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Abstrak :
Latar Belakang: Hepatitic C merupakan penyakit yang disebabkan oleh Virus Hepatitis C (HCV) dan dapat mengakibatkan peradangan hati, biasanya bersifat asimtomatik, bahkan kronik yang ditandai dengan sirosis, kanker hati, kelainan fungsi hati yang dapat menyebabkan kematian. Pengobatan standar dengan PEGinterferon-a dan ribavirin memiliki efek samping yang berat, sehingga diperlukan pengobatan alternatif sebagai anti-HCV. Dimocarpus longan merupakan tanaman yang memiliki khasiat sebagai antijamur, antivirus, antiinflamasi, antioksidan, antibakteri, dan antikanker. Tujuan penelitian ini untuk mengetahui efek dan mekanisme kerja ekstrak metanol daun D. longan terhadap virus Hepatitis C. Metode: Cell line derivate Human hepatocarcinoma (Huh 7it-1) diinfeksikan dengan HCV strain JFH1 dari genotipe 2a yang diinduksikan ekstrak metanol daun D. longan selama dua hari, kemudian diukur virus yang terbentuk ekstraseluler dan intraseluler. Pemeriksaan virus ekstraseluler dengan cara focus forming assay sedangkan intraseluler dengan qRT-PCR, western blot dan relative fluorescence assay. Pengujian sitotoksisitas terhadap Huh 7it-1 dengan metode MTT assay. Ekstrak metanol daun D. longan diuji adanya kandungan saponin, flavonoid, triterpenoid dan steroid, tanin, dan glikosida. Hasil: Konsentrasi hambatan 50% (IC50) ekstrak terhadap HCVsebesar 13,2 ± 0,52 μg/ml dan toksik 50% (CC50) terhadap sel Huh 7it-1 sebesar 681,9 ± 13,2 μg/ml dengan nilai indek selektivitas (SI) sebesar 51,2. Efek virusidal ekstrak metanol daun D. longan secara langsung terhadap HCV berupa pengurangan titer virus sebesar 99%. Analisis RNA dan protein NS3 HCV intraseluler memperlihatkan adanya hambatan sebesar 20%. Kandungan fitokimia yang terdapat pada ekstrak metanol daun D. longan di antaranya saponin, flavonoid, triterpenoid dan steroid, alkaloid, tanin, dan glikosida. Kesimpulan: Mekanisme anti-HCV dari ekstrak metanol daun D. longan diduga melalui adanya hambatan pada entry dan post-entry yang bekerja dengan menghambat pada penempelan virus, membunuh virus dengan interaksi langsung, menghambat ekspresi NS3, dan menghambat replikasi. Kandungan fitokimia yang terkandung seperti saponin, flavonoid, triterpenoid dan steroid, tanin, dan glikosida.

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Background: Hepatitic C is a disease caused by the hepatitis C virus (HCV). HCV infection can lead to inflammation of liver tend to be asymptomatic, and chronic characterized by cirrhosis, liver cancer, abnormal liver function can cause mortality. Standard HCV treatment with PEG-interferon-a and ribavirin have severe side effects, necessitating alternative treatments as anti-HCV. Dimocarpus longan is a plant that previously reported has antifungal, antiviral, anti-inflammatory, antioxidant, antibacterial, and anticancer activity. The purpose of this study is determine the effects and mechanism of action of the methanol extract of leaves of D. longan against hepatitis C virus. Methods: A derivate of Human hepatocarcinoma Cell line (Huh 7it-1) was infected with HCV of genotype 2a JFH1 strain which is inducted with methanol extracts of D. longan for two days and then number of virus produced outside of the cell (extracellular) and inside of the cell (intracellular) were measured by focus forming assay, while intracellular virus was measured by qRT-PCR, western blot and relative fluorescence assay. Cytotoxicity against Huh 7it-1 was tested by MTT assay. Examination of phytochemical content D. longan showed the presence of saponins, flavonoids, triterpenoids and steroids, alkaloids, tannins, and glycosides. Result: D. longan concentration of inhibition 50% (IC50) and Toxic effects of concentration of cytotoxicity 50% (CC50) againts cells Huh 7it-1were obtained 13,2 ± 0.52 ug/ml and 681.9 ± 13.2 ug/ml, respectively and with selectivity index (SI) 51.2. Result of direct virucidal effect was shown inhibition of titer virus 99%. RNA and NS3 protein analysis of HCV were shown inhibition 20%. Phytochemical contains of methanol extracts of Dimocarpus longan Lour. Leaves are saponins, flavonoids, triterpenoids and steroids, tannins, and glycosides. Conclusion: Anti-HCV mechanisms of methanol extracts of Dimocarpus longan Lour. Leaves are inhibition at entry and post-entry with action at attachment, direct killing, inhibition of expression NS3, and replication. Phytochemical content in the methanol extract of leaves of D. longan were saponins, flavonoids, triterpenoids and steroids, tannins, and glycosides.

