Kumpulan abstrak

1. PPT KUMPULAN ABSTRAK
PENELITIAN HEPATOLOGI

2. ABSTRACT
Quantitative Hepatitis B Surface Antigen (HBsAg) as Predictor of Liver Fibrosis in Hepatitis B Patients
Maimunah U*, Akzatama N**, Miftahussurur M*
*Division of Gastroenterology and Hepatology, Internal Medicine Department, Airlangga University, Dr.
Soetomo General Academic Hospital, Surabaya, Indonesia
Email: ummima@gmail.com
**Resident of Internal Medicine Department, Airlangga University, Surabaya, Indonesia
Email: nugrateme@gmail.com
Introduction: Hepatitis B virus (HBV) infection is one of the leading causes of chronic liver disease worldwide, lead to severe fibrosis
complications. Transient elastography (TE) can measure the liver fibrosis result by measuring the liver stiffness. However, TE is not widely
available and expensive approaches. Therefore, HBV-specific fibrosis markers are expected to be used as simpler and inexpensive non-invasive
markers for liver fibrosis in hepatitis B patients. Serum hepatitis B surface antigen (HBsAg) is specific to HBV infection and generally considered
as a diagnostic tool for HBV infection. In recent years, the availability of commercial quantitative assays reinforced the value of HBsAg for the
diagnosis and treatment of hepatitis B patients. We evaluated the diagnostic value of quantitative HBsAg and liver fibrosis by TE.
Objective: To analyse the diagnostic value of quantitative HBsAg as predictor of liver fibrosis in hepatitis B patients at Dr. Soetomo General
Academic Hospital Surabaya.
Methods: We performed a cross sectional study of hepatitis B patients who underwent TE, quantitative HBsAg, HBeAg, and HBV DNA
detection in 2020. Quantitative HBsAg, HBeAg, HBV DNA, and liver fibrosis by TE were evaluated.
Keywords: Hepatitis B, quantitative hepatitis B surface antigen, non-invasive marker, liver fibrosis

3. ABSTRACT
Serum Vascular Endothelial Growth Factor (VEGF), Portal Vein Diameter and Portal Flow Velocity
as Predictor of Liver Cirrhosis Severity Based on Child-Turcotte-Pugh (CTP) Score
Nina Oktafianti Marfu'ah
*Resident of Internal Medicine Department, Universitas Airlangga, Surabaya Indonesia
Email : nina.oktafianti@gmail.com
Introduction:
Liver cirrhosis (LC) is a condition that describes the end stage of liver fibrosis where dead hepatocyte cells are replaced by fibrous connective
tissue. The occurrence of fibrosis causes a state of hypoxia. The hypoxic state will stimulate the occurrence of angiogenesis. One of the
mediators that play a role in the process of vascular remodeling or angiogenesis is Vascular Endothelial Growth Factor (VEGF). In liver cirrhosis,
VEGF expression tends to increase significantly when liver fibrosis occurs due to hypoxia and cell inflammation and activated stella cells (which
play a role in fibrogenesis) can also increase VEGF expression, however some study report conflicting results.
Sonography is one of the diagnostic methods used for studying hepatobiliary pathologies. It is cheap and easily available, that is why is
frequently the first examination performed when liver cirrhosis or portal hypertension is suspected. There are very few studies investigated the
relationship between sonographic portal vein diameter (PVD) and portal flow velocity (PFV) with LC severity scoring system such as Child-
Turcotte-Pugh (CTP) score. Some studies showed positive relationship, while others have totally questioned the role of that.
Objectives:
To determine the correlation between serum VEGF level and severity of LC and the correlation between PVD as well as PFV and severity of
LC based on CTP score.
Methods:
This was a cross sectional study with LC who visited Soetomo General Hospital in 2020. The severity of LC was assessed using CTP score.
Blood sampling was performed for measuring serum VEGF and the patients underwent Doppler sonography to determine portal vein diameter
and flow velocity.
Keyword: Liver cirrhosis, VEGF, portal vein

