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All Journal The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Andri Sanityoso

Division of Gastroenterology, Department of Internal Medicine University of Indonesia/Dr. Cipto Mangunkusumo General National Hospital, Jakarta

Author-ID : 370291

Health Professions Medicine & Pharmacology

Published : 9 Documents Claim Missing Document

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Articles

Prevention of Hepatitis B Virus Transmission in Pregnancy Praptiwi, Dwi Rahayu NL; Sanityoso, Andri
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 15, No 3 (2014): VOLUME 15, NUMBER 3, December 2014
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Chronic hepatitis B virus infection is a serious health problem in many countries, particularly in developing countries. In Asia-Pacific region, vertical transmission from mother to child is the main endemicity factor of hepatitis B virus (HBV) infection. Almost 50% cases of hepatitis B virus infection happen during perinatal and neonatal period, including vertical transmission from mother to child during pregnancy.World Health Organization (WHO), World Gastroenterology Organization (WGO) and many countries have recommended immunoprophylaxis by the administration of hepatitis B vaccine and hepatitis B immunoglobulin (HBIg) to prevent transmission from mother to child. However, there are approximately 10-15% babies born from mother with hepatitis B infected by HBV through intrauterine transmission. Incidence of intrauterine transmission is accounted for around 43-50% if DNA of HBV in the mother is more than 107 copies/mL, although passive and active immunization to the baby has been administered. Therefore, administering antiviral drugs in pregnant women with chronic hepatitis B accompanied by immunoprophylaxis is effective in preventing hepatitis B infection transmission during pregnancy, particularly in decreasing the number of virus and administering active or even passive immunization to neonates. Keywords: hepatitis B, pregnancy, prevention, transmission

Administration of Methotrexate in Rheumatoid Arthritis Patients with Chronic Hepatitis B Herwanto, Velma; Sanityoso, Andri
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 16, No 1 (2015): VOLUME 16, NUMBER 1, April 2015
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Aim: To identify if methotrexate (MTX) may be given to chronic hepatitis B patients and to evaluate the necessity of antiviral prophylaxis administration.Method: Literature search procedure to answer this clinical problem was performed by exploring the literature online using PubMed, Highwire Stanford University, NUS Library, and MD Consult search engines. With this searching method, we found 20 articles in English. From those 20 articles, there were two articles relevant based on the title and abstract (studies by Tamori et al and Mori).Results: From 45 patients without HbsAg from Tamori et al study, only one from 3 patients receiving disease-modifying antirheumatoid drug/DMARD (including MTX) experienced reactivation. Those three patients did not receive anti-TNF-α therapy. Study by Mori concluded that DMARD was relatively safe to be given to most RA patients with the history of HBV infection, although they were not given anti HBV prophylaxis therapy.Conclusion: MTX is not recommended for patient in this case because it is contraindicated to be given in HBV infected patient with any given Child Pugh score. If MTX is still given, it is recommended to give antiviral prophylaxis therapy.

Non-invasive Markers for Diagnosis of Liver Cirrhosis in Chronic Hepatitis B Tenggara, Jeffry Beta; Hasan, Irsan; Sanityoso, Andri; Abdullah, Murdani
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 12, NUMBER 3, December 2011
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Background: Indonesia is an endemic country for hepatitis B viral infection. Thus, early diagnosis of cirrhosis is important to be established with regard to prompt treatment and to determine the patients’ prognosis. Liver biopsy which is a gold standard in diagnosing liver cirrhosis has several limitations, such as expensive and invasive. The objective of this study was to identify the accuracy of non-invasive markers: aspartate/alanine transaminase ratio (AAR), age-platelet index (API), aspartate transaminase to platelet ratio index (APRI), spleen to platelet ratio index (SPRI), and age-spleen-platelet ratio index (ASPRI) in predicting cirrhosis in chronic hepatitis B patients. Methods: A diagnostic study was performed in Division of Hepatology and Hepatology Outpatient Clinic, Depatment of Internal Medicine, Cipto Mangunkusumo Hospital between January 2009 and July 2010, with the participation of 71 chronic hepatitis B patients who had undergone liver biopsy consecutively. Stage of fibrosis was determined based on the METAVIR scoring system. Five non-invasive markers: AAR, API, APRI, SPRI, and ASPRI were compared with liver biopsy Results. Statistical analysis was performed by using T-test and Spearman correlation test using SPSS version 13. Results: API, APRI, SPRI, and ASPRI had significant correlation with the incidence of liver cirrhosis in hepatitis B infection (p < 0.05). However, AAR had no correlation with the incidence of cirrhosis. Using the cut-off point of 1.19, APRI was the best marker with area under curve (AUC) 0.91, sensitivity 83.3%, and specificity 89.2%. Conclusion: Non-invasive markers were suitable in predicting cirrhosis and have the potential to decrease the number of liver biopsy in chronic hepatitis B patients. Keywords: non-invasive markers, chronic hepatitis B, liver cirrhosis

