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All Journal Cermin Dunia Kedokteran The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy Jurnal Penyakit Dalam Indonesia Cermin Dunia Kedokteran

Juferdy Kurniawan

Divisi Hepatobilier, Departemen Ilmu Penyakit Dalam, Fakultas Kedokteran Universitas Indonesia/RSUPN Dr. Cipto Mangunkusumo, Jakarta

Author-ID : 301892

Health Professions Medicine & Pharmacology Public Health

Published : 23 Documents Claim Missing Document

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Probiotics as Alternative Therapy for Psychometric Disorders in Hepatic Encephalopathy Bany Faris Amin; Irfan Kresnadi; Vannessa Karenina; GM Yudi Prasetia A; Trivani Putri; Juferdy Kurniawan
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 20, No 1 (2019): VOLUME 20, NUMBER 1, April 2019
Publisher : The Indonesian Society for Digestive Endoscopy

Aim: To identify whether probiotics have the same effectiveness as lactulose in improving the results of psychometric testing in patients with hepatic encephalopathy.Method: Literature Searching were performed on Pubmed, EBSCOhost, Scopus, and Cochrane databases to obtain an randomized controlled trial (RCT) or a systematic review. Searches were made with the keywords "hepatic encephalopathy", "probiotic", "lactulose" and number connection test ("NCT"). Search is continued by excluding the literature through abstract and full text.Results: Two studies were found to be relevant according to the criteria. The study by Mittal showed that probiotics were better than lactulose in improving NCT-B with a risk ratio (RR) of 0.88 (95% CI: 0.54-1.44; p = 0.62) but not better for improving NCT- A with RR 1.43 (95% CI: 0.62-3.24; p = 0.40). In the Sharma study, lactulose was better in improving NCT score with the mean difference (MD) 6.7 (95% CI: 0.58-12.82) and in the Li study, there was no significant significance between MD 3.93 (95% CI: -0,72-8,58)Conclusion: In conclusion, Probiotics cannot replace lactulose as a standard therapy for hepatic encephalopathy. There is not enough evidence that proves probiotics are better than lactulose.

COVID-19 Related to Liver Impairment and Its Impact on Chronic Liver Disease Andri Sanityoso Sulaiman; Juferdy Kurniawan; Chyntia Olivia Maurine Jasirwan; Saut HH Nababan; Kemal F Calista; Cosmas Rinaldi A Lesmana; Irsan Hasan; Rino Alvani Gani; Baiq Kirana DN Mandasari
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 21, No 3 (2020): VOLUME 21, NUMBER 3, December 2020
Publisher : The Indonesian Society for Digestive Endoscopy

By late December 2019, a novel beta-coronavirus, named as COVID-19 (2019-nCoV), was discovered in Wuhan, Hubei Province, China which epidemiologically linked to a Huanan seafood market in Wuhan. Coronavirus Disease 2019 or COVID-19 cases are growing rapidly from Wuhan to many countries, finding the health care system unprepared to face this threat. No effective drugs are clinically approved to manage the disease and strategies to protect the most vulnerable from developing severe illness and infection is still unclear. Information on how COVID-19 virus infection may affects many organs, especially the liver and the relevance of pre-existing liver disease in patients as a risk factor for the infection or disease severity are still scarce and inconclusive. Besides, the recommendation and consideration in liver transplant patients, hepatocellular carcinoma, or patient on immunosuppressive therapy still need further analysis Therefore, the information on the mechanism and treatment of COVID-19 related liver injury in patients with or without pre-existing liver disease should be considered.

Abnormal Liver Function in Predicting COVID-19 Patients’ Prognosis Sari, Sakinah Rahma; Kurniawan, Juferdy
Jurnal Penyakit Dalam Indonesia Vol. 9, No. 1
Publisher : UI Scholars Hub