Abstrak :
Latar Belakang: Pasien yang menjalani hemodialisis (HD) rutin berisiko terinfeksi virus hepatitis C (VHC). Infeksi VHC kronik meningkatkan mortalitas terkait penyakit hati kronik dan kardiovaskuler.Direct Acting Anti-viral(DAA) merupakan pilihan terapi infeksi VHC pada pasien Penyakit Ginjal Kronik, tetapi sebagian besar DAA mengandung metabolit yang diekskresi melalui ginjal. Grazoprevir-elbasvir (GZR-EBV) adalah pilihan utama DAA untuk terapi infeksi VHC pada pasien HD rutin dengan keberhasilanSustained Virological Response(SVR)>90% dan adverse eventyang minimal. Namun masih belum diketahui keberhasilan terapi GZR-EBV dan faktor-faktor yang mempengaruhinya pada pasien HD rutin di Indonesia yang memiliki perbedaan genotip VHC dan genotip pasien HD. Tujuan: Menilai keberhasilan terapi GZR-EBV dan faktor-faktor yang berhubungan dengan keberhasilan terapi pada pasien HD dengan Hepatitis C kronik dan mengetahui gambaran adverse event. Metode: Penelitian ini merupakan studi kohort prospektif observasional pada pasien HD dengan Hepatitis C kronik. Data klinis dan pemeriksaan penunjang dikumpulkan dan dianalisis untuk mengetahui respon terapi, dan untuk mengetahui asosisasi antara faktor muatan virus RNA VHC, derajat fibrosis dan lama HD dengan SVR12. Hasil: Didapatkan 75 subyek yang memenuhi kriteria inklusi. Rerata usia 50,2±13,2 tahun, jenis kelamin perempuan lebih banyak ditemukan. Lama HD 6,9±4,7tahun. Keberhasilan SVR12 mencapai 97,2%. Risiko relatif keberhasilan SVR12 berdasarkan muatan virus <800.000 IU/mL dibandingkan³800.000 IU/mL adalah 1,01 (IK 95% 0,93-1,10; p=1,00), derajat fibrosis hati skor Metavir F4 dibandingkan F0-F3 adalah 0,95 (IK 95% 0,81-1,10; p=0,35) dan lama HD <3 tahun dibandingkan ≥3 tahun adalah 1,04 (IK 95% 0,99-1,09; p=1,00). Adverse eventobat minimal. Simpulan: Terapi GZR-EBV pada pasien hepatitis C kronik yang menjalani HD rutin menunjukkan efektifitas yang baik, dengan adverse eventminimal. Keberhasilan terapi tidak dipengaruhi oleh jumlah muatan virus, derajat fibrosis dan lama HD. ......Background: Patients on hemodialysis are at risk of hepatitis C virus (HCV) infection. Chronic hepatitis C virus infection increases mortality related to chronic liver and cardiovascular disease. Direct Acting Anti-viral (DAA) is a therapeutic choice for HCV infection in patients with Chronic Kidney Disease, but most of the DAA metabolite eliminated by the kidney. Grazoprevir-elbasvir is the drug of choice for chronic HCV infection in hemodialysis patients, and have Sustained Virological Response (SVR) >90% and less adverse event. However, therapeutic response and the factors that influence this drug in routine HD patients in Indonesia is still unknown. Objective: Assessing therapeutic response and side effects of grazoprevir-elbasvir for Hepatitis C Virus in routine hemodialysis patient. Methods: Observational cohort prospective study on all patients with Chronic HCV infection with routine HD. Clinical and laboratory data were analyzed for therapeutic response and determined the factors that related to therapeutic response. Viral load, degree of liver fibrosis, and duration of HD treatment and relation with response SVR12 as analyzed using bivariate method of statistical analysis. Results: Seventy-five subjects met inclusion criteria. The average age is 50.2±13.2 years, subjects with female were more than male. The average duration of HD is 6.9±4.7 years. SVR12 achievement is 97.2%. Relative risk of SVR12 based on viral load <800,000 versus ³800,000 were 1.01 (95%CI 0.93-1.10 p=1.00), Score Metavir F4 versus to F0-F3 were 0.95 (95%CI 0.81-1.10 p=0.35), duration of HD <3 years versus ≥3 years were 1.04 (95%CI 0.99-1.09 p=1.00). The adverse event of this drug is minimal. Conclusions: Grazoprevir-elbasvir therapy in HD patient with chronic HCV is effective, and minimal adverse event. SVR12 is not influenced by either viral load, degree of fibrosis or duration of HD.

