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All Journal Medical Journal of Indonesia Molecular and Cellular Biomedical Sciences (MCBS) Jurnal Gizi Klinik Indonesia Cermin Dunia Kedokteran MEDICINUS The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy Jurnal Penyakit Dalam Indonesia Proceedings Book of International Conference and Exhibition on The Indonesian Medical Education and Research Institute

Irsan Hasan

Departemen Ilmu Penyakit Dalam, Fakultas Kedokteran Universitas Indonesia

Author-ID : 277729

Biochemistry, Genetics & Molecular Biology Dentistry Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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Survival COVID-19 in Adult Patients with Liver Cirrhosis Gita Aprilicia; Syahrizal Syarif; Kemal Fariz Kalista; Andri Sanityoso Sulaiman; Irsan Hasan; Cosmas Rinaldi A Lesmana; Juferdy Kurniawan; Chyntia Olivia Maurine Jasirwan; Saut Horas Hatoguan Nababan; Rino Alvani Gani
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 22, No 2 (2021): VOLUME 22, NUMBER 2, August 2021
Publisher : The Indonesian Society for Digestive Endoscopy

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.

Success Rate of Liver Stiffness Measurement Using Transient Elastography in Non-alcoholic Fatty Liver Disease Patients with Obesity and Its Influencing Factors Edi Mulyana; Irsan Hasan; Marcellus Simadibrata; Hamzah Shatri
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 16, No 2 (2015): VOLUME 16, NUMBER 2, August 2015
Publisher : The Indonesian Society for Digestive Endoscopy

Background: Percentage of patients who had liver stiffness measurement failure using transient elastography varied between 2-10%; mainly caused by obesity. XL probe is expected to increase the success rate of liver stiffness measurement in patients with obesity. The objective of this study is to evaluate the success of liver stiffness measurement using M and XL probes and its influencing factors.Method: Patients who fulfilled the inclusion criteria were included in this study. Examination results were then analysed using statistical analysis unpaired t-test or Mann-Whitney and McNemar statistical tests.Results: From 92 NAFLD patients with obesity who were studied, the proportion of success in measuring liver stiffness using M probe was 57.6%, while that of XL probe was 88.0%. This difference was statistically significant (p 0.001). BMI, SCD, and thoracic circumference were associated with success in measuring liver stiffness using M probe, with p value of 0.007, 0.001, and 0.001 respectively. The results of Mann-Whitney statistical test revealed median value of BMI and SCD of patients who had liver stiffness measurement failure using M probe were 32.7 kg/m2 and 2.6 cm respectively. T-test results showed that the mean value of thoracic circumference of patients who had liver stiffness measurement failure using M probe was 97.8 cm.Conclusion: Proportion of success in measuring liver stiffness in NAFLD patients with obesity using XL probe was better compared to the M probe. BMI, SCD, and thoracic circumference were associated with the success of measuring liver stiffness using M probe. The same variables were not associated with XL probe.

Coffee Consumption to Reduce Liver Fibrosis Yaldiera Utami; Irsan Hasan
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 16, No 1 (2015): VOLUME 16, NUMBER 1, April 2015
Publisher : The Indonesian Society for Digestive Endoscopy

As one of the most popular drink consumed daily, coffee is known to be good for health. One of the main substance found in coffee is caffeine. Several previous studies explained that caffeine found in coffee could act as hepatoprotective agents, and recently an antifibrotic agent. Since liver fibrosis is a fatal condition that could lead to liver cirrhosis and hepatocellular carcinoma, a lot of study were trying to find any alternatives to reduce fibrosis, one of them is coffee. Several studies have reported that coffee was significantly, able to reduce fibrosis process because of its caffeine which is found in coffee. Recently, some studies also reported that a non-caffeinated coffee also showed an antifibrotic effect. It is believed that several substances beside caffeine found in coffee were also played an important role in reduce liver fibrosis. By its cellular mechanism, coffee would be a new alternatives way to reduce liver fibrosis, and of course other chronic liver disease.