Serologic and Urine Diagnostic Tests to Detect Helicobacter pylori Infection in Functional Dyspepsia Patients Wardhana, Agasjtya Wisjnu; Syam, Ari Fahrial; Sanityoso, Andri; Rumende, Cleopas Martin
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 17, No 3 (2016): VOLUME 17, NUMBER 3, December 2016
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Background: Dyspepsia is a collection of symptoms in the forms of discomfort, pain, nausea, vomiting, bloating, and early satiety in the stomach. This condition can be caused by various problems; one of them is Helicobacter pylori infection. Dyspepsia without organic problem is known as functional dyspepsia. H. pylori examination is recommended in functional dyspepsia patients.Method: In this study, we performed a diagnostic test study in dyspepsia patients in Community Health Centre of Koja District, North Jakarta, from February to April 2015. Samples were obtained through consecutive sampling method; 74 patients were included. The data was gathered by distributing questionnaires to patients, performing urea breath test (UBT) examination, serologic test, and urine test using rapid urine test (RAPIRUN). Results: Prevalence of H. pylori infection by using UBT examination reached up to 36.5%; meanwhile serologic and RAPIRUN tests showed positive results in 32.4% and 24.3% patients, respectively. Serologic test has sensitivity of 74% (95% CI: 55-87%), specificity 91% (95% CI: 80-97%), positive predictive value (PPV) 83% (95% CI: 64-93%), and negative predictive value (NPV) 86% (95% CI: 74-93%). Meanwhile, RAPIRUN has sensitivity of 63% (95% CI: 44-78%), specificity 98% (95% CI: 89-100%), PPV 94% (95% CI: 74-99%), and NPV 82% (95% CI: 70-90%).Conclusion: Sensitivity of serologic and RAPIRUN tests are still inadequate to be alternative to UBT examination. However, they have high specificity. Further studies are required with larger sample size and consideration of factors which may influence the results of both tests.

Fecal Calprotectin Level as Diagnostic Marker for Intestinal Inflammation in Inflammatory Bowel Disease Patients -, Darmadi; Makmun, Dadang; Sanityoso, Andri; Shatri, Hamzah
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 16, No 3 (2015): VOLUME 16, NUMBER 3, December 2015
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Background: Inflammatory bowel disease diagnosis was still based on invasive examination, such as endoscopy and histopathology. Fecal calprotectin was a non-invasive intestinal inflammation marker, but several study give a different result in its diagnostic value and correlation to inflammatory bowel disease. This research was aimed to prove that fecal calprotectin examination has a high diagnostic value in diagnosing inflammatory bowel disease, and also correlate to its clinical stages.Method: This is a cross sectional study to do a diagnostic test in several hospital in Jakarta, from September 2014 to February 2015. Receiver operating characteristic (ROC) curve was made to get fecal calprotectin diagnostic level and Krusskal Wallis test was performed to identify fecal calprotectin difference among each inflammatory bowel disease clinical stages.Results: A total of 71 patients with inflammatory bowel disease was invoved in this research, based on colonoscopic examination result. Among them, 57 patients was confirmed to have intestinal inflammation based on histopathology result. Fecal calprotectin level was found to be higher in patients with inflammatory bowel disease than patients without intestinal inflammation (553,8 µg/g vs. 76,95 µg/g, p < 0,001). A cut off point of 179,3 µg/g was gathered, with 96% sensitivity (95% CI: 0,88-0,99), 93% specificity (95% CI: 0,69-0,99), and 99,5% area under curve (AUC) 99,5% (95% CI: 0,98-1,00). A significant difference was found between fecal calprotectin in each inflammatory bowel disease clinical stages (p < 0,001).Conclusion: Fecal calprotectin has a high diagnostic value for inflammatory bowel disease (IBD) and strongly correlate to its disease clinical stages.

