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All Journal journal of internal medicine E-Jurnal Medika Udayana Jurnal Penyakit Dalam Udayana ISM (Intisari Sains Medis) : Jurnal Kedokteran Jurnal Ilmiah Sangkareang Mataram The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy
I Dewa Nyoman Wibawa
Department Of Clinical Microbiology, Faculty Of Medicine, University Of Udayana, Bali
Biochemistry, Genetics & Molecular Biology Civil Engineering, Building, Construction & Architecture Economics, Econometrics & Finance Education Health Professions Immunology & microbiology Medicine & Pharmacology Public Health Social Sciences

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KARAKTERISTIK PASIEN KO-INFEKSI HIV-HCV DI RSUP SANGLAH DENPASAR Somia, Agus; Utama, Susila; Parwati, Tuti; Wibawa, I Dewa Nyoman
journal of internal medicine Vol. 11, No. 2 Mei 2010
Publisher : journal of internal medicine

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Abstract

Human Immunode! ciency Virus (HIV) and Hepatitis C Virus (HCV) are similar in many respects. Both viruses have asingle stranded RNA genome, both share similar routes of transmission and both cause chronic infection. However, HIV andHCV are also different in the pathogenesis, clinical manifestation and treatment. The aim of this study is to know characteristicof HIV-HCV coinfection patients in Sanglah Hospital. This study was descriptive study. Data based on patients medical recordduring from 1 januari 2004 sampai 31 Desember 2007 at VCT-CST. There were 48 cases HIV-HCV coinfected. 81.6% was male,mean of age of the ! rst anti HIV positive was 29.19 ± 4.63 years old. The risk factor was 75% IVDU. Baseline data showed71.4% suffered from HIV infection stage IV (WHO). The mean of body mass index was 18.78 ± 2.965 kg/m2, the mean of CD4was median of CD 4 was 222.56 ± 155.4 cell/ul, mean WBC was 4.38 ± 7.06 K/ul, mean of TLC was 1.134 ± 0.689 k/ul, meanof Hb was 12.53 ± 2.29 g/dl, Mean of PLT was 247.9 ± 90.11 k/ul, mean of SGOT 62.29 ± 71.91 IU, mean of SGPT was 77.34 ±109.83 IU. HbsAg positif 8.3% and 79.6% with HAART. The mortality rate was 10.8%. Most of HIV-HCV coinfected was male,productive age and the risk factor were IVDU.
PENDEKATAN DIAGNOSTIK DAN TERAPI DIARE KRONIS Wiryan, NGP Cilik; Wibawa, I Dewa Nyoman
journal of internal medicine Vol. 8, No. 1 Januari 2007
Publisher : journal of internal medicine

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Abstract

Diarrhea is defined as a change in bowel habit, with an increase in stool frequency or fluidity or both, more than 3 timesdaily or stool weight > 200 g/day. Acute diarrhoe if it is less than 2 weeks of duration, persistent if between 2-4 weeks in duration,and Chronic if it is more than 4 weeks in duration. Diarhoea is a common problem around the world. Chronic diarrhea morecompleksabout diagnosis and treatment than acute one. The pathophysiiological mechanisms chronic diarhoea divided into major grouposmotic, secretory and imflamtory. A carefull history will often suggest the diagnosis and direct investigations. Physical examinationmore usefull to measure the severity of diarhoe rather than suggest the cause of chronic diarhoea. Iinitial investigation includeblood test, serology for celiac ds, stool examinations. Small intestinal and colon ds need for enteroscopy, capsul endoscopy,sigmoidoscopy, colonoscopy, many test for non invasive for malabsorption. In specific clinical conditions need specific examinationtoo. Small Intestinal Bacterial Overgrowth can be diagnosed directly by culture from aspiration of duodenal fluid or indirectly byusing breath test. Bile acid malabsorption can be diagnosed by by measured bile acid radioactif labelled measured of metaboliteserum, and bile acid excretion. Lactose malabsorption can be diagnosed by lactose assay, breath test (hydrogen 14C Lactose and 13C lactose). Increasing orocaecal transit time diagnosed by using barium study, radionucleide scintygraphy, lactose hydrogenbreath test. Chronic diarrhoea due to increasing hormones producing tumours diagnosed by measured increasing level of hormonesin to serum. Investigations patients with chronic diarrhoea available in the ambulatory or hospitalised patients. Treatment ofchronic diarrhoea depends on the specific aetiology and may be curative, suppressive or empirical.
AKURASI PULSE OKSIMETRI UNTUK MENDETEKSI DILATASI VASKULAR INTRAPULMONER (DVIP) PADA PASIEN SIROSIS HATI Sujana, I Ketut; Wibawa, I Dewa Nyoman; Santoso, Anwar
journal of internal medicine Vol. 9, No. 1 Januari 2008
Publisher : journal of internal medicine