4. Correlation of APRI Test and Serum Hyaluronic Acid Level combination with Degree of
Hepatic Fibrosis in Hepatitis C Infection patient
Khanifah Fitria Dewi
Introduction : Chronic hepatitis C is associated with the development of hepatic fibrosis that can lead to
cirrhosis after years of infection. Cirrhosis is associated with high morbidity and mortality. The accuracy of the
diagnosis related to the stage of hepatic fibrosis can help the physician to choose the correct treatment and
follow-up in HCV-infected patients. Given the possible complications of liver biopsy, a non-invasive method for
assessing hepatic fibrosis is needed. Aspartate aminotransferase-to-platelet ratio index (APRI ) is one of the
simplest marker panels that can diagnose significant fibrosis and cirrhosis with acceptable accuracy. Similarly,
several studies have proven the usefulness of serum hyaluronic acid level as a non-invasive marker of hepatic
fibrosis or cirrhosis in HCV-infected patients.
Objective : To analyze the correlation between APRI score and serum hyaluronic acid level combination with
liver stiffness using transienst elastrography in HCV-infected patients in the Gastroenterohepatology
Outpatient Clinic at Dr. RSUD. Soetomo Surabaya.
Methods: An observational cross sectional analytic study involving 50 samples of HCV-infected patients. The
aspartate aminotransferase-to-platelet ratio index (APRI) is calculated in the following way: APRI = [AST level
(/ULN)/Platelet counts (109/L)] x 100. Serum hyaluronic acid was measured by the ELISA (Enzyme Linked
Immunosorbent Assay) method. Degree of hepatic fibrosis measured with Fibroscan. Data analysis using SPSS
23.0 with Spearman test, output p value and correlation coefficient (r) to find out the correlation.
Keyword : Fibrosis, APRI, Hyaluronic acid, Hepatitis C

5. Sarcopenia is Associated with Minimal Hepatic Encephalopathy in Patients with
Liver Cirrhosis
Ariella Maisie Sugiarto
Introduction: Sarcopenia is frequently found in patients with cirrhosis and is related to some complications
including minimal hepatic encephalopathy (HE). In patients with liver cirrhosis, sarcopenia may alter muscle
strength and function and is associated with a higher prevalence of complications of liver cirrhosis including
hepatic encephalopathy, due to the possible involvement of muscle in ammonia metabolism and trafficking. As
cirrhosis leads to a decline in the capacity of the liver to detoxify ammonia, skeletal muscle plays a
compensatory role in ammonia metabolism and clearance. Therefore, changes in muscle quantity and quality
may lead to an increase in circulating ammonia levels and have relevant implications in favoring HE. Only few
studies have investigated the relationship between sarcopenia and MHE in cirrhosis.
Objectives: To investigate the relationship between sarcopenia and minimal HE (MHE).
Methodes: All patients with cirrhosis were prospectively enrolled and sarcopenia status were measured using
BIA and hand-grip strength test. A cross-sectional study is taken using psychometry evaluation to all patients
during observation period to determine progress of hepatic encephalopathy in 6 months.
Keywords: Sarcopenia, enchephalopathy, liver chirrosis

6. Relationship Between Vascular Endothelial Growth Factor and Severity of Hepatocellular
Carsinoma
EFENDI
Background: Severity of hepatocellular carcinoma (HCC) that is assessed using barcelona
clinic liver cancer (BCLC) classification is a main prognostic factor of hepatocellular
carcinoma. Assessment of the serum level of vascular endothelial growth factor (VEGF) is
considered to reflect the severity of HCC. However, there is still no fundamental basis of
the association of severity of HCC with the serum VEGF level.
Objective : to know the relationship between serum VEGF levels with the severity of HCC
by assessing the average difference of serum VEGF level in various severity of HCC in the
Gastroenterohepatology Outpatient Installation at Dr. RSUD. Soetomo Surabaya.
Methods: We perfomed a cross sectional study of patient presenting with HCC compared
to serum VEGF level. Data analysis used spearman correlation test and was considered
significant if p < 0,05.
Keywords : VEGF, HCC, BCLC

7. ABSTRACT
The Correlation between APRI and FIB-4 Scoring Combination and Liver Stiffness In Chronic
Hepatitis B Compared with Transient Elastrography
Amos Pongbulaan
Introduction: Liver stiffness staging is important step during the management of chronic hepatitis B
(CHB). However, Transient elastography (TE) is not widely available and there is a need for less
expensive and simpler noninvasive approaches especially in terms of the hepatitis B elimination
strategy worldwide. We evaluated the diagnostic performance of the APRI and FIB-4 combine scores
compared to TE in detecting liver stiffness
Objective: To analyze the correlation between APRI and FIB-4 scoring combination and liver
stiffness in CHB patients in the Gastroenterohepatology Outpatient Installation at Dr. RSUD.
Soetomo Surabaya.
Methods: We perfomed a cross sectional study of patient presenting with CHB who underwent TE
in January 2020. APRI, FIB-4 and combined score APRI/FIB-4 scores were compared to TE.
Keyword: Hepatitis B, Fibroscan, FIB-4, APRI