The Effect of Branched Chain Amino Acids and L-Ornithine L-Aspartate Combination as The Late Evening Snacks on Nutritional Status and Minimal Hepatic Encephalopathy in Liver Cirrhosis Tenda, Eric Daniel; Hasan, Irsan; Sanityoso, Andri; Setiati, Siti
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 13, NUMBER 3, Desember 2012
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

ABSTRACTBackground:Minimal hepatic encephalopathy (MHE) in liver cirrhotic patients is critical manifestation of low grade hepatic encephalopaty (HE), is caused quality of life decrease and risk of deteriorating into distinct HE. The study was conducted to asses the effect of combination of branched-chain amino acids (BCAA) and L-ornithine L-aspartate (LOLA), which was given late evening, on nutritional status and degree of HE.Method: This single-blind randomized study was conducted on liver cirrhotic outpatients in hepatology clinic of Cipto Mangunkusumo Hospital period June 2011-June 2012. The study subjects were divided into two groups, group of late evening snack (LS) and day snack (DS). Each group was supplemented with combination of milk of BCAAs and LOLA (3.7 g/serving). Evaluation based on history, physical examination, laboratory tests and critical flicker frequency (CFF) was performed one month after the intervention. Data were statistically analyzed with SPSS 15.Results: Thirty-two patients whose the inclusion criteria were divided into 16 subjects for each group, LS and DS. After one month of the intervention, the average level of prealbumin for DS group was increased statistically significant (p < 0.001), but not significant for LS group (p = 0.259). The increase of average body weight,mid-arm muscle circumference (MAMC) and CFF test result in both groups. There was no improvement on subject global assessment (SGA) score after one month intervention in both groups.Conclusion: This study proved that giving combination of BCAAs and LOLA may improve the condition of MHE, however for nutritional status can not be assessed. Keywords: minimal hepatic encephalopathy, BCAAs, LOLA, prealbumin, SGA score, nutritional status

Efficacy and Safety of In-Asia-manufactured Interferon alpha-2b in Combination with Ribavirin for Therapy of Naïve Chronic Hepatitis C Patients: A Multicenter, Prospective, Open-Label Trial Akbar, Nurul; Sulaiman, Ali; Gani, Rino Alvani; Hasan, Irsan; Lesmana, Laurentius; Sanityoso, Andri; Noer, Sjaifoellah; Pridady, FX; Soemarno, Soemarno
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 10, ISSUE 1, April 2009
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Background: An open-label, multi center and non-comparative study was conducted to evaluate the efficacy and safety of a more affordable in-Asia-manufactured interferon á-2b product in combination with ribavirin to treat naïve chronic hepatitis C patients. Method: Thirty chronic naïve hepatitis C patients were treated with in-Asia-manufactured interferon a-2b subcutaneously 3 MIU thrice weekly and ribavirin 800-1,200 mg daily for 48 weeks. Follow-up was done until 24 weeks after the end of treatment. Efficacy was assessed by examining serologic and biochemical parameters at pre and post-treatment. Safety was assessed by evaluating clinical symptoms and laboratory parameters. Results: The virological response and sustained virological response rates of all Hepatitis C Virus (HCV) genotypes were 83.3% and 76.7% respectively. Post-treatment, 80% patients had significant alanine transaminase (ALT) decreased into normal level and remained normal in 76.7% patients at 24th week follow up period. At that time, the ALT level and sustained virological response were lower in HCV genotypes 1 and 4 than in non-1 and non-4 genotypes. The most frequent adverse event was flu-like syndrome. Conclusion: The efficacy and safety study on combination therapy of in-Asia-manufactured interferon a-2b and ribavirin has shown a good result based on the current standard of interferon alpha and ribavirin combination therapy. Keywords: interferons, combination drug therapy, chronic hepatitis C, treatment efficacy, safety