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Despite of the high prevalence of liver enzyme elevation in COVID-19 patients, its effect on predicting COVID-19 patients’ prognosis was still debatable. This evidence-based case report aims to evaluate the effect of abnormal liver function in the prognosis of COVID-19 patients. Literature searching was performed on August 16-17 2021 using 3 databases: PubMed, Scopus, and Proquest. The articles selected by title/abstract screening, duplication elimination, and applying eligibility criteria were then appraised using Centre of Evidence Based Medicine (CEBM), University of Oxford. Some of the studies reported there were no significant difference in the prognosis of COVID-19 patient with and without abnormal liver function. However, most of the studies reported abnormal liver function as an independent poor prognosis predictor in COVID-19 patients. Based on the study with the highest level of evidence, the elevation of AST and ALT increase the risk of poor prognosis in COVID-19 patients [OR 2.98 (95% CI 2.35-3.77), p<0.0001) and OR 1.73 (95% CI 1.32-2.27, p<0.001)]. Based on the 34 studies appraised, we conclude that abnormal liver function will increase the risk of poor prognosis in COVID-19 patients. Thus, careful monitoring must be done in COVID-19 patients with abnormal liver function.

Comparison of Absolute Neutrophil Count between Hospital and Community Acquired Methicillin-Resistant Staphylococcus aureus Infection Kurniyanto, Kurniyanto; Santoso, Widayat Djoko; Nainggolan, Leonard; Kurniawan, Juferdy
Jurnal Penyakit Dalam Indonesia Vol. 5, No. 4
Publisher : UI Scholars Hub

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Introduction. The virulence factors from community acquired-methicillin resistant Staphylococcus aureus (CA-MRSA) mainly due to toxins like Panton Valentin Leukocidin (PVL) and Phenol Soluble Modulin (PSM). Both of toxins cause decrease of value through neutrophil lysis. This study aimed to identify different value of absolute neutrophil count between hospital and community acquired MRSA. Methods. A cross sectional was conducted which included subjects who were infected by MRSA and hospitalized during 2012-2017. Classification of MRSA were divided due to its sensitivity and resistance to non-beta lactam antibiotics. Isolate that resistance to ≤ 2 antibiotics were classified as CA-MRSA. The others with resistance to ≥ 3 antibiotics were classified as hospital acquired MRSA. Absolute neutrophils count (ANC) were collected 24 hours from the positive MRSA culture. Data were analyzed by using independent T test and Mann-Whitney test. Results. We collected 62 subjects infected by MRSA which 35 subjects were HA-MRSA and 27 subjects were CA-MRSA. The median of ANC from CA-MRSA was 7,410.7 (1,147.3-26,560.2) and HA-MRSA was 16,198.0 (3,921.6-28,794.1) with p value < 0.001. Conclusion. There was a different value of absolute neutrophil count in infections due to community and hospital acquired MRSA.

Perkembangan Terapi Hepatitis B Kronis di Indonesia Kurniawan, Juferdy
Jurnal Penyakit Dalam Indonesia Vol. 8, No. 3
Publisher : UI Scholars Hub

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Indonesia merupakan salah satu negara dengan prevalensi hepatitis B yang tinggi di Asia Tenggara (kedua setelah Vietnam). Berdasarkan Riskesdas yang dilakukan oleh Kementerian Kesehatan Republik Indonesia, pada studi yang dilakukan pada sampel darah PMI, 10 dari 100 orang Indonesia terinfeksi hepatitis B atau C. Maka dari itu, dibutuhkan penanganan yang ekstra untuk penanggulangan masalah infeksi hepatitis B

Profil Klinis dan Kesintasan Pasien Karsinoma Sel Hati di Rumah Sakit Rujukan Tersier Indonesia Tahun 2015-2021 Hasan, Irsan; Gani, Rino Alvani; Sulaiman, Andri Sanityoso; Kurniawan, Juferdy; Lesmana, Cosmas Rinaldi A.; Jasirwan, Chyntia Olivia M; Nababan, Saut Horas H.; Kalista, Kemal Fariz; Aprilicia, Gita; Teressa, Maria
Jurnal Penyakit Dalam Indonesia Vol. 10, No. 2
Publisher : UI Scholars Hub

