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"ABSTRAKPada tahun 1987 dan 1991 terjadi wabah Hepatitis E (HE) di Kabupaten Sintang, Kalimantan Barat. Sampai saat ini di Indonesia belum ada angka-angka yang jelas mengenai prevalensi HE, khususnya mengenai endemisitas. Tujuan penelitian adalah mendapatkan prevalensi petanda serologik VHE pada penderita tersangka hepatitis akut dan pada orang sehat.Pemeriksaan anti-VHE IgG dilakukan terhadap 192 sampel (31 anak, 161 dewasa) penderita tersangka hepatitis akut dan 75 sampel dari orang sehat. Hasil anti-VHE IgG yang positif dikonfirmasi dengan Western Blot (WB).Tidak dijumpai anti-VHE IgG positif pada populasi sehat yaitu donor darah. Di Jakarta dijumpai hepatitis virus E secara endemik, dengan prevalensi anti-VHE IgG pada kelompok tersangka hepatitis akut sebesar 3,3%. Dari 48 orang dewasa tersangka hepatitis A akut ada 1 orang dengan anti-VHE IgG positif setelah konfirmasi. Adanya hasil anti-VHA IgM dan anti-VHE IgG positif mungkin disebabkan oleh adanya superinfeksi dari HA atau terjadi infeksi ganda HA dan HE. Pada anak tersangka hepatitis akut maupun hepatitis A (HA) akut tidak ada yang anti-VHE IgG positif.Penelitian HE masih perlu dilanjutkan untuk mengetahui sampai berapa jauh dampaknya di Indonesia. Kriteria sampel dan keadaan lingkungan hidup dapat mempengaruhi prevalensi penyakit. Untuk HE akut sebaiknya dilakukan pemeriksaan anti-VHE IgM bila reagen anti-VHE IgM sudah tersedia. Pemeriksaan ini dapat dipertimbangkan sebagai salah satu pemeriksaan pada penderita hepatitis yang diduga penularannya melalui fekal-oral, terutama pada daerah endemis.

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ABSTRACTEpidemies of Hepatitis E at Sintang, West Kalimantan on 1987 and 1991 were reported. However, endemicity of this disease in Indonesia is still unknown. The aim of this study is to determine the prevalence of serologic marker for HEV in patients with suspected acute hepatitis as well as in healthy individuals.IgG Anti-HEV was determined on 192 samples from patients with suspected acute hepatitis (31 children and 161 adults), and 75 samples of blood donors. Positive results were confirmed by Western blot method.None of the blood donors positive for IgG anti-HEV. We found viral hepatitis Eendemic in Jakarta with prevalence of 3,3% among acute hepatitis patients. One out of 48 adult patients with suspected hepatitis A was anti-HEV confirmed positive, this finding probably caused by HAV superinfection or coinfection of HAV and HEV. None of children with suspected acute hepatitis or hepatitis A was anti-HEV positive.This study need to be continued on other places in Indonesia to find how big the problem of HEV infection is. For diagnosis of acute hepatitis E, IgM anti-HEV should be used. Anti-HEV should be considered as one of parameters in diagnosis of patients with acute hepatitis, especially in endemic areas."

"ABSTRAKHepatitis B adalah suatu penyakit yang disebabkan oleh virus hepatitis B. Salah satu faktor yang berpengaruh dalam pembentukan virus hepatitis B adalah core protein Cp . Sehingga Cp dapat digunakan sebagai salah satu target pengobatan hepatitis B. Pada penelitian ini dilakukan penapisan virtual senyawa dari basis data tanaman herbal Indonesia sebagai core protein allosteric modulator CpAM menggunakan peranti lunak AutoDock dan AutoDock Vina. Metode divalidasi dengan menggunakan parameter Enrichment Factor EF , Receiver Operating Characteristics ROC , dan Area Under Curve AUC . Pada penapisan menggunakan AutoDock digunakan grid box ukuran 55x55x55 dengan nilai EF10 0.7652 dan AUC 0.6709 sementara grid box ukuran 20.625x20.625x20.625 untuk penapisan menggunakan AutoDock Vina dengan nilai EF5 0.5075 dan AUC 0.7832. Sepuluh senyawa terbaik hasil penapisan virtual menggunakan AutoDock memiliki rentang DG: -11.74 -10.31 kkal/mol adalah yuehchukene, lansionic acid, stigmast-4-en-3-one, myrtillin, sanggenol O, lanosterol, erycristagallin, alpha-spinasterol, cyanidin 3-arabinoside, dan cathasterone. Sepuluh senyawa terbaik hasil penapisan virtual menggunakan AutoDock Vina memiliki rentang DG: -12.1 -10.7 kkal/mol adalah sanggenol O, cucumerin A, yuehchukene, palmarumycin CP1, dehydrocycloguanandin, myrtilin, liriodenine, myricetin 3-alpha-L-Arabinopyranoside, myricetin 3-galactoside, dan cassameridine.

