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Perbandingan Kadar C-Reactive Protein Kuantitatif dengan Hasil Deteksi Antigen Cryptococcus neoformans pada Penderita Human Immunodeficiency Virus Hendrajaya, Maenaka Smaratungga; Indrati, Agnes Rengga; Ganiem, Ahmad Rizal
Global Medical & Health Communication (GMHC) Vol 1, No 2 (2013)
Publisher : Fakultas Kedokteran Universitas Islam Bandung

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Abstrak Infeksi Cryptococcus neoformans merupakan salah satu infeksi oportunistik pada penderita HIV yang dapat menyebabkan meningitis kriptokokus dan dapat dideteksi secara dini melalui antigen yang terdapat pada kapsul polisakarida. Ketersediaan pemeriksaan antigen ini sangat terbatas sehingga dibutuhkan parameter lain untuk mendeteksi secara dini kemungkinan terjadi meningitis kriptokokus. Parameter tersebut adalah C-reactive protein (CRP). Penelitian ini bertujuan untuk membandingkan kadar CRP kuantitatif dengan hasil deteksi antigenÂ Â C. neoformans pada penderita infeksi HIV. Serum diambil dari penderita HIV di klinik TerataiÂ Â RSUP Dr. Hasan Sadikin Bandung yang baru pertama kali terdeteksi, CD4+ <100 sel/mm3, belum diterapi, serta tidak didiagnosis meningitisÂ kriptokokus.Â DilakukanÂ deteksiÂ antigenÂ menggunakanÂ CryptococcalÂ antigenÂ latexÂ agglutination system (Meridian Diagnostics) dan pemeriksaan CRP kuantitatif. Desain penelitian analitik komparatif dengan analisis statistik menggunakanÂ Â statistical product and service solutions (SPSS) ver. 13, Uji Mann-Whitney U, dan dilakukan perhitungan sensitivitas dan spesifisitas serta penentuan cut-off CRP kuantitatif dengan kurva ROC. Hasil penelitian menunjukkan perbedaan bermakna kadar CRP kuantitatif pada hasil CALAS positif dengan negatif. Kadar CRP pada CALAS positif lebih tinggi dibandingkan dengan CALAS negatif (p<0,05). Dari kurva ROC didapatkan sensitivitas 84,3% dan spesifisitas 42,4%, serta cut-off CRP >5,8197 mg/dL. Dari 14 sampel dengan CALAS positif, 12 (85,7 %) dengan CRP >5,8197 mg/dL dan Â 2 (14,3%) Â dengan CRP â¤5,8197 mg/dL. Simpulan, CRP kuantitatif dapat Â dipertimbangkan sebagai salah satu parameter untuk mendeteksi secara dini kemungkinan meningitis kriptokokus pada pasien HIV dengan menyingkirkan Â kemungkinan lain yang dapat mengakibatkan peningkatan CRP. Â Kata kunci: Cryptococcal antigen latex agglutination system, C-reactive protein, meningitis kriptokokusÂ Comparison of Quantitative C-Reactive Protein Concentration and Cryptococcus neoformans Antigen Detection Results in Human Immunodeficiency Virus Patients Â Abstract Cryptococcus neoformans infection is one of the opportunistic infections in HIV patients, it caused cryptococcal meningitis, which can be detected earlier using the antigen contained in the polysacharide capsule. The availability of this antigen test is very limited that other parameter are needed for early detection of cryptococcal meningitis. That parameter is C-reactive protein (CRP). The aim of this study was to compare the levels of quantitative CRP with the Â C. neoformans antigen detection in HIV patients. This was a comparative analytical study design using serum taken from HIV patients who came to the Teratai Clinic RSUP Dr. Hasan Sadikin Bandung. The inclusion criteria was subject on their first detection having Â CD4 + <100 cells/mm3, have never been treated before and was not diagnosed with cryptococcal meningitis. Cryptococcal antigen detection using antigen latex agglutination system (Meridian Diagnostics) and quantitative CRP examination was performed. Data analysis used statistical analysis statistical product and service solution (SPSS) ver. 13 to calculate sensitivity and specificity and the determination of CRP cut-off by ROC curve. Results showed that there was significant differences in the levels of quantitative CRP from positive and negative CALAS results. CRP levels in CALAS positive results was higher than negative result (p<0.05). From ROC curve, the CRP had 84.3% sensitivity Â and 42.4% specificity, and the cut-off was >5.8197 mg/ dL. Of 14 samples with positive CALAS result, 12 (85.7%) had CRP >5.8197 mg/dL and 2 (14.3%) with CRP â¤5.8197 mg/dL. In conclusion, quantitative CRP could be considered as a parameter for early detection of cryptococcal meningitis in HIV patients, by eliminating the possibilities that can lead to increased level of CRP. Â Key words: C-reactive protein, Cryptococcal antigen latex agglutination system, cryptococcal meningitisÂ