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Introduction. Hepatocellular carcinoma (HCC) is the most common primary liver cancer in the world and Indonesia. This study aimed to describe the clinical presentation and survival rate of HCC patients in Dr. Cipto Mangunkusumo Hospital (RSCM) as the Indonesian tertiary referral hospital in year 2015-2021 Methods. Cohort study was performed in year 2015-2021. Clinical presentations at the time of diagnosis were recorded from electronical health record. All HCC patients were followed up until death. One-year survival based on staging was assessed using log rank test and presented with Kaplan Meier curve. Results. A total of 799 HCC patients were included. Majority of HCC patients were male, 619 patients (77.5%), and aged 55 (SD 11.9) years. Hepatitis B was the major etiology, found in 500 patients (62.6%). Median of alfa feto-protein (AFP) was 1,109 (0.8-3,462,499) ng/ml. At the time of diagnosis, Barcelona Clinic Liver Cancer (BCLC) stage C (37.7%) was the most commonly found. Portal vein thrombosis was found in 205 patients (25.7%). There were 271 (33.9%) HCC patients received curative and palliative treatment, and others had supportive care. One year survival rate of HCC was 61.2%. One year survival rate of HCC based on staging for BCLC A, BCLC B, BCLC C, and BCLC D were 91.1%, 68.6%, 47.6%, and 13.3%, respectively (log-rank test: p<0.001). Conclusion. The majority of patients diagnosed with HCC were at an advanced stage so that the one-year survival is poor.

Perlemakan Hati Non-Alkoholik dan Risiko Fibrosis Hati pada Pasien Hepatitis B Kronik Sulaiman, Andri Sanityoso; Hasan, Irsan; Lesmana, Cosmas Rinaldi A.; Kurniawan, Juferdy; Jasirwan, Chyntia Olivia Maurine; Nababan, Saut Horas H.; Kalista, Kemal Fariz; Aprilicia, Gita; Gani, Rino Alvani
Jurnal Penyakit Dalam Indonesia Vol. 10, No. 3
Publisher : UI Scholars Hub

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Introduction. Prevalence of non-alcoholic fatty liver disease (NAFLD) is increasing throughout the world due to sedentary lifestyle and dietary habit, including in patients with chronic hepatitis B (CHB). In several studies, advanced of liver disease were more likely observed among those CHB patients with NAFLD. NAFLD might increase the risk of liver disease progression in CHB patients, but prior investigations were still limited. This study aimed to determine the association between NAFLD and risk of liver fibrosis in CHB patients. Methods. All patients with positive serum hepatitis B surface antigen in the Hepatobilier Data Registry, Cipto Mangunkusumo Hospital, were included in this study. Based on abdominal ultrasonography, patients were divided into two group (group I: non-NAFLD – hepatitis B patients vs. group II: NAFLD – hepatitis B patients). Data demographic and clinical examination were collected. Significant liver fibrosis was defined as stage liver fibrosis above 7 kPa (≥ F2). Logistic regression was used to identify NAFLD as risk factor for significant fibrosis. Variables were expressed as prevalence odd ratio (POR) with 95% CI. P values <0.05 were considered statistically significant. Results. Among 130 hepatitis B patients, 45 patients (34.6%) were diagnosed with NAFLD. Of 45 patients in group II, 36 patients (80%) had significant liver fibrosis. It was observed that a higher percentage of patients in group II were HBeAg negative compared to those in group I (66.7% vs. 35.9%; p=0.038). Furthermore, group II also displayed higher levels of liver stiffness compared to group I (12.22 (8.6 kPa) vs. 8.57 (7.8 kPa); p 0.016). In multivariate analysis, NAFLD was significantly associated with significant liver fibrosis (POR: 5.87; CI95%: 2.48 – 13.86; p < 0.001) after adjusted with HBeAg status. Conclusion. NAFLD associated with the higher risk of liver fibrosis in patients with hepatitis B. Modification of lifestyle and potential therapeutic intervention may help in reducing the progression of liver fibrosis.