Abstrak :
Latar belakang: Penelitian ini bertujuan untuk merancang dan menganalisis pelacak oligonukleotida apakah dapat diterapkan dalam hibridisasi dot blot menggunakan radioisotop 32P untuk mendeteksi virus hepatitis C. Metode: Sampel yang digunakan adalah 46 plasma darah. Plasma diekstraksi untuk mendapatkan RNA genom virus sebagai cetakan reaksi RT-PCR dan amplikon digunakan untuk nested PCR. Genom HCV berjumlah 24 diunduh dari GeneBank dan penderetan sekuen DNA dilakukan dengan Software Bio Edit versi 7.0.9.0. Pelacak oligonuklueotida dirancang berdasarkan daerah lestari genom HCV yang terletak pada sekuen internal di antara 2 primer yang digunakan pada nested PCR. Homologi oligonukleotida HCV dianalisis menggunakan teknik Blast di GeneBank. Radioisotop 32P digunakan untuk melabel oligonukleotida. Oligonukleotida berlabel diaplikasikan untuk produk nested PCR menggunakan metode hibridisasi dot blot. Konfirmasi hasil amplifikasi dan hibridisasi dot blot dilakukan menggunakan metode sekuensing DNA. Hasil: Hasil analisis Blast menunjukkan homologi yang tinggi untuk HCV (100%). Hasil nested PCR menunjukkan tiga pola fragmen DNA. Tiga pola tersebut masing-masing adalah genotip HCV 1, 2, dan 3. Primer yang digunakan dalam nested PCR tidak spesifik dinyatakan dengan adanya tiga fragmen DNA sehingga sulit diinterpretasikan. Hasil hibridisasi dot blot menggunakan oligonukleotida yang didesain dalam penelitian ini menunjukkan intensitas dot yang tebal. Semua pola fragmen hasil nested PCR menunjukkan hasil positif dot blot. Hasil hibridisasi dot blot sesuai dengan hasil sekuensing DNA. Kesimpulan: Pelacak oligonukleotida menunjukkan kriteria yang sangat memuaskan secara bioinformatika. Hasil hibridisasi dot blot menggunakan 32P menunjukkan intensitas dot yang tebal dan lebih mudah diinterpretasi dibandingkan dengan hasil nested PCR.

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Abstract
Background: This study aimed to design and analyze the applicability of an oligonucleotide probe in radioisotope 32P-based dot blot hybridization for detection of hepatitis C virus. Methods: Forty-six of plasma samples were used. The plasma was extracted to obtain viral RNA genome as template for RT-PCR and the amplicon was used for nested PCR. Twenty-four HCV genomes were retrieved from GeneBank DNA sequence and alignment was performed by Bio Edit Software version 7.0.9.0. An oligonucleotide probe was designed based on a highly conserved region that is located on internal sequence between two primers used for nested PCR. Blast analysis on GeneBank was performed to obtain homology of the oligonucleotide for HCV. The oligonucleotide was then labeled with 32P and dot blot hybridization was applied for nested PCR products. DNA Sequencing was performed to confirm the amplicon and dot blot hybridization results. Results: Blast analysis showed high homology (100%) for HCV. Nested PCR resulted in three patterns of DNA fragments representing HCV genotypes 1, 2, and 3, respectively. The primers used in nested PCR were not specific and resulted in DNA fragments difficult to be interpreted. Dot blot hybridization using the designed oligonucleotide showed high intensity dots. All nested PCR fragments showed the dot blot positive. The dot blot results were in accordance with DNA sequencing that confirmed three patterns of DNA fragments as different HCV genotypes. Conclusion: The oligonucleotide showed excellent bioinformatically criteria. 32P-based dot blot hybridization yielded high intensity dots and was easier to be interpreted than nested PCR assay.