Validity of Immunoglobulin M Anti Salmonella typhi Serologic Test in Childhood Typhoid Fever Marsela, Hilda; Setiabudi, Djatnika; Indrati, Agnes Rengga
Althea Medical Journal Vol 4, No 1 (2017)
Publisher : Althea Medical Journal

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Background: Typhoid fever, which mostly affects children, remains a major health problem in developing countries. Early diagnosis will help the management and thus, reduce morbidity and mortality. However, a rapid diagnostic test that detects the presence of immunoglobulin M (IgM) directed towards Salmonella typhi (S. typhi) antigen remains controversial despite its popularity. This study was aimed to assess the validity of IgM anti S. typhi serologic test in childhood typhoid fever. Methods: This retrospective diagnostic test, used blood culture as gold standard. Forty-one typhoid fever children with fever of 1â14 days admitted to Dr. Hasan Sadikin General Hospital Bandung from 2013 to 2015 were recruited. Diagnosis of typhoid fever is made clinically. Data were analyzed by Receiver Operating Characteristic (ROC) curve and diagnostic test.Results: Forty one children diagnosed with typhoid fever, 37 were positive for IgM anti S. typhi, but only 18 were positive for S. typhi in blood culture. IgM anti S. typhi (cut-off â¥4) test had an Area Under the Curve (AUC) of 59%, sensitivity of 100% and specificity of 17.39%. IgM anti S. typhi with cut-off >8 showed the highest AUC with sensitivity of 55.56% and specificity of 73.68%.Conclusions: IgM anti S. typhi test of cut-off >8 performs better than cut-off â¥4 in terms of AUC..[AMJ.2017;4(1):138â42]Â DOI:Â 10.15850/amj.v4n1.1035