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Abstract

Hepatopulmonary syndrome (HPS) is a complication of liver cirrhotic in the lung. This clinicalsyndrome has three components; liver disease, intrapulmonary vascular dilatation (IPVD), and a defect inoxygenation. Transthoraxic echocardiography with contras enhancement (CE-TTE) is a gold standart methodbut still expensive and difficult to detect IPVD because it needs expertise. Therefore, a simple non-invasivemethod to detect IPVD would be desirable. In this study pulse oximetry was evaluated as predictor foridentification of IPVD in patient with liver cirrhotic.Objective of ythis study is to determine the diagnostic accuracy of pulse oxymetry in detection IPVDcompared with CE-TTE as a gold standart. The diagnostic test was perfomed with pulse oxyimetry in 49consecutive patient with liver cirrhotic of >17 years old without primary cardiopulmonary diseases. Oxygensaturation (SO2) was determined using a pulse oximeter in supine and upright position. The IVPD measured byCE-TTE as gold standard. Measurement of predictor and effect variables were singgle blinded which mean thedifferent examiner, each of them does not know the result of others. Sensitivity, specificity, positif predictivevalue, negative predictive value, accuracy, and likelihood ratio was calculated with computer programmed.Eight patients (16.3%) had IPVD and fourty (83.7%) without IPVD. The cut off SO2 95.5 % in supineposition can predict IPVD with sensitivity 97.6% (CI 95% 72.8;100.0), specificity 87.5% (CI95% 93.2;100.0),positif predictive value 87. 0% (CI95% 78.2;96.7) negative predictive value 100% (CI95% 72.8;100.0),accuracy 95% (CI95% 75.8;100.0), positif likelihood ratio 7.8, and negatif likelhood ratio 0.3. The cut off SO293.0 % in upright position can predict IPVD with sensitivity 100% (CI95% 94.2;100.0), specificity 87.5%(CI95% 78.2;96.7), positif predictive value 100% (CI95% 94.2;102.2), negative predictive value 97.6 %(CI95% 93.4;100.0), accuracy 97.5%(94.1;100.0), positif likelihood ratio 8, and negatif likelhood ratio 0. Thecut off slope oxygen saturation from supine to upright position ( SO2) 2.5% can predict IPVD with sensitivity100% (CI95% 97.2;100.1), specificity 95.1% (CI95% 89.1;100.0), positif predictive value 80% (CI95% 52.0;100.0), negative predictive value 100 %, accuracy 100% (97.1;100.0), positif likelihood ratio 20.4, andnegatif likelhood ratio 0. Pulse oxymetry is accurate predictor to detect of IPVD in liver cirrhotic patientwithout primary cardiopulmonary disease.
PENGARUH PENGGUNAAN TATO PERMANEN DAN ALAT CUKUR SECARA BERGANTIAN TERHADAP INFEKSI VIRUS HEPATITIS B DI KOTA DILI TIMOR–LESTE H Da Silva; I. D. N Wibawa; Pinatih Indraguna; Mulyanto
JURNAL SANGKAREANG MATARAM Vol. 3 No. 1 (2017): Maret 2017
Publisher : SANGKAREANG