Hepatitis B Virus Double Mutations is There any Role in Pathogenesis of Hepatocellular Carcinoma in Young Patients Andri Sanityoso Sulaiman; Rino Alvani Gani; Irsan Hasan; Andi Utama; Susan Tai; Griscalia Christine
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 10, NUMBER 3, December 2009
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/103200996-98

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

Impact of Endoscopic Ultrasound (EUS) Procedure in Pancreatico-biliary Disorders in Indonesia Cosmas Rinaldi A Lesmana; Rino Alvani Gani; Irsan Hasan; Andri Sanityoso Sulaeman; Laurentius A Lesmana
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 18, No 1 (2017): VOLUME 18, NUMBER 1, April 2017
Publisher : The Indonesian Society for Digestive Endoscopy

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.

Primary Tupaia Javanica Hepatocyte Culture as an In Vitro Model for Human Hepatitis B Virus Infection Kemal Fariz Kalista; Maryati Surya; Silmi Mariya; Diah Iskandriati; Irsan Hasan; Rino Alvani Gani
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 22, No 3 (2021): VOLUME 22, NUMBER 3, December 2021
Publisher : The Indonesian Society for Digestive Endoscopy

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.

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 Nurul Akbar; Ali Sulaiman; Rino Alvani Gani; Irsan Hasan; Laurentius Lesmana; Andri Sanityoso; Sjaifoellah Noer; FX Pridady; Soemarno Soemarno
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 10, ISSUE 1, April 2009
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/10120097-13

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

Difference in the Faecal Elastase-1 Concentration between Resectable and Unresectable Pancreatic Cancer Abdul Rahman M; Marcellus Simadibrata; Irsan Hasan; Suhendro Suhendro; E Mudjadid
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 21, No 2 (2020): VOLUME 21, NUMBER 2, August 2020
Publisher : The Indonesian Society for Digestive Endoscopy

Background: In the pancreatic cancer can occur pancreatic exocrine insufficiency (PEI) that can be detected by measurement of fecal elastase-1 level. The aim of this study was to identify the proportion and the degree of PEI, proportion of steatorrhea in pancreatic cancer, the concentration difference of faecal elastase-1 between resectable and unresectable pancreatic cancer and mean concentration difference of faecal elastase-1 based on the stage of pancreatic cancer.Method: This was a cross-sectional study to determine the concentration difference of faecal elastase-1 between resectable and unresectable pancreatic cancer. This research was conducted at Cipto Mangunkusumo hospital, several network hospitals of Cipto Mangunkusumo hospital, and Wahidin Sudirohusodo Makasar hospital from November 2014 until May 2015. The statistical test used to assess differences in the levels of faecal elastase-1 between resectable and unresectable pancreatic cancer was Mann Whitney and Kruskal Wallis test was performed to assess the differences between the mean levels of faecal elastase 1 based on staging pancreatic cancer.Results: A total of 48 subjects with pancreatic cancer participated in this study, with resectable category was 19 (39.6%) subjects, and 29 (60.4%) subjects were unresectable. The proportion of patients with pancreatic cancer who experienced PEI was 75% (CI 95% 0.63 - 0.87) and the proportion of patients with pancreatic cancer who showed steatorrhea symptoms was 68.8% (CI 95% 0.557 - 0.819). There was no significant difference of faecal elastase-1 levels (P = 0.738) between the resectable and unresectable whereas the resectable group median value was 38.0 (15-500) μg/g and in unresectable group was 35.0 (15-500) μg /g. There was no significant difference (p = 0.767) in faecal elastase-1 levels based on the stage of pancreatic cancer with median (range) in stage IB 36 (15-100) pg/g, stage IIA 62 (15-500) pg/g, stage III 15 (15-500) μg/g, and stage IV 36 (15-500) μg/g.Conclusion: This study found a high proportion of PEI and steatorrhea in pancreatic cancer. There was no significant difference in faecal elastase-1 levels between the resectable and unresectable pancreatic cancer. There was no significant difference between mean levels of faecal elastase-1 based on the stage of pancreatic cancer.