Abstrak :
Latar Belakang : Virus Hepatitis C (HCV) merupakan salah satu penyebab penyakit hati kronik yaitu hepatitis kronik, sirosis dan karsinoma hepatoseiuiar. Dari berbagai penelitian tentang HCV, didapatkan adanya hubungan antara penderita HCV dengan gangguan jiwa/psikiatrik, demikian pula berbagai penelitian tentang HCV dan terapi interferon (IFN) telah dilaporkan adanya efek samping berupa gejala neuropsikiatri seperti, malaise, futique, gangguan cemas, gangguan depresi, tentamen suicide dan psikotik. Prevalensi penelitian terakhir tentang gangguan jiwa pada penderita HCV dengan atau tanpa terapi IFN sekitar 32%. Tujuan : Untuk mendapatkan frekuensi dan jenis gangguan jiwa pada penderita hepatitis C di Poliklinik Hepatologi RSCM dan berbagai variabel yang mempengaruhinya. Metode : Penelitian ini menggunakan rancangan cross sectional, dilakukan pada 85 penderita HCV yang berobat di Poliklinik Hepatologi RSCM. Sampel diambil secara consecutive sampling. Instrumen yang digunakan adalah MINI (Mini International Neuropsychiatric Interview) ICD-10. Analisis statistik dilakukan dengan menggunakan SPSS for windows 10.0 dengan batas kemaknaan 0,05 serta regresi logistik. Hasil dan Simpulan : Frekuensi gangguan jiwa pada penderita HCV adalah 38 subyek (44,7%), dengan jenis gangguan jiwa antara lain ; Episode Depresi 12 subyek (14,0%), Gangguan yang berkaitan dengan Zat Psikoaktif (nikotin) 1 1 subyek (12,9%), Episode Depresi dan Gangguan Ansietas Menyeluruh 7 subyek (8,3%), Gangguan Ansietas Menyeluruh 5 subyek (5,9%) Episode Depresi dan Distimia 1 subyek (1,2%), Episode Depresi , Gangguan Ansietas Menyeluruh dan Gangguan berkaitan dengan Alkohol 1 subyek (1,2%), Gangguan yang berkaitan Zat Psikoaktif dan Gangguan berkaitan dengan Alkohol 1 subyek (1,2%). Pada 21 penderita HCV dengan terapi Interferon (IFN), terdapat 10 subyek mengalami gangguan jiwa. Tidak terdapat penilaian status mental (evaluasi psikiatrik) penderita HCV oleh tim terpaduu, saat sebelum, selama maupun sesudah dilakukan terapi IFN. Pada uji kemaknaan bivariat, terdapat hubungan bermakna antara status pemikahan (p0,001) dan risiko penularan HCV (p,0,000) dengan gangguan jiwa, sedangkan Pada uji kemaknaan multivariat, didapatkan hubungan bermakna antara risiko penularan HCV dengan gangguan jiwa (p0,001). ......Background : Hepatitis C Virus (HCV) is one of the causes of chronic liver disease, such as chronic hepatitis, cirrhosis, and hepatoceliular carcinoma. Several researches conducted on HCV, a correlation between patients with HCV and mental disorder is found, and also several researches on I-ICV and interferon therapy (IFN) have been reported on side effects neuropsychiatry symptoms such as malaise, Fatigue, anxiety disorder, suicidal attempt, and psychotic. The latest research prevalence on mental disorder in patients with HCV, with or without IFN reaches 32 %. Purpose : To attain the frequency and type of mental disorder in patients with HCV found in the hepatology outpatient clinic RSCM and the influencing variables. Method: This research is using cross-sectional design, conducted on 85 HCV patients seeking medical help in the hepatology outpatient clinic. The sample is obtained with consecutive sampling. The chosen instrument is MINI (Mini International Neuropsychiatry Interview) ICD-10. Statistic analysis is using SPSS for windows 10.0 with the level of significance 0.05 and the logistic regression. Result and Conclusion: The frequency of mental disorder in patients with HCV is 38 subjects (44.7%), with the following types of mental disorders; Depression Episode (14.0%), Mental Disorder related to Psychoactive Substance (nicotine) 11 subjects (12.9%), Depression Episode and Generalized Anxiety Disorder 7 subjects (8.3%), Generalized Anxiety Disorder 5 subjects (5.9%), Depression Episode and Mental Disorder related to Alcohol 1 subject (1.2%), Mental Disorder related to Psychoactive Substance and Mental Disorder related to Alcohol 1 subject (1.2%). In 21 HCV patients, with interferon therapy (IFN), 10 subjects suffer from mental disorder. There is no psychiatric evaluation in HCV patients, with a well-integrated team, as in before, during, and after the IFN therapy. In the bivariate test of significance, there is a significant relevance between the marital status (p 0.001) and the risk of transmission (p 0.000) with mental disorder, meanwhile in the multivariate test of significance, a significant correlation is found between the risk of HCV transmission and mental disorder (p 0.001).