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Abstract

Penggunaan tato permanen dan silet cukur bergantian masih kerap sekali dijumpai pada penduduk Kota Dili, Timor-Leste. Hal ini berdampak pada terjangkitnya virus menular Hepatitis B. Tujuan penelitian ini adalah untuk mengetahui apakah ada pengaruhpenggunaan tattoo permanen danalat cukur (silet atau pisau cukur) dengan kejadian infeksi virus hepatitis B. Penelitian ini dilakukan dengan metode diskriptif korelatif.Analisis statistik menggunakan regresi binary logisticpada taraf signifikansi 5%. Sampel penelitian ditentukan dengan caramultistage random samplingsehingga diperoleh jumlah sampel sebanyak 110. Hasil penelitian menunjukkan bahwa terdapat pengaruh yangsignifikan (p<0,05) antara penggunaan tattoo permanendan alat cukur secara bergantian secara simultan terhadap infeksi Virus Hepatitis B. variabel prediktor penggunaan tatto permanen terhadap infeksi virus hepatitis B diperoleh hubungan positif yang signifikan, sedangkan prediktor penggunaan alat cukur bergantian terhadap infeksi virus hepatitis B diperoleh hubungan positif yang tidak signifikan. Secara simultan penggunaan tatto permanen dan alat cukur secara bergantian mempengaruhi kejadian infeksi virus hepatitis B sebesar 16,6%. Sehingga dapat disimpulkan bahwa terdapat pengaruh antara penggunaan tattoo permanen dan alat cukur bergantian terhadap kejadian infeksi virus hepatitis B di Kota Dili, Timor-Leste.
Gambaran hasil pemeriksaan endoskopi pada pasien dispepsia di Rumah Sakit Umum Pusat (RSUP) Sanglah tahun 2015 Anak Agung Gde Waisampayana Putra; I Dewa Nyoman Wibawa
Intisari Sains Medis Vol. 11 No. 1 (2020): (Available online: 1 April 2020)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (217.777 KB) | DOI: 10.15562/ism.v11i1.529

Abstract

Background: Dyspepsia is recurrent and persistent pain or discomfort in the upper abdomen. Dyspepsia can be divided into two, which are organic dyspepsia and functional dyspepsia, respectively. Endoscopy is one of the recommended diagnostic tools for dyspepsia. This study aims to describe the endoscopic results in dyspeptic patients at Sanglah General Hospital.Method: The quantitative cross-sectional descriptive study design was used. This study used secondary data from medical records. The sample population of this study was patients with dyspepsia who undergone endoscopy procedure at the Sanglah Central General Hospital in 2015 with a total sampling method that resulted in 260 samples. Data were analyzed using SPSS version 21 for Windows.Results: The sex of the respondents involved in this study were male (50.8%) and female (49.2%), which have almost the same percentage. Nearly half of the study respondents were 41-60 years old (47.7%). About 92.3%, patients were organic dyspepsia and 7.7%, functional dyspepsia. While the most diagnosed endoscopic examination results were gastritis (40.0%) and found in the young age group (≤ 64 years).Conclusion: Patients with symptoms of dyspepsia are mostly male, young adults, have organic dyspepsia, and the picture of endoscopic examination is dominated by gastritis at a young age. Latar Belakang: Dispepsia adalah nyeri yang berulang dan menetap atau rasa tidak nyaman di daerah perut bagian atas. Dispepsia dapat dibagi menjadi dua yaitu dispepsia organik dan dispepsia fungsional. Endoskopi merupakan salah satu alat diagnostik yang di rekomendasikan untuk diagnosis dispepsia. Penelitian ini bertujuan untuk mengambarkan hasil endoskopi pada pasien dispepsia di RSUP Sanglah.Metode: Desain studi penelitian deskriptif kuantitatif cross sectional dengan menggunakan data sekunder dari rekam medis. Populasi sampel penelitian ini adalah pasien dispepsia yang melakukan endoskopi di Rumah Sakit Umum Pusat Sanglah Tahun 2015 dengan metode Total sampling yang menghasilkan 260 sampel. Data dianalisis menggunakan SPSS 21Hasil: Jenis kelamin responden yang terlibat pada penelitian ini adalah laki-laki (50,8%) dan perempuan (49,2%) dimana memiliki persentase yang hampir sama. Hampir setengah responden penelitian berusia 41-60 tahun (47,7%). Sekitar 92,3%, pasien merupakan dispepsia organik dan 7,7%, merupakan dispepsia fungsional. Sedangkan diagnosis terbanyak pada hasil pemeriksaan endoskopi adalah gastritis (40,0%) dan ditemukan pada kelompok usia muda (≤ 64 tahun).Kesimpulan: Pasien dengan gejala dispepsia sebagian besar berjenis kelamin laki-laki, berusia dewasa muda, memiliki dispepsia organik, dan gambaran pemeriksaan endoskopi didominasi oleh gastritis pada usia muda.
Transient Elastography sebagai Alat Skrining Kecurigaan Hipertensi Portal pada Penderita Sirosis Hepatis I Made Wisnu Wardhana; Gde Somayana; Ketut Mariadi; I Dewa Nyoman Wibawa
Intisari Sains Medis Vol. 11 No. 2 (2020): (Available online: 1 August 2020)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (684.178 KB) | DOI: 10.15562/ism.v11i2.620