8. Sarcopenia as Predictor Three Months Survival in Hepatocelluler Carcinoma Patient who
Underwent First Transarterial Chemoembolization.
Ayudi C**, Maimunah U*
*Division of Gastroenterology and Hepatology, Internal Medicine of Medicine Departmet, Faculty of Medicine, Airlangga Universitas -
Dr. Soetomo Teaching Hospital, Surabaya, Indonesia
Email: umima@gmail.com
**Resident of Internal Medicine Department, Airlangga University, Surabaya, Indonesia
Email: caesarayudi2@gmail.com
Introduction: Hepatocelluler carcinoma (HCC) is the most common primary liver malignancy and is a leading cause of cancer-related
death worldwide. Transarterial chemoembolization (TACE) is standard therapy for patients with intermediate stage HCC. Skeletal
muscle depletion or sarcopenia, defined as the loss of skeletal muscle mass that occurs with aging, has garnered attention as a new
and prognostic factor for various malignancies, including HCC. Skeletal muscle depletion assessed by computed tomography (CT)
predicts poor prognosis of all cancer stages. The impact of sarcopenia on tumor response and overall survival in patients receiving
therapy in a palliative intent has not been sufficiently assessed to date. Therefore, we evaluate the role of sarcopenia as marker
which easy to do to predict clinical outcome in hepatocelluler carcinoma patient who underwent TACE.
Objective: To analyze sarcopenia as predictor three months survival in hepatocelluler carcinoma patient who underwent first
transarterial chemoembolization.
Methods: We perform three months observational cohort, involving hepatocelluler carcinoma who underwent TACE during 2020.
Data analysis used in hazard ratio (HR) with kaplan meier curve and we considered significant if p <0.05.
Keyword: Sarcopenia, Hepatocelluler Carcinoma, Transarterial Chemoembolization

9. ABSTRACT
The Correlation between Frailty and Sarcopenia in Patients with Hepatic Cirrhosis
Rahmadika, R**, Maimunah U*
* Division of Gastroenterology and Hepatology, Internal Medicine Department, Universitas Airlangga, Dr. Soetomo General Academic, Surabaya
Indonesia.
Email : ummima@gmail.com
**Resident of Internal Medicine Department, Universitas Airlangga, Surabaya Indonesia.
Email : rheza.rahmadika@gmail.com
Introduction: Frailty and sarcopenia are serious complications of chronic liver disease that may negatively affect quality of life and survival.
Physical frailty is described as a multidimensional syndrome of decreased reserve, functional impairment, and resistance to stressors, resulting
from cumulative declines across multiple systems, whereas cognitive frailty is characterized by reduced neurophysiological reserve. Sarcopenia,
which is nearly universal in chronic liver disease, is a muscle disease characterized by low muscle strength, low muscle quantity or quality, and
low physical performance. Frailty is prevalent in patient with cirrhosis and is hypothesized to result in part from sarcopenia, but the precise
contribution of sarcopenia to frailty in this population is poorly understood
Objective: To analyze the correlation between frailty and sarcopenia with their characteristics in hepatic cirrhosis patients in the
Gastroenterohepatology Outpatient Installation at Dr. RSUD. Soetomo Surabaya.
Methods: We performed cross sectional study of patient presenting with hepatic cirrhosis who underwent control at gastroenterohepatology
installation between July 2020 to October 2020. Physical frailty was measured by liver frailty index and sarcopenia was measured by BIA and
hand-grip strength test. Logistic regression assessed the association between frailty (=Liver frailty index > 4.5) and sarcopenia in patients with
hepatic cirrhosis.
Keywords: Frailty, Sarcopenia, Hepatic cirrhosis