Biliary Drainage and Inflammatory Environment in Patients with Malignant Obstructive Jaundice Irsan Hasan
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 17, No 2 (2016): VOLUME 17, NUMBER 2, August 2016
Publisher : The Indonesian Society for Digestive Endoscopy

Non-invasive Markers for Diagnosis of Liver Cirrhosis in Chronic Hepatitis B Jeffry Beta Tenggara; Irsan Hasan; Andri Sanityoso; Murdani Abdullah
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 12, NUMBER 3, December 2011
Publisher : The Indonesian Society for Digestive Endoscopy

Background: Indonesia is an endemic country for hepatitis B viral infection. Thus, early diagnosis of cirrhosis is important to be established with regard to prompt treatment and to determine the patients’ prognosis. Liver biopsy which is a gold standard in diagnosing liver cirrhosis has several limitations, such as expensive and invasive. The objective of this study was to identify the accuracy of non-invasive markers: aspartate/alanine transaminase ratio (AAR), age-platelet index (API), aspartate transaminase to platelet ratio index (APRI), spleen to platelet ratio index (SPRI), and age-spleen-platelet ratio index (ASPRI) in predicting cirrhosis in chronic hepatitis B patients. Methods: A diagnostic study was performed in Division of Hepatology and Hepatology Outpatient Clinic, Depatment of Internal Medicine, Cipto Mangunkusumo Hospital between January 2009 and July 2010, with the participation of 71 chronic hepatitis B patients who had undergone liver biopsy consecutively. Stage of fibrosis was determined based on the METAVIR scoring system. Five non-invasive markers: AAR, API, APRI, SPRI, and ASPRI were compared with liver biopsy Results. Statistical analysis was performed by using T-test and Spearman correlation test using SPSS version 13. Results: API, APRI, SPRI, and ASPRI had significant correlation with the incidence of liver cirrhosis in hepatitis B infection (p 0.05). However, AAR had no correlation with the incidence of cirrhosis. Using the cut-off point of 1.19, APRI was the best marker with area under curve (AUC) 0.91, sensitivity 83.3%, and specificity 89.2%. Conclusion: Non-invasive markers were suitable in predicting cirrhosis and have the potential to decrease the number of liver biopsy in chronic hepatitis B patients. Keywords: non-invasive markers, chronic hepatitis B, liver cirrhosis