Abstract

Background: Portal hypertension was causes by extensive fibrosis on liver cirrhosis. The diagnosis of portal hypertension can only be identified by invasive procedure. Transient elastography (TE) is a non-invasive examination to determine the level of liver fibrosis by liver stiffness (LS).Objective: Transient elastography is expected to predict the possibility of portal hypertension in liver cirrhosis.Methods: The study used a cross-sectional design, where data were analyzed using a receiver operating curve (ROC) to determine the area under the curve (AUC). Data was collected from 2015 to 2018 using consecutive sampling. Analysis were done using SPSS and Medcalc to determine the cut-off point that has the best sensitivity, specificity, positive likelihood ratio (+ LR) and negative likelihood ratio (-LR).Results: In this study we found 69 patients with hepatic cirrhosis which consisted of 57 men (82.6%) and 12 women (17.4%) with a mean age of 48.57. From 69 patients with cirrhosis, portal hypertension manifestations were found by endoscopy in 45 patients (65.2%), while 24 (34.8%) were absent. TE was examined to determine LS, where the lowest value was 11.0 kPa, the highest value was 75.0 kPa, with mean value of 29.89 kPa. AUC results for LS were 0.763 (95% CI 0.645-0.857, p <0.001). The best cut-off point for LS is above 17.5 kPa with a sensitivity of 82.22% (95% CI 67.9-92.0%), specificity 62.50% (95% CI 40.6-81.2%), + LR 2.19 (95% CI 1.3-3.7), and -LR 0.28 (95% CI 0.1-0.6).Conclusion: Transient elastography with liver stiffness above 17.5 kPa can be used as a screening tool to predict manifestations of portal hypertension in patients with liver cirrhosis. Latar belakang: Hipertensi portal adalah dampak fibrosis ekstensif pada sirosis hepatis. Dimana diagnosis hipertensi portal hanya dapat ditegakkan melalui prosedur invasif. Transient elastography (TE) merupakan pemeriksaan non invasif untuk mengetahui tingkat fibrosis hati dengan hasil berupa liver stiffness (LS).Tujuan: TE diharapkan dapat digunakan sebagai alat screening bagi penderita sirosis hepatis yang memerlukan tindakan endoskopi. Metode: Penelitian menggunakan desain potong lintang, dimana data dianalisis dengan menggunakan receiver operating curve (ROC) untuk menentukan area under curve (AUC). Data dikumpulkan dari tahun 2015 hingga 2018 secara konsekutif. Analisis menggunakan SPSS dan Medcalc untuk menentukan titik potong yang memiliki sensitivitas, spesifisitas, positive likelihood ratio (+LR) dan negative likelihood ratio (-LR).Hasil: Pada penelitian ini didapatkan 69 penderita sirosis hepatis yang terdiri dari 57 orang laki-laki (82,6%) dan 12 orang perempuan (17,4%) dengan rata-rata usia 48,57 tahun. Dari 69 penderita sirosis hepatis dilakukan dievaluasi dengan menggunakan endoskopi dimana didapatkan 45 orang (65,2%) mengalami manifestasi hipertensi portal, sedangkan 24 orang (34,8%) lainnya tidak. Kemudian dilakukan pemeriksaan TE untuk mengetahui LS, dimana didapatkan nilai terendah adalah 11,0 kPa, nilai tertinggi 75,0 kPa, dengan rata-rata 29,89 kPa. Analisis kurva ROC terhadap LS yang diperoleh dari TE, diperoleh hasil AUC 0,763 (95% CI 0,645-0.857, p<0,001). Titik potong untuk LS adalah >17,5 kPa dengan sensitivitas 82,22% (95% CI 67,9-92,0%), spesifisitas 62,50% (95% CI 40,6-81,2%), +LR 2,19 (95% CI 1,3-3,7), dan -LR 0,28 (95% CI 0,1-0,6).Simpulan: TE dengan LS>17,5 kPa dapat digunakan sebagai alat screening untuk memprediksi adanya manifestasi hipertensi portal dengan interpretasi sedang. 
Profil klinis pasien dengan gejala gangguan motilitas predominan konstipasi di unit endoskopi gastrointestinal rumah sakit tersier Godfried Erycesar Yeremia Saragih; I Dewa Nyoman Wibawa; I Ketut Mariadi; Gde Somayana
Intisari Sains Medis Vol. 12 No. 1 (2021): (Available online : 1 April 2021)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (433.573 KB) | DOI: 10.15562/ism.v12i1.855