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ABSTRACTHepatitis B is a disease caused by hepatitis B virus. One of the main factor in virus assembly is core protein Cp . Therefore Cp is suitable to use as one of therapeutic target for hepatitis B. In this study virtual screening of Indonesia herbal database as CpAM of hepatitis B virus was performed using AutoDock and AutoDock Vina software. The methode was validated by Enrichment Factor EF , Receiver Operating Characteristics ROC , and Area Under Curve AUC parameters. The grid box size used in virtual screening with AutoDock is 55x55x55 with EF10 0.7652 and AUC 0.6709 meanwhile grid box size that will be use in virtual screening using AutoDock Vina is 20.625x20.625x20.625 with EF5 0.5075 and AUC 0.7832. The best top ten compounds from virtual screening with AutoDock has DG levels 11.74 10.31 kkal mol theare yuehchukene, lansionic acid, stigmast 4 en 3 one, myrtillin, sanggenol O, lanosterol, erycristagallin, alpha spinasterol, cyanidin 3 arabinoside, dan cathasterone. The best top ten compounds from virtual screening with AutoDock Vina has DG levels 12.1 10.7 kkal mol adalah sanggenol O, cucumerin A, yuehchukene, palmarumycin CP1, dehydrocycloguanandin, myrtilin, liriodenine, myricetin 3 alpha L Arabinopyranoside, myricetin 3 galactoside, dan cassameridine"

"Hepatitis E adalah peradangan yang menyerang organ hati yang disebabkan virus hepatitis E (HEV), yang ditularkan secara "fecal oral" melalui makanan dan minuman yang terkontaminasi oleh tinja manusia yang mengandung HEV.Di Indonesia Kejadian Luar Biasa (KLB) Hepatitis E pernah terjadi di Kabupaten Sintang Kalimantan Barat, pada tahun 1987, 1989, dan 1991 dan di Kabupaten Bondowoso Jawa Timur pada tahun 1998. Sampai dengan akhir April 2001 masih ditemukan penderita Hepatitis E yang berobat ke Puskesmas Sukosari dan Wonosari Kabupaten Bondowoso.Penelitian ini bertujuan untuk mengetahui hubungan kualitas bakteriologi air yang digunakan oleh masyarakat dengan kejadian Hepatitis E di Puskesmas Sukosari dan Wonosari Kabupaten Bondowoso tahun 2000 - 2001.Disain penelitian menggunakan disain kasus kontrol tidak berpadanan, dengan perbandingan kasus dan kontrol 1 : 1. Jumlah sampel minimal yang diperlukan sebanyak 88 kasus dan 88 kontrol. Populasi kasus adalah penderita Hepatitis E yang berobat ke Puskesmas Sukosari dan Wonosari sedang populasi kontrol adalah penderita bukan penyakit Hepatitis E yang berobat ke Puskesmas Wonosari dan Sukosari sejak 1 Januari 2000 sampai dengan 31 April 2001.Variabel dependen dalam penelitian ini adalah kejadian Hepatitis E, sedangkan variabel independen utamanya adalah, kualitas bakteriologi air.Hasil penelitian menunjukkan air yang terkontaminasi coliform berhubungan dengan kejadian HEV setelah dikontrol oleh faktor konfounder (OR : 2.45 (95% CI : 1.23 - 4.89; p = 0.01)). Variabel konfounder tersebut adalah kebiasaan minum air masak, kebiasaan jajan, kebiasaan mencuci tangan sebelum makan.Jadi orang yang menggunakan air yang terkontaminasi coliform berisiko terkena HEV 2 kali dibanding orang yang menggunakan air yang tidak terkontamininasi tinja/coliform.Bila kelompok kontrol diasumsikan mewakili populasinya, maka upaya perbaikan kualitas bakteriologi air yang digunakan masyarakat, penerapan kebiasaan minum air masak, dan mencuci tangan dengan air dan sabun sebelum makan, maka diperkirakan dapat menurunkan proporsi kejadian HEV sebesar 55%.