Abstrak :
ABSTRAK
Hepatitis C virus HCV menginfeksi lebih dari 170 juta penduduk dunia dan menyebabkan penyakit hati kronis yang berkembang menjadi sirosis dan kanker hati. Diagnosis yang akurat sangat diperlukan untuk memberikan penanganan tepat secara dini, termasuk mencegah penularan virus tersebut secara lebih luas. Pada penelitian ini plasmid pQE80L-HCV_ME telah berhasil dibuat untuk produksi antigen rekombinan HCV. Gen pengkode antigen tersebut dirancang berdasarkan multiepitop yang bersifat imunodominan, lestari, mewakili subtipe HCV di Indonesia dan global. Gen tersebut dibuat dengan teknik DNA sintetik kemudian diklona dari plasmid pUC57 ke pQE80L. Pengklonaan dilakukan menggunakan situs restriksi BamHI dan HindIII dalam sel E. coli Top10. Plasmid pQE80L-HCV_ME kemudian diverifikasi dengan PCR koloni, analisis restriksi, dan sekuensing.

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ABSTRACT
Hepatitis C virus HCV have been infected more than 170 million people in the world and caused chronic liver disease that lead to liver cirrhosis and hepatocellular carcinoma. Accurate diagnosis is very important to give early proper treatment and to prevent HCV transmission broadly. In this research pQE80L HCV ME plasmid has been successfully created to produce HCV recombinant antigen. Gene that encodes antigen was designed based on multiepitop sequences from immunodominat region, conserve, and represent the most prevalence HCV subtypes in Indonesia and global. The gene was generated through synthetic DNA then be cloned from pUC57 plasmid to pQE80L. Cloning was performed by using BamHI dan HindIII in E. coli Top10 cell. pQE80L HCV ME plasmid then be verified by colonies PCR, restriction analysis, and sequencing.

Abstrak :
Hepatitis C Virus (HCV) adalah virus yang menginfeksi hati dan menyebabkan penyakit serius dalam jangka panjang. Pengobatan saat ini menggunakan obat Direct-Acting Antiviral (DAA), namun adanya variasi genotipe dan resistensi terkait mutasi dapat menyebabkan kegagalan pengobatan, sehingga memerlukan pengembangan kandidat antivirus baru. Ekstrak daun P. betle telah dilaporkan memiliki aktivitas anti HCV. Penelitian ini bertujuan untuk mengetahui mekanisme efek antiviral ekstrak daun P. betle terhadap HCV dan potensinya sebagai komplementer dengan telaprevir atau sofosbuvir. Aktivitas antivirus diuji menggunakan sel Huh7it-1 dan HCV genotipe 2a (JFH1a), kemudian dianalisis persentase penghambatan dengan titrasi pada kultur sel dan qRT-PCR. Efek sinergis dan antagonis dengan telaprevir atau sofosbuvir dianalisis dengan perangkat lunak CompuSyn. Analisis in silico juga dilakukan untuk memprediksi interaksi senyawa pada ekstrak daun P. betle dengan protein NS3, NS5A, dan NS5B. Ekstrak daun P. betle diketahui mampu menghambat replikasi HCV, dengan daya hambat pada semua perlakuan lebih rendah dibandingkan kontrol. Kombinasi dengan telaprevir menunjukkan efek antagonis, sedangkan kombinasi dengan sofosbuvir menunjukkan efek sinergis pada konsentrasi tinggi, tanpa menyebabkan toksisitas. Prediksi interaksi mengidentifikasi senyawa ‐fenilpropena‐3,3‐diol diasetat dan 4-Allyl-1,2-diasetoksibenzena memiliki interaksi kuat dengan protein NS5A dan NS5B. Energi ikat masing-masingnya -6,86 kkal/mol dan -6,40 kkal/mol pada NS5A, serta 6,01 kkal/mol dan -5.93 kkal/mol pada NS5B. Dari penelitian ini dapat disimpulkan bahwa, ekstrak daun P. betle mampu menghambat replikasi HCV dan memiliki potensi sebagai komplementer dengan sofosbuvir pada konsentrasi tinggi. ......Hepatitis C Virus (HCV) is a virus that infects the liver and causes serious disease in the long term. Current treatment uses Direct-acting Antiviral (DAA) drugs, but the presence of genotypic variations and resistance-associated mutations cause treatment failure, thus requiring the development of new antiviral candidates. P. betle leaf extract has anti-HCV activity. This study analyzes the antiviral mechanism and its potential synergy with telaprevir or sofosbuvir. Antiviral activity was tested using Huh7it-1 cells and HCV genotype 2a (JFH1a), then the inhibitory activity was analyzed by titration on cell culture and qRT-PCR. Synergistic and antagonistic effects with telaprevir or sofosbuvir were analyzed with CompuSyn software. In silico analysis was also carried out to predict the interaction of compounds in P. betle leaf extract with NS3, NS5A, and NS5B proteins. P. betle leaf extract is known to be able to inhibit HCV replication, with virus inhibition in all treatments being lower than the control. The combination with telaprevir showed an antagonistic effect, while the combination with sofosbuvir showed a synergistic effect at high concentration without causing toxicity. Interaction prediction identified the compounds 1-phenylpropene-3,3-diol diacetate and 4-allyl-1,2- diacetoxybenzene as having strong interactions with the NS5A and NS5B proteins, with binding energies of -6.86 kcal/mol and -6 .40 kcal/mol in NS5A, and 6.01 kcal/mol and -5.93 kcal/mol in NS5B, respectively. Based on this research, we conclude that P. betle leaf extract can inhibit HCV replication and has the potential to act as a complement to sofosbuvir at high concentrations.