Abstract

Background: Investigating constipation requires careful evaluation of general examinations cascaded into specifics to identify treatable or significant causes for early detection. This study aims to determine patients' clinical profile with symptoms of motility disorders, predominantly constipation, in the gastrointestinal endoscopy unit of the tertiary hospital.Methods: This descriptive cross-sectional study involved 82 participants collected through consecutive sampling. Patients with predominant constipation symptoms who underwent colonoscopy in Sanglah Hospital Endoscopy Unit from 2017 to 2018 were recruited. Primary data comprising clinical assessments, laboratory test results, and colonoscopy and histopathology interpretation were analyzed accordingly. Constipation and fecal incontinence severity was indicated by Patient Assessment of Constipation – Symptoms (PAC-SYM) and Jorge-Wexner score. Data was analyzed using SPSS version 25 for Windows.Results: Most of the respondents were male (62.2%). The PAC-SYM and Jorge-Wexner Score were relatively low, with mean values of 2.44±0.73 and 2.18±0.99, respectively. The prevalence of patients initially assessed with chronic constipation (57.32%) remained high (26.83%) despite adjustment being done after colonoscopic exclusion.Conclusion: Diagnostic challenges of constipation exceeded the exhaustive efforts utilizing extensive diagnostic modalities. Suboptimal treatment would be inevitable in the absence of a good-quality management algorithm. Latar Belakang: Investigasi konstipasi memerlukan kecermatan dalam mengevaluasi pemeriksaan umum yang berjenjang menjadi spesifik untuk mengidentifikasi kausa yang dapat ditangani atau bermakna terhadap deteksi dini. Penelitian ini bertujuan untuk mengetahui profil klinis pasien dengan gejala gangguan motilitas predominan konstipasi di unit endoskopi gastrointestinal Rumah Sakit Tersier.Metode: Penelitian deskriptif potong lintang ini melibatkan 82 responden yang dikumpulkan melalui pengambilan sampel secara konsekutif. Pasien dengan gejala dominan konstipasi yang menjalani kolonoskopi di Unit Endoskopi RSUP Sanglah selama tahun 2017 hingga 2018 direkrut. Data primer yang terdiri dari penilaian klinis, hasil tes laboratorium, dan interpretasi kolonoskopi maupun histopatologi dianalisis. Tingkat keparahan konstipasi dan inkontinensia feses ditunjukkan pada skor Patient Assessment of Constipation – Symptoms (PAC-SYM) dan Jorge-Wexner. Data dianalisis menggunakan SPSS versi 25 untuk Windows.Hasil: Sebagian besar atau responden berjenis kelamin laki-laki (62,2%). Skor PAC-SYM dan Jorge-Wexner relatif rendah dengan nilai rata-rata masing-masing 2,44±0,73 dan 2,18±0,99. Prevalensi pasien yang awalnya dinilai dengan konstipasi kronis (57,32%) tetap tinggi (26,83%) meskipun penyesuaian dilakukan setelah eksklusi kolonoskopi.Simpulan: Tantangan diagnostik konstipasi melebihi upaya maksimal dengan memanfaatkan modalitas diagnostik yang luas. Terapi yang kurang optimal tidak dapat dihindari jika tidak ada algoritma manajemen yang berkualitas baik.
Correlation between Quantitative HBsAg and HBV-DNA in Chronic Hepatitis B Infection Putu Prathiwi Primadharsini; I Dewa Nyoman Wibawa
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 14, NUMBER 1, April 2013
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (257.075 KB) | DOI: 10.24871/14120139-12