Profil Ekspresi Koreseptor Human Immunodeficiency Virus CCR5 dan CXCR4 pada penderita Infeksi Human Immunodeficiency Virus yang menggunakan Narkoba Suntik Indrati, Agnes Rengga; Parwati, Ida; Garna, Herry; Alisjahbana, Bachti
Majalah Kedokteran Bandung Vol 50, No 3 (2018)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Infeksi human immunodeficiency virus masih merupakan masalah kesehatan global, termasuk di Indonesia dan pemakai narkoba suntik merupakan populasi yang besar di antara orang denganÂ infeksi HIV/AIDS (ODHA) yang berperan penting dalamÂ transmisi infeksi HIV. Opioid banyak digunakan penasun dan memengaruhi ekspresi CCR5 serta CXCR4 yang merupakanÂ koreseptor yang digunakan oleh HIV untuk menginfeksi sel limfosit T CD4. Penelitian ini bertujuan menganalisisperbedaan Â ekspresi koreseptor HIV CCR5 dan CXCR4 antara ODHA penasun dan ODHA bukan pemakai narkoba. Penelitian observasional analitik denganÂ rancangan cross sectional ini dilaksanakan pada September 2011âˆ’Mei 2013. Subjek penelitian adalah ODHA penasun yang diikutsertakan secara consecutive samplingÂ di RSUP Dr. Hasan Sadikin BandungÂ serta di komunitas di Jawa Barat. Pemeriksaan ekspresi koreseptor CCR5, CXCR4 dan jumlah sel limfosit T CD4 dilakukan dengan metode flowsitometri. Ditemukan 80 orang subjek penelitian dengan 17 orang pengguna narkoba suntik aktif, 16 orang dalam terapi metadon, 15 orang mantan penasun, dan 32 orang bukan pemakai narkoba. Persentase CXCR4 di permukaan sel limfosit T CD4 lebih tinggi bermakna pada ODHA bukan pemakai narkoba dibanding dengan ODHA penasun (86,13; 78,23; p 0,001). Tidak terdapat perbedaan bermaknaÂ ekspresi CCR5 dan MFI CXCR4 di permukaan sel limfosit T CD4 antara ODHA penasun dan ODHA bukan pemakai narkoba (p>0,05).Â Dari penelitian ini disimpulkan bahwaekspresi CXCR4Â lebih tinggi pada ODHA penasun dibanding dengan ODHA bukan pemakai narkoba pada sel limfosit T CD4. Ekspresi koreseptor CXCR4 yang lebih tinggi dibanding dengan CCR5 baik pada kelompok ODHA penasun dan bukan pemakai narkoba. Â Human Immunodeficiency Virus-Coreceptors CCR5 and CXCR4 Expression Profile in Injecting Drug Users Living with HIVÂ Human immunodeficiency virus (HIV) is considered as global health problem, includingin Indonesia. A large proportion of people living with HIV/AIDS (PLHAs) are Injecting Drug Users (IDUs) who play an important role in HIV transmission. Opioid that is used by many IDUs influence the expression of CCR5 and CXCR4, which are the co-receptors used by HIV to infect CD4 T lymphocyte cells. This study aimed to compare the expression of HV CCR5 and CXCR4 co-receptors between IDU PLHAs and non-drug user PLHAs. This was a crossectional analytical observation performed in the period of September 2011âˆ’May 2013 on IDU PLHAs who were sampled consecutively in Dr. Hasan Sadikin General Hospital Bandung and community in West Java. Flowcytometry was used for analyzing CCR5 and CXCR4 co-receptors as well as the CD4 T lymphocyte count. Eighty subjects were included in the study, consisting of 17 active injecting drug users, 16 IDUs on methadone therapy, 15 former IDUs, and 32 non-drug user PLHAs. The percentage of CXCR4 on CD4 T lymphocyte surface was significantly higher in non-drug user PLHAs when compared to IDU PLHAs (86,13; 78,23; p 0,001). No significant difference was found in the expression of CCR5 and MFI CXCR4 on CD4 T lymphocyte surface between IDU PLHAs and non-drug user PLHAs (p>0,05).Â It is concluded that the expression of CXCR4 on CD4 T lymphocyte surface is higher in IDU PLHAs compared to non-drug user PLHAs. The expression of CXCR4 co-receptors is higher than the expression of CCR5 both in IDU PLHAs and non-drug user PLHAs. Â Â Â

CHARACTERISTICS OF ANEMIA IN CHILDREN WITH HIV INFECTION Ghozali, Mohammad; Adhi Sunjaya, Al Farizi; Indrati, Agnes Rengga
Majalah Kedokteran Bandung Vol 50, No 2 (2018)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Anemia is a hematologic complication commonly encountered in HIV patients. Although the severity of anemia is generally mild, anemia has been shown to be a strong risk factor for disease progression, particularly in HIV infected person. With different severity and types of anemia in HIV patients, it is necessary to identify the severity and type of anemia in HIV-infected children, thus helping to determine the prognosis and management of their anemia. The purpose of this study was to describe HIV patient staging infection, co-morbidities, and type of anemia in HIV-infected children based on their therapy. A descriptive quantitative research was conducted in Dr. Hasan Sadikin General Hospital Bandung. Data were collected from patients? medical records diagnosed with HIV between 2015?2017. The severity of anemia was set according to World Health Organization standards in 2011 and the types of anemia were identified from the erythrocyte index on routine hematologic examination. Forty-seven of 73 children had anemia. Based on the severity of anemia, 26% mild anemia, 60% moderate anemia, and 15% severe anemia were found. Subsequently, hypochromic microcytic (40%), macrocytic (32%), and normocytic normochromic (28%) anemia were identified. Considering the direct and indirect mechanism to yield anemia in HIV-infected patients, this double sword symptom becomes the most common complication burdened the growth and development of HIV-infected children. This study made it even more pronounced. Key words: Anemia, Children, HIV Karakteristik Anemia pada Anak Terinfeksi HIVAnemia adalah komplikasi hematologi paling sering ditemukan pada pasien HIV. Meskipun tingkat anemia pada umumnya ringan, anemia telah terbukti menjadi faktor risiko kuat terhadap perkembangan penyakit. Terdapat perbedaan tipe anemia pada pasien HIV dengan etiologi yang berbeda pula sehingga perlu dilakukan identifikasi mengenai tingkat dan tipe anemia pada pasien HIV anak, yang pada akhirnya dapat membantu menentukan prognosis dan penatalaksanaan anemia pada pasien ini. Suatu penelitian deskriptif kuantitatif ini bertujuan mengetahuitingkat dan tipe anemia dengan mengklasifikasikannya berdasarkan komorbiditas pada pasien HIV/AIDS anak di RSHS tahun 2015?2017 menggunakan data rekam medik pasien pemeriksaan hematologi rutin. Tingkat anemia ditetapkan berdasar atas standar WHO, sementara jenis anemia dilihat dari indeks eritrosit. Sebanyak 73 pasien anak terinfeksi HIV, didapatkan 47 anak mengalami anemia. Tingkat anemia ditemukan anemia ringan (26%), anemia sedang (60%), dan anemia berat (15%). Tipe anemia yang ditemukan adalah normositik normokromik (28%), makrositik (32%), dan mikrositik hipokromik (40%). Tingkat anemia pada pasien HIV anak di RSHS pada umumnya adalah anemia sedang. Tipe anemia terbanyak pada penelitian adalah mikrositik hipokromik. Kata kunci: Anak, anemia, HIV