Abstrak :
Until recently the etiology and pathogenesis of oral lichenoid reaction remain unclear. Usually lichenoid reaction is associated with systemic disease or particular drugs such as ACE inhibitor anti hypertension and several dental materials. Amalgam restorations have been reported as most frequent cause of oral lichenoid reaction induced by dental materials. Mercury hypersensitivity is predicted to be responsible in inducing the reaction. The aim of this review was to describe oral lichenoid reaction associated with hypersensitivity to dental amalgam, so the clinician can manage the cases properly. In conclusion, replacement the amalgam filling which contact to the oral mucosa with other inert dental materials would be useful for hypersensitive patient.

Abstrak :
[ABSTRAK
Latar belakang. Uji saring darah donor dapat menurunkan risiko tertularnya infeksi HCV. Di Indonesia telah dilakukan uji saring terhadap antibodi HCV dan RNA HCV. Uji saring terhadap Antigen-Antibodi belum dilakukan di Indonesia. Antigen HCV biasanya ditemukan pada 0 sampai 20 hari setelah RNA HCV pertama muncul. Anti-HCV dapat terdeteksi antara 10-40 hari setelah antigen HCV terdeteksi. Atas dasar pemikiran bahwa antigen HCV muncul didalam darah lebih dahulu daripada anti-HCV, maka penelitian yang dilakukan ingin melihat apakah penggunaan reagensia serologi antigen-antibodi HCV dapat meningkatkan keamanan darah dan apakah sensitivitas serta spesifisitasnya sudah memenuhi standard yang dikeluarkan oleh Kementerian Kesehatan bila dibandingkan terhadap metoda NAT, yaitu sensitivitas 99,8% dan spesifisitas 95%. Metodologi. Pada penelitian ini dilakukan pemeriksaan pada 135 sampel darah donor yang terdiri dari 35 sampel positif dengan NAT HCV dan 100 sampel Positif dengan NAT HCV juga non reaktif terhadap HIV, HBsAg dan Sifilis dengan uji saring anti-HCV dengan metode CMIA, Ab-Ag HCV dengan metode ELISA dan bila ada perbedaan hasil pada pemeriksaan NAT HCV, CMIA HCV dan ELISA Ag-Ab HCV dilakukan pemeriksaan dengan menggunakan imunoblot HCV. Hasil. Dari 135 sampel, pada pemeriksaan ELISA Ag-Ab HCV terhadap 35 sampel positif RNA HCV menunjukkan hasil positif pada 35 sampel tersebut, tetapi pada 100 sampel negatif RNA HCV terdapat 3 sampel reaktif dan 97 non reaktif. Sedangkan pada 35 sampel positif RNA HCV dengan pemeriksaan CMIA anti-HCV menunjukkan hasil reaktif pada 35 sampel dan pada 100 sampel negatif RNA HCV terdapat 11 sampel reaktif dan 89 sampel non reaktif. Sensitivitas dari perbandingan hasil pemeriksaan metoda NAT HCV dengan CMIA Ab-HCV adalah 100%, spesifisitasnya adalah 89%. Sensitivitas dari perbandingan hasil pemeriksaan metoda NAT HCV dengan ELISA Ag-Ab HCV adalah 100%, spesifisitasnya adalah 97%. Simpulan. Pemeriksaan Antigen-Antibodi HCV ELISA memenuhi kriteria standar untuk digunakan sebagai uji saring darah donor. Pemeriksaan Antibodi HCV CMIA tidak memenuhi kriteria standar untuk digunakan sebagai uji saring darah donor.