Abstract

Background: Methods used to diagnose and monitor chronic hepatitis B (CHB) by quantitation of hepatitis B virus-deoxyribonucleic acid (HBV-DNA) levels is expensive. Cheaper laboratory test as an additional markeris needed, thus we studied serum quantitative HBsAg to be used as surrogate marker in CHB patients. This study was aimed to investigate correlation between serum quantitative HBsAg and HBV-DNA in CHB patients.Method: In this cross-sectional study, we enrolled 62 CHB patients between January 2010 and December 2012 who had quantitative HBsAg and HBV-DNA assays in a private laboratory at Denpasar. HBV-DNA was measured by real-time polymerase chain reaction and quantitative serum HBsAg was measured by chemiluminescent microparticle immunoassay (CMIA). Stastistical analysis was performed by Mann-Whitney and Spearman’s correlation.Results: Of 62 patients, most subjects were males (82.26%). Mean HBsAg titer of CHB in HBeAg positive and negative patients were 281,000 and 4,900 IU/mL, respectively; while mean HBV-DNA in HBeAg positiveand negative patients were 59,000,000 and 7,530,000 IU/mL, respectively. We found that quantitative HBsAg and HBV-DNA in HBeAg positive and HBeAg negative patients were statistically signi cant (p = 0.0001, p = 0.0001, respectively). Signi cant correlation was found between serum quantitative HBsAg and HBV-DNA (r = 0.737; p= 0.000). Quantitative HBsAg was signi cantly correlated with HBV-DNA in HBeAg-positive subgroup (r = 0.717; p = 0.0001); and signi cant correlation was also found in HBeAg-negative subgroup (r = 0.443; p = 0.006) although the correlation was weak. Conclusion: Quantitative HBsAg has signi cant correlation with HBV-DNA in CHB patients. Keywords: quantitative HBsAg Assay, HBV-DNA, HBeAg, chronic hepatitis B infection
Drug-induced Esophagitis Pande Made Juniarta; I Dewa Nyoman Wibawa
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 (594.002 KB) | DOI: 10.24871/2022019104-110

