Andri Sanityoso Sulaiman
Divisi Hepatobilier, Departemen Ilmu Penyakit Dalam Fakultas Kedokteran Universitas Indonesia / Rumah Sakit Umum Pusat Nasional Dr. Cipto Mangunkusumo

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Kekuatan genggam tangan, skor Child Pugh, dan massa otot pada pasien dengan sirosis hati Amanda Trixie Hardigaloeh; Rino Alvani Gani; Irsan Hasan; Andri Sanityoso Sulaiman
Jurnal Gizi Klinik Indonesia Vol 14, No 3 (2018): Januari
Publisher : Minat S2 Gizi dan Kesehatan, Prodi S2 IKM, FK-KMK UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/ijcn.34302

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Background: Malnutrition is independent factor related to morbidity, mortality and high cost of treatment in liver cirrhosis. Hand grip strength (HGS) is one of the method use for malnutrition detection and prognosis evaluation. The correlation of HGS with liver function (Child Pugh score) and muscle mass is controversial. These important evaluation is not yet avalaible in Indonesia.Objective: Aim of this study is to assess the role of HGS measurement in malnutrition and its correlation with liver function and muscle mass.Method: This is a cross-sectional study in liver cirrhosis patients at Hepatobiliary Clinic of Cipto Mangunkusumo Hospital from February to June 2015. Nutritional status was assessed by HGS. Muscle mass was obtained from bioimpedance. Data were analyzed using Spearman correlation test.Results: There were 115 patients liver cirrhosis at Hepatobiliary Clinic of Cipto Mangunkusumo Hospital, 112 patients who fit the inclusion criteria, consisted of 79 men and 33 women with mean age 54.15±10.55 years, median Child Pugh score 6 (5-13) with median HGS 26 (11-50) kgF, mean muscle mass 44.43±8.12 kg. The median intake of energy 1334.82 (604.75-3023.7) kkal, median protein 45.87 (19-114.5) gram. Prevalence of malnutrition according HGS was 33%. Hand grip strength is not correlated with Child Pugh score (p=0.046; r=-0.19) however it is correlated with muscle mass (p<0.00; r=0.70).Conclusion: There are 33% malnutrition cases based on HGS in out patient liver cirrhosis. There is no correlation between HGS with Child Pugh score however HGS is correlated with muscle mass in liver cirrhosis.
Cardiac Tamponade Due to Liver Amebiasis Rupture Birry Karim; Afifah Is; Ikhwan Rinaldi; Dono Antono; Cleopas Martin Rumende; Andri Sanityoso Sulaiman
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 11, NUMBER 3, December 2010
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/1132010150-155

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Amebiasis is common cases in Asia, Africa, and South Africa. Liver amebiasis has become a serious problem worldwide especially in health and social aspect. The protozoa named Entamoeba histolytica was easily found in area with poor sanitation, low socioeconomic status, and poor nutrition status. The incidence of amebiasis in several hospitals in Indonesia is 5-15% per year. Epidemiological observation showed the comparison of incidence among male and female population and it was approximately 3 : 1 until 22 : 1 with male predominance. The potential age suffered from amebiasis is around 20 - 50 years old. The route of infection spread to oral-fecal and oral-anal-fecal. The most common complication is abscess rupture (5-15.6%). Rupture may be located in pleural cavity, pericardial cavity, lung, bowel, intraperitoneal, and skin. Rupture of liver amebias spread to pleural and pericardial cavity is a rare case and frequently under reported. This case report illustrates a 40-year-old male with cardiac tamponade due to rupture of liver amebiasis. Patient’s was admitted with chief complaint of shortness of breath, positive Beck’s triad, hepatomegaly, pleural effusion, liver abscess on sonography and swinging of heart on echocardiography. This patient was treated with metronidazole as a drug of choice, and pericardiocentesis for the cardiac tamponade.Keywords: cardiac tamponade, Entamoeba histolytica, oral-anal-fecal, metronidazole, pericardiocentesis
Factors Associated with Surveillance for Early Detection of Hepatocellular Carcinoma in Liver Cirrhosis Patients Ario Perbowo Putra; Andri Sanityoso Sulaiman; Juferdy Kurniawan; Kuntjoro Harimurti
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 18, No 3 (2017): VOLUME 18, NUMBER 3, DECEMBER 2017
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (167.745 KB) | DOI: 10.24871/1832017153-158

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Background: Minimal number of KHS patients diagnosed through surveillance is thought to be the cause of continued low survival. It is important knowing the proportion of surveillance for early detection of KHS in patients with liver cirrhosis and related factors.Objective: Determine the proportion of surveillance for early detection of KHS in patients with liver cirrhosis and related factors.Method: Cross-sectional study of patients with liver cirrhosis at RSCM from January to December 2013. Data obtained from medical records and reconfirmed by telephone. Surveillance is required for abdominal ultrasound with or without AFP at least once a year within 3 years after that period. Factors studied were gender, ethnicity, education level, income level, availability of medical assurance, location of residence, surveillance education, cirrhosis etiology, and severity of cirrhosis. Then logistic regression test is used in the multivariate analysis.Results: From 200 patients, 50 patients (25,0%) underwent surveillance, 150 patients (75,0%) did not. Bivariate analysis resulted in 4 variables with p 0.25, gender (p = 0,056), ethnicity (p = 0, 231), surveillance education (p = 0,005), and severity of cirrhosis (p = 0, 005). Multivariate analysis resulted risk factors for surveillance were surveillance education (OR = 2,598; CI 95% (1,325 - 5,094), p = 0,005) and severity of cirrhosis (OR = 1.815; CI 95% = 1,210-2,724; p = 0,004).Conclusion: Surveillance education and severity of cirrhosis are factors associated with surveillance for early detection of KHS in liver cirrhosis patients.
Efficacy of Combination Sofosbuvir, Pegylated-Interferon, and Ribavirin for Treatment of Hepatitis C Virus Genotype 1 Infection in Indonesia Andri Sanityoso Sulaiman; Rino Alvani Gani; Irsan Hasan; Cosmas Rinaldi A Lesmana; Juferdy Kurniawan; Chyntia Olivia Maurine Jasirwan; Kemal Fariz Kalista; Muhammad Yusuf Hanif
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 19, No 2 (2018): VOLUME 19, NUMBER 2, August 2018
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (475.176 KB) | DOI: 10.24871/192201874-78