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ABSTRACT
Background. Screening of donor blood may reduce the risk of transmission of HCV infection . In Indonesia has be screened for HCV antibodies and HCV RNA . Screened against the antigen - antibody has not been done in Indonesia . HCV antigens commonly found in 0 to 20 days after HCV RNA first appears . Anti - HCV can be detected between 10-40 days after HCV antigen was detected . On the basis of the notion that HCV antigens appear in the blood earlier than the anti - HCV , the research done to see if the use of antigen - antibody reagents HCV serology can improve blood safety and whether the sensitivity and specificity already meet the standards issued by the Ministry of Health when compared to NAT method , the sensitivity 99.8 % and specificity of 95 % . Methodology. In this study conducted checks on 135 blood samples from 35 donors comprising the NAT HCV positive samples and 100 samples positive by HCV NAT is also non- reactive to HIV , HBsAg and syphilis with anti - HCV screening of the CMIA method, HCV Ab-Ag ELISA method and the examination confirmed using immunoblot HCV HCV . Results. Of the 135 samples, the Ag-Ab ELISA against HCV 35 HCV RNA positive samples showed positive results in 35 samples, but at 100 HCV RNA negative samples contained 3 samples reactive and non- reactive 97. While the 35 HCV RNA positive samples with anti-HCV CMIA examination showed reactive results on 35 samples and in 100 HCV RNA negative samples contained 11 samples 89 samples reactive and non reactive. Sensitivity of the results of the comparison method with CMIA HCV NAT-HCV Ab was 100%, specificity was 89%. Sensitivity of the results of the comparison method of NAT HCV Ag-Ab ELISA with HCV was 100%, specificity was 97%. Conclusion. Examination of HCV Antigen-Antibody ELISA meet the standard criteria for use as a screening of donor blood. Examination of HCV antibodies CMIA does not meet the standard criteria for use as a screening of donor blood.;Background. Screening of donor blood may reduce the risk of transmission of HCV infection . In Indonesia has be screened for HCV antibodies and HCV RNA . Screened against the antigen - antibody has not been done in Indonesia . HCV antigens commonly found in 0 to 20 days after HCV RNA first appears . Anti - HCV can be detected between 10-40 days after HCV antigen was detected . On the basis of the notion that HCV antigens appear in the blood earlier than the anti - HCV , the research done to see if the use of antigen - antibody reagents HCV serology can improve blood safety and whether the sensitivity and specificity already meet the standards issued by the Ministry of Health when compared to NAT method , the sensitivity 99.8 % and specificity of 95 % . Methodology. In this study conducted checks on 135 blood samples from 35 donors comprising the NAT HCV positive samples and 100 samples positive by HCV NAT is also non- reactive to HIV , HBsAg and syphilis with anti - HCV screening of the CMIA method, HCV Ab-Ag ELISA method and the examination confirmed using immunoblot HCV HCV . Results. Of the 135 samples, the Ag-Ab ELISA against HCV 35 HCV RNA positive samples showed positive results in 35 samples, but at 100 HCV RNA negative samples contained 3 samples reactive and non- reactive 97. While the 35 HCV RNA positive samples with anti-HCV CMIA examination showed reactive results on 35 samples and in 100 HCV RNA negative samples contained 11 samples 89 samples reactive and non reactive. Sensitivity of the results of the comparison method with CMIA HCV NAT-HCV Ab was 100%, specificity was 89%. Sensitivity of the results of the comparison method of NAT HCV Ag-Ab ELISA with HCV was 100%, specificity was 97%. Conclusion. Examination of HCV Antigen-Antibody ELISA meet the standard criteria for use as a screening of donor blood. Examination of HCV antibodies CMIA does not meet the standard criteria for use as a screening of donor blood., Background. Screening of donor blood may reduce the risk of transmission of HCV infection . In Indonesia has be screened for HCV antibodies and HCV RNA . Screened against the antigen - antibody has not been done in Indonesia . HCV antigens commonly found in 0 to 20 days after HCV RNA first appears . Anti - HCV can be detected between 10-40 days after HCV antigen was detected . On the basis of the notion that HCV antigens appear in the blood earlier than the anti - HCV , the research done to see if the use of antigen - antibody reagents HCV serology can improve blood safety and whether the sensitivity and specificity already meet the standards issued by the Ministry of Health when compared to NAT method , the sensitivity 99.8 % and specificity of 95 % . Methodology. In this study conducted checks on 135 blood samples from 35 donors comprising the NAT HCV positive samples and 100 samples positive by HCV NAT is also non- reactive to HIV , HBsAg and syphilis with anti - HCV screening of the CMIA method, HCV Ab-Ag ELISA method and the examination confirmed using immunoblot HCV HCV . Results. Of the 135 samples, the Ag-Ab ELISA against HCV 35 HCV RNA positive samples showed positive results in 35 samples, but at 100 HCV RNA negative samples contained 3 samples reactive and non- reactive 97. While the 35 HCV RNA positive samples with anti-HCV CMIA examination showed reactive results on 35 samples and in 100 HCV RNA negative samples contained 11 samples 89 samples reactive and non reactive. Sensitivity of the results of the comparison method with CMIA HCV NAT-HCV Ab was 100%, specificity was 89%. Sensitivity of the results of the comparison method of NAT HCV Ag-Ab ELISA with HCV was 100%, specificity was 97%. Conclusion. Examination of HCV Antigen-Antibody ELISA meet the standard criteria for use as a screening of donor blood. Examination of HCV antibodies CMIA does not meet the standard criteria for use as a screening of donor blood.]