Evaluasi Pengukuran Kekakuan Limpa dalam Memprediksi Perdarahan Varises Esofagus Berulang pada Pasien Sirosis Hati Tahir, Andi Cahaya; Kurniawan, Juferdy; Simadibrata, Marcellus; Rizka, Aulia; Shatri, Hamzah; Lesmana, Cosmas Rinaldi A.; Mulansari, Nadia Ayu
Jurnal Penyakit Dalam Indonesia Vol. 11, No. 1
Publisher : UI Scholars Hub

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Introduction. Esophageal variceal bleeding is one of the complications caused by an increase in pressure within the portal vein blood vessels. The gold standard examination for portal pressure is the hepatic venous pressure gradient (HVPG), but HVPG examination is invasive, involving transjugular catheterization of the hepatic vein. Currently, non-invasive methods for measuring portal hypertension are being developed to predict esophageal varices and esophageal variceal bleeding using spleen stiffness measurements. This study aimed to evaluate the accuracy of spleen stiffness measurement in predicting recurrent esophageal variceal bleeding in patients with liver cirrhosis. Methods. This study used a retrospective cohort design with secondary data sourced from medical records at Cipto Mangunkusumo Hospital. Spleen stiffness assessment was conducted using the vibration controlled transient elastography (VCTE) spleen-dedicated stiffness measurement (FibroScan®, Echosens, France) with a frequency of 100Hz. After six weeks post-first esophageal variceal bleeding in liver cirrhosis patients, an evaluation of recurrent esophageal variceal bleeding was performed. The collected data were analyzed using SPSS 26. The ability of spleen stiffness measurement to predict recurrent esophageal variceal bleeding was assessed by evaluating the AUROC (area under the curve of receiver operating characteristic) curve. Results. A total of 102 liver cirrhosis patients who experienced first-time esophageal variceal bleeding were included in the study. Recurrent esophageal variceal bleeding was found in 23/102 (22.5%) liver cirrhosis patients. There was a significant difference in spleen stiffness values between the two groups, with higher values in the group of patients with recurrent esophageal variceal bleeding (90.9 kPa (IQR: 86.5 – 96.2) vs. 59.3 kPa (IQR: 45.2 – 74.3), p < 0.001). The AUC value of spleen stiffness for predicting recurrent esophageal variceal bleeding provided good predictability, with an AUC value of 0.898 (95% CI 0.808 – 0.988), p < 0.001. The cut-off value of spleen stiffness at 70 kPa yielded a sensitivity of 87% and specificity of 65% in predicting recurrent esophageal variceal bleeding. Conclusion. Spleen stiffness measurement can be beneficial as an evaluation method to assess the likelihood of recurrent esophageal variceal bleeding in patients with liver cirrhosis at the 6th week after the first bleeding episode.

Spleen and Liver Stiffness as Noninvasive Predictors of Varices in HBV Cirrhosis Siahaan, Billy Stinggo; Kurniawan, Juferdy; Simadibrata, Marcellus; Rizka, Aulia; Sanityoso, Andri; Rumende, Cleopas Martin; Rachman, Andhika; Shatri, Hamzah
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 24, No 2 (2023): VOLUME 24, NUMBER 2, August, 2023
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/2422023137-142

Background: Esophageal varices (EV) are the most frequent complication of portal hypertension in patients with liver cirrhosis. Due to many reasons, esophagogastroduodenoscopy remains impractical for routine surveillance in everyday practice. Hence, ongoing studies into reliable non-invasive test for predicting EV are still important.Methods: A total of 71 patients with liver cirrhosis due to hepatitis B who underwent endoscopy, spleen stiffness measurement (SSM), and liver stiffness measurement (LSM) between January and April 2023 were enrolled in this study. Diagnostic applicability was assessed using the area under the receiver-operator curve (AUC) to measure and compare the performance of each measurement and combination for predicting EV, as well as to obtain the corresponding optimal prediction value.Results: This study included 71 patients with liver cirrhosis. Among them, 74.6% (53 patients) were classified as Child-Pugh A, 22.5% (16 patients) as Child-Pugh B, and 2.8% (2 patients) as Child-Pugh C. The prevalence of esophageal varices (EV) within the cohort was 71.8%. This study showed that SSM with a cut-off of 38.8 kPa had AUC 0.867 (95% CI: 0.774–0.960) (sensitivity 78.4%, specificity 80%), and LSM with a cut-off of 10.55 kPa had AUC 0.822 (95% CI: 0.701–0.943) (sensitivity 88.2%, specificity 65%).Conclusion: Spleen and liver stiffness measurements demonstrate good performance in predicting EV in patients with liver cirrhosis caused by hepatitis B.

