, which could lead to chronic hepatitis, cirrhosis and hepatocellular carcinoma. Treatment for HBV infection has not yet achieved a functional cure. More studies are needed to investigate human HBV (HuHBV), but the scarcity of animal models for HuHBV infection became a barrier. Recently, many studies have shown that Tupaia are suitable for the study of HuHBV. The purpose of this study was to develop a primary tupaia hepatocyte (PTH) culture from T. javanica, a species of Tupaia found in Indonesia, and to prove that HuHBV can replicate in the PTH.Method: In vitro experimental study using PTH isolated from five wild adult T. javanica in Primate Research Center, IPB University. HuHBV was taken from humans with HBsAg and HBV-DNA (+). PTH cells then were infected with HuHBV after reaching 80% confluence. Observation on PTH cells was done everyday for 20 days. Qualitative and quantitative HBsAg were measured using a CMIA while HBV-DNA and cccDNA were measured by RT-PCR.Results: A cytopathic effect was seen on day post infection (DPI)-16. HBsAg and HBV-DNA were detected from DPI-2 until DPI-18, with HBV-DNA level peaked on DPI-12. cccDNA concentration was fluctuating from DPI-2 until DPI-20 with highest level on DPI-16.Conclusion: HuHBV could infect and replicate in PTH from T. javanica can be infected with HuHBV and HuHBV can replicate in the PTH from T. javanica.]]>
<![CDATA[Efficacy and Safety of In-Asia-manufactured Interferon alpha-2b in Combination with Ribavirin for Therapy of Naïve Chronic Hepatitis C Patients: A Multicenter, Prospective, Open-Label Trial ]]>
<![CDATA[Nurul Akbar]]>;
<![CDATA[Ali Sulaiman]]>;
<![CDATA[Rino Alvani Gani]]>;
<![CDATA[Irsan Hasan]]>;
<![CDATA[Laurentius Lesmana]]>;
<![CDATA[Andri Sanityoso]]>;
<![CDATA[Sjaifoellah Noer]]>;
<![CDATA[FX Pridady]]>;
<![CDATA[Soemarno Soemarno]]>
<![CDATA[ The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 10, ISSUE 1, April 2009 ]]>
Publisher : <![CDATA[The Indonesian Society for Digestive Endoscopy ]]>
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DOI: 10.24871/10120097-13
<![CDATA[Background: An open-label, multi center and non-comparative study was conducted to evaluate the efficacy and safety of a more affordable in-Asia-manufactured interferon á-2b product in combination with ribavirin to treat naïve chronic hepatitis C patients. Method: Thirty chronic naïve hepatitis C patients were treated with in-Asia-manufactured interferon a-2b subcutaneously 3 MIU thrice weekly and ribavirin 800-1,200 mg daily for 48 weeks. Follow-up was done until 24 weeks after the end of treatment. Efficacy was assessed by examining serologic and biochemical parameters at pre and post-treatment. Safety was assessed by evaluating clinical symptoms and laboratory parameters. Results: The virological response and sustained virological response rates of all Hepatitis C Virus (HCV) genotypes were 83.3% and 76.7% respectively. Post-treatment, 80% patients had significant alanine transaminase (ALT) decreased into normal level and remained normal in 76.7% patients at 24th week follow up period. At that time, the ALT level and sustained virological response were lower in HCV genotypes 1 and 4 than in non-1 and non-4 genotypes. The most frequent adverse event was flu-like syndrome. Conclusion: The efficacy and safety study on combination therapy of in-Asia-manufactured interferon a-2b and ribavirin has shown a good result based on the current standard of interferon alpha and ribavirin combination therapy. Keywords: interferons, combination drug therapy, chronic hepatitis C, treatment efficacy, safety]]>
<![CDATA[Changes in Tumor Nekrosis Factor Alpha and Interleukin 6 Levels in Patients with Obstructive Jaundice due to Pancreatobiliary Cancer Who Underwent Biliary Drainage ]]>
<![CDATA[Adang Sabarudin]]>;
<![CDATA[Rino Alvani Gani]]>;
<![CDATA[Murdani Abdullah]]>;
<![CDATA[Cleopas Martin Rumende]]>
<![CDATA[ The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 17, No 2 (2016): VOLUME 17, NUMBER 2, August 2016 ]]>
Publisher : <![CDATA[The Indonesian Society for Digestive Endoscopy ]]>
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DOI: 10.24871/172201692-98
<![CDATA[Background: Obstructive jaundice represents the most common complication of biliary tract malignancy. Obstructive jaundice causes releases of proinflammatory cytokine. There has been controversy about effect of biliary drainage on the change in proinflammatory cytokine level in pancreatobiliary cancer patients. The present study was designed to determine levels of tumor necrosis factor alpha (TNF-alfa) and interleukin 6 (IL-6) in preprocedure of either endoscopic retrograde cholangio pancreatography (ERCP) or percutaneous transhepatic biliary drainage (PTBD) and postprocedure of them in obstructive jaundice patient caused by pancreatobiliary cancer.Method: The study method was before-and-after case study design with consecutive sampling. Blood was collected five days prior to either endoscopic retrograde cholangio pancreatography (ERCP) procedure or percutaneus transhepatic biliary drainage (PTBD) procedure and five days after either of them. Enzyme linked immunosorbed assay (ELISA) was used to determine TNF-alfa and IL-6.Results: Forty subjects were included in this study which consisted of 22 men and 18 women. The age was 55.3 (SD 13.7) years old. According to the results of imaging and endoscopy procedure, twenty-two people were diagnosed cholangicarcinoma, ten people were diagnosed ampulla vateri and eigth people were diagnosed pancreatic tumor. In preprocedure, the TNF-alfa concentration was 4.81 (SD 2.91) pg/mL, the IL-6 concentration was 7.79 (SD 1.57) pg/mL and the bilirubin concentration was 15.5 (SD 6,9) mg%. In postprocedure, the TNF-alfa concentration was 8.05 (SD 6.7) pg/mL, there was a significant increase in TNF-alfa concentration (p = 0.02). However, IL-6 concentration was 7.75 (SD 1.76) pg/mL, there was not any significant chance in IL-6 concentration (p = 0.52). The bilirubin concentration was 11.3 (SD 6,5) mg%.Conclusion: There was a significant increase in mean concentration value of TNF-alfa after biliary drainage procedure. On the other hand there was not any significant decrease in the mean concentration value of IL-6 after biliary drainage procedure. ]]>