Co-Authors -, Gunawan - -, Gunawan - Abdul Aziz Rani Abdul Aziz Rani Abdul Rahman M Aditama, Humala Prika Agus Sudiro Waspodo Agus Waspodo Agustinus, Taolin Alessa Fahira Ali Sulaiman Ali Sulaiman Alvin Nursalim Alvin Nursalim Amanda Trixie Hardigaloeh Anandhara Indriani Khumaedi Anandhara Indriani Khumaedi, Anandhara Indriani ANDI UTAMA Andi Utama Andri Sanityoso Andri Sanityoso Andri Sanityoso Sulaeman Andri Sanityoso Sulaiman Aprilicia, Gita Ari Fahrial Syam Arnold Hasahatan Harahap Asep Saepul Rohmat Asep Saepul Rohmat, Asep Saepul Aulia Rizka, Aulia Azzaki Abubakar Azzaki Abubakar, Azzaki Baiq Kirana DN Mandasari Bambang Sutopo C Rinaldi A Lesmana C. Martin Rumende C. Martin Rumende, C. Martin Chyntia Olivia M. Jasirwan Chyntia Olivia Maurine Jasirwan, Chyntia Olivia Maurine Cleopas Martin Rumende Dadang Makmun Danang Agung Yunaidi Deskian Kostermans Deskian Kostermans, Deskian Diah Iskandriati E Mudjadid E. Mudjaddid A. Siswanto Deddy N.W.Achadiono Hamzah Shatri Edi Mulyana Edi Mulyana, Edi Edy Rizal Wahyudi Ening Krisnuhoni Eric Daniel Tenda Erni Erfan, Erni Esthika Dewiasty, Esthika Evy Yunihastuti Felix F Widjaja, Felix F FX Pridady Gita Aprilicia Gita Aprilicia Griscalia Christine Griskalia Christine Gunawan - - Guntur Darmawan H. M.S. Noer Hamzah Shatri Hamzah Shatri Hanif, Muhammad Yusuf Hardigaloeh, Amanda Trixie Hendra Koncoro Hilman Zulkifli Amin Idrus Alwi Idrus Alwi Idrus Alwi Ignatius Bima Prasetya, Ignatius Bima Iman Firmansyah Iman Firmansyah Imelda Maria Loho Imelda Maria Loho, Imelda Maria Indra Marki Indra Marki Jasirwan, Chyntia Olivia M Jeffry Beta Tenggara Juferdy Kurniawan Karmel Tambunan Kartika, Ronald Winardi Kemal F Calista Kemal Fariz Kalista Kemal Fariz Kalista Kemal Fariz Kalista Kemal Fariz Kalista, Kemal Fariz L A Lesmana L. A. Lesmana Laniyati Hamijoyo, Laniyati Laurentius A Lesmana Laurentius A Lesmana, Laurentius A Laurentius Lesmana Laurentius Lesmana Leonard Nainggolan Liana W. Susanto Lianda Siregar Lies Luthariana Lies Luthariana Lutfie Lutfie, Lutfie Marcellus Simadibrata Marcellus Simadibrata Marcellus Simadibrata Marcellus Simadibrata Marcellus Simadibrata Marcellus Simadibrata Martha Iskandar Maryati Surya Maulana Suryamin, Maulana Mondrowinduro, Prionggo Muhammad Sjaifoellah Noer Muhammad Yamin Lubis Muhammad Yamin Lubis, Muhammad Yamin Muhammad Yusuf Hanif Murdani Abdullah Murdani Abdullah Murdani Abdullah Murdani Abdullah Nababan, Saut Horas H. Nafrialdi Nafrialdi Nurul Akbar Nurul Akbar Paramita Khairan, Paramita Paulus Kusnanto Prionggo Mondrowinduro Pudji Rahardjo Pudji Rahardjo Raymond R. Tjandrawinata Rino A Gani Rino A Gani Rino A. Gani Rino Alvani Gani Rino Alvani Gani Rino Alvani Gani Rino Alvani Gani Rino Alvani Gani Rino Alvani Gani Rino Alvani Gani Rino Alvani Gani Rino Alvani Gani Rino Alvani Gani Rino Alvani Gani Ruswhandi - Ruswhandi -, Ruswhandi Salius Silih Sartika, Katarina Dewi Saut HH Nababan Saut Horas H. Nababan Saut Horas Hatoguan Nababan Saut Horas Hatoguan Nababan Saut Horas Hatoguan Nababan Seruni Tyas Khairunissa Silmi Mariya Siti Setiati Sjaifoellah Noer Soemarno Soemarno Soemarno Soemarno Suhendro Suhendro Suhendro Suwarto Suhendro Suwarto, Suhendro Sulaeman, Andri Sanityoso Suradji, Eka Widrian Susan Tai Suzanna Ndraha Syahrizal Syarif Taolin Agustinus Teguh H. Karjadi Teguh H. Karjadi, Teguh H. Telly Kamelia Tendean, Marcel Teng, Wei Teressa, Maria THARIQAH SALAMAH, THARIQAH Unggul Budihusodo Wiguna, Candra Wijaya, Indra Wismandari Wisnu Yaldiera Utami Yaldiera Utami, Yaldiera Yong, Bernard Jonathan Christian Zulkifly, Steven

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