UJI DIAGNOSTIK PEMERIKSAAN KADAR TRANSFORMING GROWTH FACTOR BETA 1 CAIRAN PLEURA PADA PLEURITIS TUBERKULOSIS Wahyuningrum, Woro Hapsari; Indrati, Agnes Rengga; Rachmayati, Sylvia; Turbawaty, Dewi Kartika
Majalah Kedokteran Bandung Vol 49, No 4 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Sulitnya penegakan diagnosis pleuritis tuberkulosis (TB) disebabkan oleh gambaran klinis yang tidak spesifik dan rendahnya sensitivitas pemeriksaan bakteriologik, akibat cairan pleura yang bersifat pausibasiler.Transforming growth factor beta 1 (TGF-?1) mampu menekan respons imun seluler terhadap M. tuberculosis, berperan dalam aktivasi TB laten, kerusakan jaringan, dan fibrosis. Penelitian ini bertujuan mengetahui peranan pemeriksaankadarTGF-?1 cairan pleura dalam penegakan diagnosis pleuritis TB. Penelitian ini adalah uji diagnostik, pengambilan data secara potong lintang. Bahan pemeriksaan berupa cairan pleura yang disimpan dalam ultra low freezer dari pasien rawat inap di RSUP Dr. Hasan Sadikin (RSHS) Bandung dan Rumah Sakit Paru Dr. H.A Rotinsulu Bandung periode Oktober 2014 ? Maret 2015. Total subjek penelitian 68, terdiri dari 17 pleuritis TB confirmed, 22 pleuritis TB probable, dan 29 pleuritis non TB.Kadar TGF-?1 cairan pleura pleuritis TB: 41,4 (10,4 ?19.481) pg/mL. Pemeriksaan kadar TGF-?1 menunjukkan sensitivitas 66,7%, spesifisitas 65,5% pada nilai cut-off >37 pg/mL. Sensitivitas pemeriksaan kadar TGF-?1 lebih tinggi bila dibanding dengan pemeriksaan bakteriologik. Hasil negatif pada pemeriksaan bakteriologik dari subjek pleuritis TB probable, 77,3% di antaranya memberikan hasil positif pada pemeriksaan kadar TGF-?1. Pemeriksaan ini dapat digunakan sebagai tambahan modalitas pemeriksaan laboratorium untuk mendiagnosis pleuritis TB, terutama bila didapatkan hasil negatif pada pemeriksaan bakteriologik, namun kecurigaan pleuritis TB sangat kuat.Kata kunci: Kadar TGF-?1, pemeriksaan bakteriologik, pleuritis TB Diagnostic Value of Pleural Fluid Transforming Growth Factor Beta 1 Level in Tuberculous PleurisyTuberculous(TB) pleurisy was difficult to be diagnosed as it has nonspecific symptoms and low sensitivity in bacteriological tests which are caused by paucibacillary of pleural fluid. Transforming Growth Factor Beta 1 (TGF-?1) could suppress the immune response to M. tuberculosis infection, activating latent TB infection that involves tissue damages and fibrosis. This study aimed to determine the role of pleural fluid TGF-?1 level in diagnosing TB pleurisy. This was a cross-sectional specific descriptive observational study involving a total subjects of 68 that consisted of 17 confirmed TB pleurisy, 22 probable TB pleurisy, and 29 non-TB pleurisy. Pleural fluid collected in October 2014 ? March 2015 from the subjects was stored in an ultra low freezer. The which.level of TGF-?1 in pleural fluid in TB pleurisy was 41,4(10,4 ? 19.481) pg/mL. Pleural fluid TGF-?1 level showed a sensitivity of 66,7%, specificity of 65,5% and a cut-off value >37pg/mL. The sensitivity level of pleural fluid TGF-?1 was higher than that of the bacteriological test. Pleural fluid TGF-?1 level can be used as an adjunct modality of laboratory test for diagnosing TB pleurisy, especially for patient with high suspiscion of TB pleurisy but yield negative result in the bacteriological test.Key words: Bacteriological tests, TB pleurisy, TGF-?1 levels

