HUBUNGAN ANTARA TITER ANTI-HBs DENGAN ANGKA CD4 DAN CD8 PADA ANAK YANG TELAH MENDAPATKAN IMUNISASI HEPATITIS B LENGKAP

Caessar Pronocitro, dr. Nenny Sri Mulyani, SpA(K); dr. Didik Setyo Heriyanto, PhD, SpPA

2015 | Tesis | S2 Ilmu Kedokteran Klinik

Latar belakang. Beban penyakit hepatitis B masih tinggi secara global, dimana 15 hingga 40 persen dari individu yang terinfeksi virus hepatitis B akan menderita sirosis, gagal hati, dan karsinoma hepatoseluler. Imunisasi bertujuan membentuk antibodi anti-HBs dengan titer protektif untuk mencegah infeksi. Sel limfosit T CD4 dan CD8 memiliki peran dalam proses pembentukan imunitas paska imunisasi. Tujuan. Mengetahui hubungan antara titer anti-HBs dengan angka CD4 dan CD8 pada anak yang telah mendapatkan imunisasi hepatitis B lengkap. Metode. Desain penelitian adalah potong lintang dengan subjek 52 anak berusia 8 bulan hingga 5 tahun di Posyandu Bungas, Daerah Istimewa Yogyakarta. Titer anti-HBs diperiksa dengan metode ELISA dan angka sel CD4 dan CD8 diperiksa dengan metode immunocytochemistry. Hasil. Didapatkan 52 subjek penelitian dengan median titer anti-HBs 72,965 IU/L (kisaran interkuartil 360,98), rerata angka CD4 49,73% ± 29,75 dan angka CD8 60,43 ± 25,50. Titer antibodi yang protektif ditemukan pada 73% subjek penelitian. Setelah dilakukan uji korelasi, tidak didapatkan hubungan antara titer anti-HBs dengan angka CD4 (r=-0,104, p=0,464) dan angka CD8 (r=0,199, p=0,157). Kesimpulan. Tidak terdapat hubungan antara titer anti-HBs dengan angka CD4 dan CD8 pada anak yang telah mendapatkan imunisasi hepatitis B lengkap.

BACKGROUND. Hepatitis B remains a global burden, with estimated 15 to 40 percents of infected individuals eventually suffer from liver cirrhosis, liver failure, and hepatocellular carcinoma. Immunization aims to form anti-HBs antibody with protective titer to prevent infection. CD4 and CD8 T cell lymphocytes are known to play major role in establishing immunity after immunization. OBJECTIVE. This study aims to find correlation between anti-HBs titer with CD4 and CD8 count in children who have obtained complete hepatitis B immunization. METHODS. This is a cross-sectional study with 52 subjects between 8 months to 5 years of age in Bungas Community Health Service, Special Region of Yogyakarta, Indonesia. Anti-HBs titer was examined using enzyme immunoassay and CD4 and CD8 counts were examined using immunocytochemistry method. RESULT. Of 52 subjects, median anti-HBs titer was 72.965 IU/L (interquartile range 360.98), mean CD4 and CD8 counts were 49.73% ± 29.75 and 60.43 ± 25.50, respectively. Protective level of antibody was found in 73.1% of subjects. Correlation test was conducted and no correlation was found between anti-HBs titer with neither CD4 count (r=-0.104, p=0.464) nor CD8 count (r=0.199, p=0.157). Age was found to have weak negative correlation with anti-HBs titer (r=-0.367, p=0.007). CONCLUSION. We found no correlation between anti-HBs titer with neither CD4 count nor CD8 count in children who have obtained complete hepatitis B immunization.

Kata Kunci : anti-HBs titer, CD4, CD8, hepatitis B, immunization