Hubungan antara Viral Load HBV-DNA dan Enzim Transaminase pada Pasien Hepatitis B

ARUM TRI W, Prof. dr. Budi Mulyono, Sp.PK(K)., MM.

2021 | Tesis-Spesialis | PATOLOGI KLINIK

Latar belakang: Hepatitis B kronik masih merupakan penyakit infeksi yang menjadi masalah utama di Asia. Keberhasilan terapi antivirus terhadap infeksi hepatitis B telah banyak didukung oleh pemeriksaan laboratorium yang sangat sensitif untuk memantau HBV-DNA. Peningkatan kadar enzim transaminase (ALTdan AST) merupakan penanda serum yang umum digunakan sebagai indikator kerusakan sel hepar. Tujuan: Mengetahui hubungan antara viral load HBV-DNA dan enzim transaminase (ALT dan AST) pada pasien hepatitis B. Metode: Penelitian observasional dengan data sekunder kadar HBV-DNA, ALT dan AST bulan Januari-November 2020 pada pasien hepatitis B di RSUP Dr. Sardjito. Analisis data dasar secara deskriptif, ditampilkan dalam median (minimal-maksimal). Uji korelasi menggunakan Spearman dengan p<0,05 bermakna secara statistik. Data kategorikal disajikan dalam proporsi. Hasil: Subjek penelitian ini sebanyak 153 pasien hepatitis B. Median usia subjek 50 tahun (termuda 19 tahun, tertua 75 tahun). Proporsi subjek laki-laki lebih banyak daripada perempuan [87 (62,59%) dan 52 (37,41%)]. Median kadar HBV-DNA adalah 4,40 log IU/mL (0,84-9,00). Median kadar ALT dan AST berturut-turut adalah 42,0 (6,0-1041,0) U/L dan 45,0 (13,0-1058,0) U/L. Analisis korelasi didapatkan adanya hubungan yang lemah namun bermakna secara statistik antara HBV-DNA dan ALT (r=0,368; p<0,01) serta HBV-DNA dan AST (r=0,311;p<0,01). Simpulan: Terdapat hubungan positif yang lemah namun bermakna secara statistik antara kadar viral load HBV-DNA dan enzim transaminase (ALT dan AST) pada pasien hepatitis B.

Background: Chronic hepatitis B is still an infectious disease which is a major problem in Asia. The success of antiviral therapy against hepatitis B infection has been widely supported by very sensitive laboratory tests to monitor HBV-DNA. Increased levels of the transaminase enzyme are commonly used as an indicator of liver cell damage. Objective: Analysis of the relationship between HBV-DNA viral load and transaminase enzymes (ALT and AST) in hepatitis B patients. Method: Observational research with secondary data on HBV-DNA, ALT and AST levels from January to November 2020 in hepatitis B patients at Dr. Sardjito hospital. Descriptive baseline data analysis, presented in median (minimum-maximum). Correlation test using Spearman with p<0.05 was statistically significant. Categorical data are presented in proportions. Result: The study subjects were 153 hepatitis B patients. The median age of the subjects was 50 years (the youngest was 19 years old, the oldest was 75 years). The proportion of male subjects was higher than female [87 (62.59%) and 52 (37.41%)]. The median HBV-DNA level was 4.40 log IU / mL (0.84-9.00). The median ALT and AST levels were 42.0 (6.0-1041.0) U/L and 45.0 (13.0-1058.0) U/L, respectively. Correlation analysis showed a weak but statistically significant relationship between HBV-DNA and ALT (r=0.368; p<0.01) and HBV-DNA and AST (r=0.311; p<0.01). Conclusion: There was a weak but statistically significant positive relationship between HBV-DNA viral load and transaminase enzyme (AST and ALT) levels in hepatitis B patients.

Kata Kunci : Hepatitis B, HBV-DNA, ALT, AST