Liver Disease Associated with Inflammatory Bowel Disease Kurniawan, Juferdy; Budiman, Refael Alfa
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 25, No 1 (2024): VOLUME 25, NUMBER 1, April, 2024
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/251202471-75

Inflammatory Bowel Disease (IBD) is a chronic condition characterized by persistent inflammation of the gastrointestinal tract, comprising ulcerative colitis (UC) and Crohn’s disease (CD). While the current global incidence of IBD exceeds 0.3% in Western nations, Indonesia reports a comparatively lower prevalence however with projections indicate a potential rise in incidence from 2020 to 2050. Hepatobiliary manifestation is one of the most common extraintestinal manifestations of IBD. Some of the liver disease associated with IBD had similar background immune response, inflammatory reaction, similar risk factor, or due to the treatment of IBD. Primary sclerosing cholangitis (PSC) has close association with IBD and both affect the prognostic and disease progression of each other. Non-alcoholic fatty liver disease (NAFLD) shares common metabolic risk factors. Several drugs used as the treatment of IBD might cause hepatic injury especially due to the long treatment duration of IBD. Hepatitis B reactivation is another concerning event found after prolonged used of immunosuppressive drugs of IBD. Therefore, close monitoring of liver function test periodically is a mandatory test to screen liver disease in IBD patients. Keyword: Inflammatory bowel disease, liver disease, autoimmune hepatitis, drug-induced liver injury

Co-Authors -, Gunawan - -, Gunawan - A, GM Yudi Prasetia Agnes Elsha Maria Simbolon Amin, Bany Faris Andhika Rachman Andri Sanityoso Andri Sanityoso Sulaiman Anggi Anggelina Permatasari Aprilicia, Gita Aravinda Pravita Ario Perbowo Putra Ario Perbowo Putra, Ario Perbowo Aulia Rizka, Aulia Baiq Kirana DN Mandasari Bany Faris Amin Budiman, Refael Alfa C Rinaldi A Lesmana Chairunisa, Shafira Chyntia Olivia Maurine Jasirwan, Chyntia Olivia Maurine Cleopas Martin Rumende Dadang Makmun Dela Ryana Swaraghani Dewi ANGGRAENI Dewi Martalena Diana Sunardi E. Mudjaddid A. Siswanto Deddy N.W.Achadiono Hamzah Shatri Esthika Dewiasty, Esthika Felix Firyanto Widjaja Gita Aprilicia GM Yudi Prasetia A Gunawan - - Hanif, Muhammad Yusuf Hasan Maulahela, Hasan Ikhwan Rinaldi Imanuel Setiawan, Stefanus Irfan Kresnadi Irfan Kresnadi Irsan Hasan Jasirwan, Chyntia Olivia M Karenina, Vannessa Kemal F Calista Kemal Fariz Kalista Kemal Fariz Kalista Kemal Fariz Kalista, Kemal Fariz Kie Chen Kresna Adhiatma Kresnadi, Irfan Kuntjoro Harimurti Kurniyanto Kurniyanto Kurniyanto, Kurniyanto Leonard Nainggolan Lutfie Lutfie, Lutfie Marcellus Simadibrata Marcellus Simadibrata Muhammad Yusuf Hanif Nababan, Saut Horas H. Nadia Ayu Mulansari, Nadia Ayu Permatasari, Anggi Anggelina Prasetyadi, Yosafat Lambang Purwita Wijaya Laksmi Putra Nur Hidayat Putri, Trivani Rino Alvani Gani Rino Alvani Gani Rino Alvani Gani Rino Alvani Gani Rudy Hidayat Sakinah Rahma Sari Sari, Sakinah Rahma Saut HH Nababan Saut Horas Hatoguan Nababan Sepmeitutu, Iwandheny Shafira Chairunisa Siahaan, Billy Stinggo Simbolon, Agnes Elsha Maria Stefanus Imanuel Setiawan Swaraghani, Dela Ryana Syahrizal Syarif Tahir, Andi Cahaya Teguh Karyadi Teressa, Maria Trivani Putri Triyanta Yuli Pramana Vannessa Karenina Widayat Djoko Santoso Widayat Djoko Santoso, Widayat Djoko Yosafat Lambang Prasetyadi

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