Abstrak :
ABSTRAK
Anti-HCV menjadi marker serologi utama yang digunakan untuk uji saring hepatitis C pada donor darah di Indonesia. Selain serologi anti-HCV, untuk lebih meningkatkan kemananan darah, Unit Transfusi Darah UTD DKI Jakarta juga menerapkan pemeriksaan Nucleic Acid Test NAT . Pemeriksaan anti-HCV tidak dapat membedakan antara infeksi aktif dan infeksi yang telah sembuh. Darah akan dianggap terifeksi HCV apabila salah satu dari pemeriksaan serologi atau molekuler positif, begitupula dengan darah donor dengan hasil pemeriksaan anti-HCV grayzone dan NAT negatif. Diperlukan kepastian atas berisiko tidaknya darah tersebut dalam menularkan infeksi HCV, mengingat kebutuhan darah di sebagian besar provinsi di Indonesia masih belum memenuhi target. Sehingga dibutuhkan uji molekuler lain untuk dijadikan pembanding dengan hasil NAT. Interpretasi hasil anti-HCV dilakukan berdasarkan rasio S/CO, yang dapat dijadikan prediksi status viremia donor, sehingga perlu dilakukan analisis hubungan antara S/CO dengan hasil pengujian molekuler dan HCV Ag-Ab. Nilai prediksi viremia diharapkan dapat menjadi alternatif bagi UTD yang belum mampu menerapkan NAT. Kemudian dipilih 93 sampel dengan kriteria anti-HCV positif dan NAT positif; anti-HCV positif dan NAT negatif serta anti-HCV grayzone dan NAT negatif untuk diuji dengan nested PCR kualitatif dan HCV Ag-Ab. Berdasarkan perbandingan hasil pengujian NAT dan nested PCR diperoleh nilai sensitivitas NAT sebesar 90, 63 , dengan Spesifisitasnya 96,71 . Dari hasil analisis chi-square diperoleh hubungan yang bermakna antara nilai S/CO anti-HCV dengan hasil pengujian NAT, nested PCR kualitatif dan HCV Ag-Ab P5 dapat dijadikan prediksi adanya infeksi aktif pada donor.

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ABSTRACT
Anti HCV is the main serological marker for hepatitis C screening in blood donors in Indonesia. Besides anti HCV, UTD DKI Jakarta also implementing Nucleic Acid Test NAT to improve blood transfusion safety. Anti HCV assay can not distinguish between active infection and cured infection. Blood will be considered HCV infected if either from a positive serologic or molecular test, including blood with anti HCV grayzone and NAT negative. There is a requirement to ensure the risk status of blood with anti HCV grayzone and NAT negative, because the supply of blood in most provinces in Indonesia still insufficient. So, it takes another molecular test to compare with NAT result. Interpretation of anti HCV results was calculating by S CO ratio, which could be a predictor of viremia status. It is necessary to analyze the correlation between S CO with molecular test and HCV Ag Ab results.Viremia prediction value is expected to be an alternative for UTDs who have not been able to apply NAT. There are 93 samples collected then tested with NAT and anti HCV. Sample with concondantly positive anti HCV and NAT anti HCV positive and NAT negative and anti HCV grayzone and NAT negative. These samples then tested with nested PCR and HCV Ag Ab. Based on comparison of NAT and nested PCR, obtained NAT sensitivity value of 90, 63 , with Specificity 96.71 . The result of chi square analysis shows a significant correlation between S CO anti HCV with NAT, qualitative nested PCR and HCV Ag Ab P 5 can be used as predictors of active infection in donors.