KORELASI JUMLAH FOLIKEL ANTRAL DENGAN KADAR 25(OH)D SERUM PADA PENDERITA SINDROM OVARIUM POLIKISTIK Mustari, Asri Dini; Rostini, Tiene; Indrati, Agnes Rengga; Bayuaji, Hartanto; Rachmayati, Sylvia
Majalah Kedokteran Bandung Vol 50, No 4 (2018)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Sindrom ovarium polikistik (SOPK) ditandai oleh hiperandrogenisme, oligo atau anovulasi, dan morfologi ovarium polikistik. Penanda ovarium polikistik, yaitu terdapat ?12 folikel antral dengan diameter 2?9 mm pada pemeriksaan ultrasonografi. Vitamin D (25-hidroksivitamin D; 25(OH)D) berperan pada proses steroidogenesis di sel teka ovarium dan pengaturan ekspresi reseptor follicle stimulating hormone (FSH) di sel granulosa ovarium. Defisiensi 25(OH)D menyebabkan penurunan aktivitas FSH, sehingga folikel antral di ovarium berukuran kecil dan berjumlah banyak. Tujuan penelitian ini mengetahui korelasi jumlah folikel antral dengan kadar 25(OH)D serum pada penderita SOPK. Uji observasional analitik dengan rancangan potong lintang di Rumah Sakit Umum Pusat Dr. Hasan Sadikin (RSHS) Bandung dilakukan selama bulan September 2017?Juni 2018. Subjek penelitian adalah 52 penderita SOPK yang telah didiagnosis oleh klinisi obstetri dan ginekologi RSHS Bandung. Pengambilan darah vena dilakukan untuk pemeriksaan kadar 25(OH)D serum dengan metode ELISA. Hasil penelitian ini mendapatkan 56% subjek memiliki kadar 25(OH)D serum ?20 ng/mL. Hasil uji korelasi Spearman didapatkan korelasi negatif kuat yang bermakna (r = -0,867, p<0,001) jumlah folikel antral dengan kadar 25(OH)D serum. Kadar 25(OH)D serum yang rendah pada penderita SOPK berkorelasi dengan jumlah folikel antral yang banyak. Terdapat korelasi negatif antara jumlah folikel antral dan kadar 25(OH)D serum pada penderita SOPK. Kata kunci: Folikel antral, 25(OH)D serum, sindrom ovarium polikistik Correlation between Antral Follicles Count and Serum 25(OH)D Levels in Polycystic Ovary Syndrome PatientsPolycystic ovary syndrome (PCOS) is characterized by hyperandrogenism, oligo- or anovulation, and polycystic ovarian morphology. Vitamin D (25-hydroxyvitamin D; 25(OH)D) plays a role in the steroidogenesis process in the ovarian theca cells and regulates follicle stimulating hormone (FSH) receptor expression in granulosa cells. In 25(OH)D deficiency there is a decrease in FSH activity that the follicles become small and the antral follicles count in the ovary increases. The aim of this study was to determine the relationship between antral follicles count and serum 25(OH)D levels in PCOS patients. A cross-sectional analytical observational study was conducted in Dr. Hasan Sadikin General Hospital Bandung in September 2017?June 2018. Subjects of this study were 52 PCOS patients diagnosed by obstetricians and gynecologists of the hospital. Blood vein samples were collected to examine serum 25(OH)D levels using ELISA method. Serum 25(OH)D level of ?20 ng/mL was found in 55.8% of the subjects in this study. Analysis using Spearman?s correlation test showed a significant negative correlation (r = -0.867, p <0.001) between antral follicles count and serum 25(OH)D level in patients with PCOS. Lower levels of 25(OH)D serum in PCOS patients correlates with higher number of antral follicles count. There is a negative correlation between antral follicles count and serum 25(OH) D level in PCOS patients.Key words: Antral follicle count, 25(OH)D serum levels, polycystic ovary syndrome