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Water quality and Hepatitis E Virus at the Health Center of Sukosari and Wonosari, District of Bondowoso, for period 2000 ? 2001Hepatitis E is known as one of the liver inflammation, caused by Hepatitis E virus. The disease is transmitted by the fecal - oral route and fecally contaminated water and food.

The outbreaks of Hepatitis E have been reported from District of Sintang, West Kalimantan, in the year of 1987, 1989 and 1991. So did from District of Bondowoso, Provincial of East Java in 1998.

Up to the end of April 2001, there were still found the patients of Hepatitis E who were treated at the Health Center of Sukosari and Wonosari, District of Bondowoso.

The Objective of this study is to identify the association between the microbiological water qualities used by community with the occurrence of Hepatitis E.

The research design use unmatched case control study, with control to case ratio 1 : 1.

The minimum sample size used is 88 cases and 88 controls respectively. The sources of case are patients of Hepatitis E who were treated at the Health Center of Sukosari and Wonosari. On the other hand, the sources of control are non Hepatitis E patients who were treated in both of the Health Centers mentioned before.

Dependent variable in this study is the occurrence of Hepatitis E, and its main independent variable is microbiological water quality.

The result of this study shown that the microbiological water quality has a significant association with the occurrence of HEV after has been adjusted by the confounder factors. (OR : 2.45; 95% CI 1.23 - 4.89; p = 0.01). Those factors are, the habit of drinking boiled water, and hand washing before eating. Therefore, respondent who used fecally contaminated water has a risk infected by HEV 2 times bigger than the respondent who used safe water.

Referring to the result of this study, if control group is assumed represent its population, a water quality improvement, practical of drinking boiled water and hand washing before eating, are predicted reduce the proportion of HEV occurrence about 55%."

"BackgroundProdromal factors of Guillain-Barre syndrome (GBS) are often associated with previous viral infection (60%). The ailment supported by the acquired immunomediated disorder concept. Viral hepatitis is very rarely found in GBS, preceded by cytomegalovirus (15-18%), Campylobacter jejuni (28%), and Epstein-Barr virus (5%). There is no specific etiology of GBS because those viruses usually appear sporadically (subclinically). All hepatitis virus infection can cause neurological complications, including GBS.Case ReportWe report two cases of hepatitis A virus infection (HAV) in GBS patients in Dr. Sardjito General Hospital during 5 years of observation (1996-2000) from 92 GBS patients. The diagnosis of HAV was based on more than 2 times increment of transaminase enzyme, positive IgM anti HAV, negative HbsAg, and negative IgM ami HCV. The diagnosis of GBS was based on clinical symptoms of acute generalized paralysis, cerebrospinal fluid examination, and electromyelography. In both cases, sub-clinical and sporadic symptoms appeared several days before paralysis, which makes it more likely that the prodromal period of GBS occurred at the same time of HAV incubation period.DiscussionThe incidence of HAV in GBS patients during 5 years of observation was 2%. This corresponds with the case reported by Verona et al, 1996 and Pelletier et al, 1985, i.e. the presence of peripheral neuropathy (n. facialis and n. occulomotorius). Possible alternative pathways for hepatitis virus complicating as GBS are perivascular and endometrial peripheral nerve infiltration by mononuclear cells, T cell sensitization, stimulation of IL-2 growth factor surface receptor, and B cell stimulation. All of the conditions mentioned above causes necrotizing arteritis, vascular occlusion, and at the end, segmental demyelinization. Hepatitis virus may replicate in the central nervous system or peripheral nervous system, subsequently developing into multiple neuropathy disorder and poly arteritis.ConclusionThe diagnoses of HAV and GBS in both cases were established. HAV is one of several viruses that may trigger GBS. In both cases, HAV infection was sub-clinical and sporadic. Symptoms of hepatitis infection subsided along with improvements in the patient's neurological status. Acute viral hepatitis has a wide clinical spectrum and laboratory manifestation that is in accordance with the severity, varying from unclear symptom (anicteric) to jaundice. Acute hepatitis A, B, C infections have the same symptoms in general. However, hepatitis B and C tend to be more severe. The mildest symptoms are transaminase enzyme level increment, no jaundice, gastrointestinal symptoms, flu-like symptoms, and sometimes it can not be diagnosed. The more severe symptoms are jaundice with obvious generalized symptoms.' The incidence of hepatitis A is difficult to be determined accurately because of its characters, i.e. sporadic, endemic, and has a high rate of asymptomatic infection.23-4"