10. ABSTRACT
Quantitative Hepatitis B Surface Antigen (HBsAg) Level in Pregnant Women as Predictor of Vertical
Transmission of Hepatitis B Virus in Neonates
Maimunah U*, Aulia D**, Miftahussurur M*
* Division of Gastroenterology and Hepatology, Internal Medicine Department, Airlangga University, Dr. Soetomo General Academic Hospital, Surabaya,
Indonesia.
Email : ummima@gmail.com
**Resident of Internal Medicine Department, Airlangga University, Surabaya, Indonesia.
Email : dienaulia.da@gmail.com
Introduction: In hepatitis B endemic areas, particularly in Indonesia and other South-East Asia countries, vertical transmission is still the major
route of Hepatitis B Virus (HBV) transmission in infants or neonates. This remains a challenge in triple elimination program of HBV infection by
global health sector, despite improvements in HBV vaccination coverage. The risk of transmission is related to levels of maternal viremia, which
very high maternal HBV DNA concentrations of greater than 107 IU/mL confer a 10% or more risk of transmission. However, access to HBV DNA
examination remains limited and unaffordable in many developing countries with high prevalences. Quantitative HBsAg testing may provide a
practical and more accessible alternative to predict the mother to child transmission (MTCT) of HBV infection.
Objective: To study and analyse the diagnostic value of quantitative HBsAg level in mothers as a predictor of HBV infection’s transmission to
neonates in Doctor Soetomo General Hospital Surabaya.
Methods: We conducted a cross-sectional study of pregnant women with HBV infection who gave birth in 2020 and examined the quantitative
HBsAg level, HBeAg, and HBV DNA in mothers in early third trimester of pregnancy, and HBsAg in newborns aged 0-28 days.
Keywords: HBV Infection, quantitative HBsAg, vertical transmission, mother to child transmission.

11. ABSTRACT
Serum VEGF As A Predictor Of Degree Liver Fibrosis In Hepatitis B Patients
Supriadi
Introduction: Hepatitis B virus (HBV) infection is a liver disorder that can result in cirrhosis, liver
failure and hepatocellular carcinoma. The detection and quantification of liver fibrosis is a key factor
for disease management and prognostication for an individual with HBV. Recent data indicate that
hepatic angiogenesis, regardless of the etiology, takes place in chronic liver diseases (CLDs) that are
characterized by inflammation and progressive fibrosis. Vascular endothelial growth factor, known
as vascular permeability factor, is the most potent angiogenic factor. it was suggested that VEGF
may contribute to liver fibrosis development by inducing the proliferation of hepatic stellate cells
and sinusoidal endothelial cells. There is no much data explain the correlation between VEGF levels
with degree of liver fibrosis in patients with HBV infection.
Objective: To analyze the correlation between serum vegf level with Degree Liver Fibrosis In
Chronic HBV Patients base on transient elastography (TE) in the Gastroenterohepatology
Outpatient Installation at Dr. RSUD. Soetomo Surabaya.
Methods: We perfomed a cross sectional study of patient presenting with chronic HBV infection
who underwent TE compared to serum VEGF level. Data analysis used spearman correlation test
and was considered significant if p < 0,05.
Keyword: VEGF, Hepatitis B, Liver fibrosis, transient elastography

12. ABSTRACT
Serum Vascular Endothelial Growth Factor (VEGF) Level, Platelet, Spleen Size as Predictor of the Liver Cirrhosis Severity Based on
Child-Turcotte-Pugh (CTP) Score
Made Bayu Agastia Rakateja*
*Resident of Internal Medicine Department, Universitas Airlangga, Surabaya Indonesia
Email : bayuagastiarakateja@gmail.com
Introduction:
Liver cirrhosis is a liver disease characterized by inflammation of liver, cell necrosis, followed by connective tissue proliferation, degeneration
and regeneration of liver cells accompanied by nodules resulting in hardening of the liver. Vascular endothelial growth factor (VEGF) is a potent
angiogenic factor and was first described as an essential growth factor for vascular endothelial cells. Increased expression of VEGF in liver
tissue in chronic liver disease occurs due to stimulation of fibrolast in the formation of fibrous tissue. One of the disturbed liver functions in
cirrhosis patient is protein metabolism which plays a role in regulating the function of blood clooting (hemostasis). One complication that is
often found in cirrhosis of the liver is bleeding. Thrombocytopenia often occurs in patients with liver cirrhosis accompanied by hemostasis
disorders. Splenomegaly is an enlarged condition of the spleen organ, which can be caused by a number of diseases or infections, one of which
is a disease related to the liver. There is not much data that explains the correlation between VEGF levels, platelet counts, and spleen size with
the severity of liver cirrhosis.
Objectives:
To determine the correlation between serum VEGF levels, platelet counts, and spleen size and the severity of the liver cirrhosis based on
CTP scores.
Methods:
We conducted a cross-sectional study of outpatients with liver cirrhosis who went to Dr Soetomo Regional Hospital during March 2020 to
June 2020. The severity of liver cirrhosis was measured using a CTP score. Blood sampling was performed to measure VEGF levels and platelet
counts. The size of the spleen is assessed by physical examination
Results:
Conclusion:
Keyword: Liver cirrhosis, VEGF, Platelet, Spleen size