Abstract

Esophageal injury could be caused by a various etiology, such as drug administration. Drug-induced esophagitis is a spectrum of esophageal lesions due to drugs that can cause complications of ulceration, perforation and stricture of the esophagus. More than one hundred drugs have been identified to cause damage to the esophageal wall, such as antibiotics, nonsteroidal anti inflammatory drugs (NSAID), alendronate, potassium chloride, anti-hypertension, quinidine, etc. Symptoms of drug induced esophagitis might appear as retrosternal pain, heartburn, odynophagia, dysphagia, weight loss, gastrointestinal bleeding, which also found in other cases of gastrointestinal lesions so they are often misdiagnosed in daily clinical practice. Endoscopic procedure is the first choice in diagnosis of drug-induced esophagitis. The lesion may appear as erosion, bleeding, ulcers, strictures, kissing ulcers, and residual drugs fragment on endoscopy. Management of drug-induced esophagitis are by stopping suspected drugs and educating about the proper drug administration. In severe cases, adequate fluid hydration and parenteral nutrition can be given. Sucralfat forms a protective layer in the area of the lesion, thus accelerates wound healing process. Acid-lowering agents can be considered in cases of reflux esophagitis. Therapeutic endoscopic may indicated in strictures cases, active bleeding due to esophageal ulcers, and retrieval remaining drug fragments that are lodged in the esophagus. While surgery should be reserved for patients with severe complications such as erosion of the mediastinal organs, heart and large blood vessels
Focal Segmental Glomerulosclerosis caused by Hepatitis B Infection Comorbid with HIV Infection Nicholas Wijayanto; Yenny Kandarini; IDN Wibawa; Ni Wayan Winarti
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 23, No 2 (2022): VOLUME 23, NUMBER 2, August 2022
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (569.031 KB) | DOI: 10.24871/2322022256-260

Abstract

Glomerulonephritis is an inflammatory condition on renal glomerulus. These entities can manifest as nephrotic syndrome. One of causes of secondary glomerulonephritis is hepatitis B infection. Glomerulonephritis due to hepatitis B only happens in 0.1 – 25% cases, with the focal segmental glomerulosclerosis (FSGS) is rarely reported. We reported 20 years old male with nephrotic syndrome. He was homosexual with history of unprotected sex and multiple partners. From kidney biopsy, we found focal segmental glomerulosclerosis lesion. Blood examination showed he had both hepatitis B (HBV-DNA 1.7x108 IU/mL) and HIV infection (HIV-RNA 820 copies/mL, CD4 839 cell/uL). We treated this patient with combination of anti-viral drugs which consist of tenofovir, lamivudine and efavirenz. After three weeks of treatment, he showed improvement in the clinical symptoms and urinalysis.
Co-Authors - Mulyanto, - Anak Agung Ayu Yuli Gayatri Anak Agung Gde Waisampayana Putra Anwar Santoso Chandrawati, Lily Cokorda Agung Wahyu Purnamasidhi Dewa Gde Agung Budiyasa Dewa Gde Agung Budiyasa Dwijo Anargha Sindhughosa, Dwijo Anargha Gde Ngurah Idraguna Pinatih Gde Somayana Godfried Erycesar Yeremia Saragih H Da Silva Hendra Koncoro Hendra Koncoro Hendra Koncoro Hendra Koncoro Hendra Koncoro Hendriketa Da Silva, Hendriketa Da I Gde Raka Widiana I Gusti Agung Suryadarma I Ketut Agus Somia I Ketut Badjra Nadha I Ketut Mariadi I Ketut Sujana I Made Juliana I Made Susila Utama I Putu Arsana I Wayan Dary Ida Bagus Nyoman Wibawa Imro'ati, Tri Asih Indraguna Pinatih, Indraguna Jemi Tubung Juniarta, Pande Made Kumbara, Cokorde Istri Yuliandari Krisnawardani Lily Chandrawati Luh Putulin Indrayani Luh Putulin Indrayani, Luh Putulin Made Wardhana Magat, Renaldy Frederich Nathanael Mario Steffanus Mulyanto Nefertiti, Eva Pravitasari NGP Cilik Wiryan Ni Wayan Winarti Nicholas Wijayanto Nyoman Purwadi Pande Made Juniarta Paramita, Anak Agung Ketut Yunita Paramita, Ida Ayu Pradnya Prihastuti, Putu Shely Purnama, Yongkie Iswandi Putu Prathiwi Primadharsini Putu Prathiwi Primadharsini Putu Prathiwi Primadharsini Titong Sugihartono Tjok Istri Anom S Tuti Parwati Wibawa, Ida Bagus Nyoman Widodo, Budi Yaditta Mirdania Yenny Kandarini Yongkie Iswandi Purnama Yuna Ariawan