Detail Research Data


Data Resident (PPDS)
Research Title Kinetics of IgG Anti-NS1 Dengue Virus and Its Relation With Thrombocytopenia and Plasma Leakage In Dengue Infection
Kaji Etik Pass Number
Kaji Etik Pass Date 10 Februari 2010
Focus Others (-)
Principal Investigator Erik Rohmando Purba
Pembimbing 1 SpPD, KPTI Leonard Nainggolan dr
Pembimbing 2 Shufrie Effendy
Pembimbing 3 SpPD-KGER, MEpid Siti Setiati Dr.dr.
Departement Internal Medicine
Category Clinic
Research Date 10 Februari 2010
Research Object Manusia
Fund Source Mandiri
Level Penelitian Resident (PPDS)
Abstract

Background. Dengue infection has been regarded as a major health issue in tropical countries such as Indonesia. This disease is known for its significant morbidity and mortality rate. Two important clinical manifestation of this disease is thrombocytopenia and plasma leakage. Many hypotheses presented as the pathogenic process involved in these mechanisms; one of them is anti-NS1 antibody dengue virus. Anti-NS1 antibody is considered important when several in-vitro studies have shown cross reaction with thrombocyte and endothelial cell. Unfortunately, only few of in-vivo studies which have been conducted and shown variables result, therefore a similar study in-vivo is deemed necessary to further investigate the proper role of anti-NS1 antibody in human dengue infection
Objectives. This study was in vivo study in human that will elaborate the kinetics of anti-NS1 antibody and its relation with thrombocytopenia and plasma leakage in dengue infection
Methods. This community-based study was conducted in Jakarta between April 2010 and December 2010, in which patients with symptoms of dengue infection and fever period less than two days were enrolled as subjects based on the result of NS1 antigen. Subjects underwent hospitalization in Cipto Mangunkusumo Hospital and were treated in accordance to WHO 2009 guidelines for dengue infection. During hospitalization, serial hematocrite, thrombocyte, albumin tests, IgG anti-NS1 with indirect ELISA test was done in day three, day five, and day seven of fever and ultrasonography examination to assess ascites and pleural effusion were conducted at day five. Subjects then were grouped based on the thrombocyte count and presence of plasma leakage. Chi square analysis was used to evaluate the relation between IgG anti-NS1 with thrombocyte count and plasma leakage
Result. Total subjects included were 50 with 36 subjects developed plasma leakage. IgG Anti-NS1 titer reached its highest level at third day of fever and decreased at the fifth day and reached its lowest level at seventh day. There was no statistically significant difference between IgG anti-NS1 with thrombocyte count >100000 and thrombocyte count <100000 (3rd day p = 0.089, PR 2.48, CI 95% 0.895-13.187; 5th day p = 0,196, OR 1.79, CI 95% 0.649-7.859; 7th day p = 0,584, OR 0.88, CI 95% 0.214-2.388). There was no significant difference between IgG anti-NS1 with plasma leakage (3rd day p = 0.979, PR 1.00, CI 95% 0.281-3.687; 5th day p = 0.511, PR 0.85, CI 95% 0.164-2.098; 7th day p = 0.198, PR 0.78, CI 95% 0.124-1.559).
Conclusions. IgG anti-NS1 titer reached its highest level on the third day and start to decrease on the fifth day and reach its lowest level on the seventh day of fever. There was no significant association between IgG anti-NS1 with thrombocytopenia and plasma leakage in dengue infection.