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Background: The presence of direct-acting antiviral (DAA) has improved the treatment of HCV infection and making it more preferable than Pegylated-interferon (PegIFN) and Ribavirin (RBV) based treatment. However, treatment with all DAA combination regimen is limited and expensive in low health care affordability country including Indonesia. The appearance of generic sofosbuvir (SOF) facilitate the utilization of SOF plus PegINF with or withour RBV combination. Therefore, in this study we assessed the efficacy of SOF+RBV and SOF+RBV+PegINF combination for treatment of chronic hepatitis C infections patient with genotype 1 in Indonesia.Method: We performed retrospective study comprising 128 patients in Cipto Mangunkusumo Hospital with chronic hepatitis C, genotype 1, infection. 36 patients was treated with PegINF+SOF+RBV and 92 patients was treated with SOF+RBV with the duration of therapy was 12 and 24 weeks in both arms. The primary endpoint was sustained virologic response after treatment completion (SVR12).Results: In the end of treatment, 99.2% patients achieved undetected HCV RNA in 12 weeks and 24 weeks duration of therapy (100% in PegINF+SOF+RBV group and 98.9% in SOF+RBV group). The SVR12 of PegINF+SOF+RBV reach 100% meanwhile The SVR12 of SOF+RBV reach 88%.  No different in SVR12 between cirrhotic and non-cirrhotic patient in PegINF+SOF+RBV group while in SOF+RBV group, the SVR12 was lower in cirrhotic patients (82.9%) compared to non-cirrhotic patients (92.2%). In multivariate analysis, HIV co-infection is associated with lower SVR12 in SOF+RBV group.Conclusion: 12 weeks and 24 weeks of PegINF+SOF+RBV and SOF+RBV is effective in the treatment of genotype 1 chronic hepatitis C infection.
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

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (672.017 KB) | DOI: 10.24871/2222021124-129

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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.
Endogenous Endotoxemia in Patients with Liver Cirrhosis Andri Sanityoso Sulaiman
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 2, NUMBER 3, December 2001
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/23200112-21

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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

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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
Red Cell Distribution Width to Platelet Ratio: in a Search of Non-Invasive Liver Fibrosis Biomarker Andri Sanityoso Sulaiman
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 19, No 3 (2018): VOLUME 19, NUMBER 3, December 2018
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (67.336 KB) | DOI: 10.24871/1932018135-136

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The Diagnosis and Management of Acute Fatty Liver of Pregnancy Ahmad Fariz MZ Zein; Irma Wahyuni Anwar; Andri Sanityoso Sulaiman
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 20, No 2 (2019): VOLUME 20, NUMBER 2, August 2019
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (577.833 KB) | DOI: 10.24871/2022019111-117

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Acute fatty liver of pregnancy (AFLP) is a rare catastrophic illness constituting an obstetric emergency in third trimester of pregnancy and may have complications for both mother and fetus, including death. Yet it is still unclear, the pathogenesis of AFLP has been identified related to defects in fatty acid metabolism during pregnancy, especially in the setting of fetal genetic defects in fatty oxidation. Establishing the diagnosis of AFLP is challenging, further it may overlap with other liver diseases of pregnancy, such as preeclampsia and hemolysis, elevated liver enzymes, low platelet count (HELLP) syndrome. The management of AFLP is a multidisciplinary progress providing the prompt intervention more than the termination of the pregnancy. The awareness of AFLP is highly needed to provide early diagnosis and management so that it can reduce the morbidity and mortality.
Role of Lamivudine as Preemptive Therapy in Cancer Patients with Hepatitis B undergoing Chemotherapy Andree Kurniawan; Andri Sanityoso Sulaiman
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 14, NUMBER 3, December 2013
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (386.299 KB) | DOI: 10.24871/1432013188-193

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Patients diagnosed with hematology malignancy and solid tumor who underwent chemotherapy, frequently encountered hepatitis B reactivation. Patients with blood cancer, including lymphoma, had higher risk of reactivation compared to those with solid tumor. Steroid and immunosuppressant drugs contained in chemotherapy regimens were responsible for those events. Hepatitis B reactivation during chemotherapy treatment could contribute to acute liver failure and increase mortality. Administration of analog nucleoside therapy in this group of patient prior to the initiation of chemotherapy could prevent reactivation of hepatitis B.A 43 year-old male patient were diagnosed with diffuse large B cell non-Hodgkin lymphoma stadium II BE (oropharynx) under chemotherapy and had hepatitis B. In this evidence based case report, we reported a critical appraisal of the role of lamivudine as preemptive therapy in blood cancer and solid tumor.Keywords: chemotherapy, hepatitis B reactivation, malignancy