Proportion of TLR-9 Gene Polymorphisms at rs352139 (G1174A) in HIV/AIDS Patients in West Java, Indonesia Yehezkiel Yonathan; Edhyana Sahiratmadja; Agnes Rengga Indrati
Althea Medical Journal Vol 7, No 4 (2020)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/amj.v7n.2014

Background: Human immunodeficiency virus (HIV) infection is the main cause of the immunodeficiency syndrome (AIDS). TLR-9 gene encodes a toll-like receptor-9 that plays a key role in innate immunity. This study aimed to describe the proportion of TLR-9 polymorphisms at rs352139 in patients with human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) in Bandung, West Java, Indonesia.Methods: This was a descriptive study involving a total of 96 patients with HIV/AIDS treated in a tertiary hospital in Bandung, West Java, Indonesia in 2013. TLR-9 gene polymorphisms at rs 352139 were examined using a mass screening platform and the genotypes proportion was presented in percentage and compared with other populations.Results: The average age of the HIV/AIDS patients recruited was 30 years (SD+6.1) and the baseline mean of CD4+ count was 318.02 mm3 (Normal was 1,500 mm3) (SD+273.1). The proportion of polymorphisms at rs352139or G1174A presented a wild type genotype GG (42.7%), GA (44.9%), and AA (12.4%), resulting in a total proportion nucleotide change of 57.3%.Conclusion: A total proportion of nucleotide change or polymorphisms is higher than the wild type. A further cohort study is of great interest to associate the rs352139 polymorphisms with a decrease in CD4+cells in HIV/AIDS patients, confirming a rapid disease progression.

Validity of Immunoglobulin M Anti Salmonella typhi Serologic Test in Childhood Typhoid Fever Hilda Marsela; Djatnika Setiabudi; Agnes Rengga Indrati
Althea Medical Journal Vol 4, No 1 (2017)
Publisher : Faculty of Medicine Universitas Padjadjaran

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Background: Typhoid fever, which mostly affects children, remains a major health problem in developing countries. Early diagnosis will help the management and thus, reduce morbidity and mortality. However, a rapid diagnostic test that detects the presence of immunoglobulin M (IgM) directed towards Salmonella typhi (S. typhi) antigen remains controversial despite its popularity. This study was aimed to assess the validity of IgM anti S. typhi serologic test in childhood typhoid fever. Methods: This retrospective diagnostic test, used blood culture as gold standard. Forty-one typhoid fever children with fever of 1–14 days admitted to Dr. Hasan Sadikin General Hospital Bandung from 2013 to 2015 were recruited. Diagnosis of typhoid fever is made clinically. Data were analyzed by Receiver Operating Characteristic (ROC) curve and diagnostic test.Results: Forty one children diagnosed with typhoid fever, 37 were positive for IgM anti S. typhi, but only 18 were positive for S. typhi in blood culture. IgM anti S. typhi (cut-off ≥4) test had an Area Under the Curve (AUC) of 59%, sensitivity of 100% and specificity of 17.39%. IgM anti S. typhi with cut-off >8 showed the highest AUC with sensitivity of 55.56% and specificity of 73.68%.Conclusions: IgM anti S. typhi test of cut-off >8 performs better than cut-off ≥4 in terms of AUC..[AMJ.2017;4(1):138–42] DOI: 10.15850/amj.v4n1.1035

Distribution of VDR Gene Polymorphisms Bsm-I rs1544410 and Apa-I rs7975232 among HIV/AIDS Patients from West Java Hendro Hendro; Edhyana Sahiratmadja; Agnes Rengga Indrati; Ani Melani Maskoen
Majalah Kedokteran Bandung Vol 52, No 1 (2020)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v52n1.1680