Non Cirrhotic Portal Fibrosis Girson, Ralph; Sanityoso, Andri; Gani, Rino A; Marwoto, Wirasmi; Abdullah, Murdani; Syam, Ari Fahrial
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 6, ISSUE 2, August 2005
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Diagnosis of non cirrhotic portal fibrosis was considered when the following criteria were fulfilled evidence of portal hypertension (oesophageal varices, hypersplenism, ascites, or increased hepatic venous pressure gradient), Doppler ultrasound showing patent portal and hepatic veins, and liver biopsy showing sign of cirrhosis. Non cirrhotic portal fibrosis clinically characterized by splenomegaly, anemia, portal hypertension, and histopathological examination portal tract showing fibrosis and sclerosis. Portal hypertension are most caused by a cirrhotic liver (85%), there are only a few reports on non cirrhotic portal hypertension, mostly in Japan and India. We reported a case of non cirrhotic portal fibrosis in young male. The clinical complications of portal hypertension are variceal bleeding and pancytopenia due to hypersplenism. Variceal band ligation and splenectomy were performed. The patient showed good clinical response. Keywords: portal hypertension, non cirrhotic portal fibrosis, young male

Combination Therapy of Sorafenib and Transarterial Chemoembolization in Management of Hepatoma Kumar, Bhanu S; Sanityoso, Andri; Syam, Ari Fahrial; Gani, Rino Alvani
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 14, NUMBER 2, August 2013
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Incidence of hepatocellular carcinoma (HCC) continues to increase in developing countries and rank 5th in male and 7th in female. Main cause being reported is chronic hepatitis B in Asian region. Treatment of choice for HCC is liver resection, however it is oftenly not possible to be performed as the disease has entered advanced stage. Due to the less choice of treatment in HCC, one of the several other alternatives has been considered is transarterial chemoembolization (TACE) which is applied in patients who cannot undergo resection or ablation therapy, failure of therapy. However limitation of TACE is very high recurrence rate of HCC. Sorafenib is ananti-angiogenic medicine approved as first systemic drug in HCC therapy. Several studies stated the benefits of combination therapy of TACE and Sorafenib administration to prevent HCC recurrence. Success rate of thiscombination therapy reaches control disease rate of 100% based on response evaluation criteria in solid tumors (RECIST) from European Association for the Study of the Liver (EASL).Keywords: TACE, sorafenib, liver cancer, HCC

Co-Authors -, Darmadi Ali Sulaiman Ari Fahrial Syam Bhanu S Kumar C Rinaldi A Lesmana C. Rinaldi A Lesmana, C. Rinaldi A Chyntia Olivia Maurine Jasirwan, Chyntia Olivia Maurine Cleopas Martin Rumende Dadang Makmun Dwi Rahayu NL Praptiwi, Dwi Rahayu NL Eric Daniel Tenda FX Pridady Hamzah Shatri Irsan Hasan Jeffry Beta Tenggara Juferdy Kurniawan Kemal Fariz Kalista, Kemal Fariz Laurentius Lesmana Lutfie Lutfie, Lutfie Maulana Suryamin, Maulana Murdani Abdullah Nurul Akbar Ralph Girson Rino A Gani Rino Alvani Gani Siti Setiati Sjaifoellah Noer Soemarno Soemarno Velma Herwanto Wardhana, Agasjtya Wisjnu Wirasmi Marwoto

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