Vitamin D receptor, encoded by VDR gene, mediates vitamin D functions by not only regulating calcium metabolism and homeostasis but also in regulating immune response. Polymorphisms in VDR gene may increase the progression of human immunodeficiency virus (HIV) infection into acquired immunodeficiency syndrome (AIDS). This study aimed to explore the distribution of VDR polymorphisms among HIV sero-positive patients in West Java. A cross-sectional study was performed, recruiting 96 patients infected with HIV and VDR polymorphisms were analyzed. The genotype distributions of Bsm-I among HIV-infected patients were 2.2%, 18.5%, and 79.3% for BB, Bb, and bb, respectively whereas the distributions of Apa-I were 54.4%, 38.9%, and 6.7% for AA, Aa and aa, respectively. The frequency of VDR polymorphisms in Bsm-I among HIV-infected patients in West Java were considered high for b allele (88.6%), and in contrast for A allele in Apa-I that was 73.91%. Further studies involving healthy controls are needed to explore the VDR polymorphisms distribution in general population. Moreover, a cohort study, albeit challenging, is needed to further assess the association between VDR polymorphisms and the progression of HIV infection.Distribusi Polimorfisme gen VDR Bsm-I rs1544410 dan Apa-I rs7975232 pada Pasien HIV/AIDS di Jawa BaratReseptor vitamin D yang dikode oleh gen VDR mempunyai peranan penting terhadap fungsi vitamin D, tidak hanya dalam regulasi metabolisme dan keseimbangan kalsium namun juga berperan dalam meregulasi respon imun. Polimorfisme pada gen VDR ditengarai dapat meningkatkan progresivitas infeksi human immunodeficiency virus (HIV) menjadi acquired immunodeficiency syndrome (AIDS). Penelitian ini bertujuan mengetahui distribusi polimorfisme gen VDR pada pasien HIV di Jawa Barat. Penelitian ini melibatkan 96 pasien HIV dan dilakukan analisis polimorfisme gen VDR. Distribusi genotip Bsm-I pada pasien HIV di Jawa Barat adalah 2,2%, 18,5%, dan 79,3% untuk BB, Bb, dan bb, secara beurutan; sedangkan pada Apa-I adalah 54,4%, 38,9%, dan 6,7% untuk AA, Aa, dan aa. Frekuensi polimorfisme pada Bsm-I pada pasien HIV di Jawa Barat tergolong tinggi pada alel b (88,6%) dan berbanding terbalik pada dan Apa-I dengan alel A yaitu 73,91%. Penelitian lebih lanjut yang melibatkan individu kontrol diperlukan untuk mengetahui distribusi polimorfisme gen VDR pada populasi umum. Selain itu, studi kohort pada pasien HIV/AIDS diperlukan untuk menilai hubungan antara polimorfisme gen VDR terhadap progresivitas infeksi HIV.

Urinary Epithelial Sodium Channel (EnaC) Level as A Diabetic Marker of Nephropathy in Type 2 Diabetes Mellitus with Hypertension Heti Kus Erni; Nina Tristina; Agnes Rengga Indrati; Dewi Kartika Turbawaty
Majalah Kedokteran Bandung Vol 54, No 1 (2022)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v54n1.2533

Increased prevalence of diabetes mellitus (DM) leads to the increased of various complications including diabetic nephropathy, which can lead to the end stage renal disease (ESRD). The Epithelial sodium channel (ENaC), which is located in distal convoluted tubules, plays an important role in transepithelial sodium reabsorption for electrolyte homeostasis. Diabetes mellitus can cause changes in ENaC function which will interfere with kidney blood pressure control, worsening hypertension, and kidney injury that eventually may trigger diabetic nephropathy. The aim of this study was to determine the validity of urinary ENaC for screening diabetic nephropathy in type 2 diabetes mellitus (T2DM) with uACR as the gold standard. This was a cross-sectional analytical observational study conducted in Dr. Hasan Sadikin General Hospital Bandung, Indonesia, from December 2020 to July 2021. The subjects were 87 patients T2DM with hypertension with the majority of subjects (n=62) had a mean age of 56 years old and were experiencing albuminuria and hyperglycemia with DM for a duration of < 10 years. The poor glycemic control in these patients accelerated the occurrence of kidney damage. Result showed that urine ENaC level had a sensitivity and specificity of 82.3% and 48%, respectively, with 72.4% accuracy. The cut-off point of urine ENaC in this study was 0.98 ng/mL. Hence, urine ENaC level can be used as a test to screen for diabetic nephropathy with 82.3% sensitivity.

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