Bagus Setyoboedi, Bagus and Reny Widayanti, - and Sjamsul Arief, - and Dwiyanti Puspitasari, - The agreement of cytomegalovirus (CMV) serology examination and CMV polymerase chain reaction of liver tissue in infants with cholestasis. Sri Lanka Journal of Child Health, 50 (1). pp. 43-48. ISSN 1391-5452 E-ISSN:2386-110X

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Abstract

Abstract Introduction: The incidence of cholestasis in infancy is associated with congenital or viral infection. Commonest cause is Cytomegalovirus (CMV) infection. In Indonesia, diagnosis of cholestasis due to CMV infection is still not optimal because the support of virological examination is still limited, so serological examination is an option. Objective: Analysing the agreement of CMV IgG or IgM serological examination and CMV polymerase chain reaction (PCR) examination of liver tissue in infants with cholestasis Method: This is an analytic observational research using cross sectional design. Samples were infants with cholestasis, 1-12 months of age, in the Department of Child Health, Dr. Soetomo General Hospital, who met the inclusion criteria. Samples were taken from December 2017- May 2018. Liver biopsy was done in Department of Child Health, Dr. Soetomo Hospital. CMV PCR examination of liver tissue was carried out in the Tropical Disease Laboratory at Airlangga University. Data were analysed by calculating the kappa coefficient CMV IgG or IgM serology examination and CMV PCR examination of liver tissue. Results: There were 30 infants with cholestasis, consisting of 16 (53%) boys and 14 (47%) girls. Positive CMV IgG was found in 28 subjects and CMV IgM was found in 15 subjects. CMV PCR was positive in 20 (67%) subjects. The most common age range with positive CMV IgG and IgM as well as CMV PCR was 1-3 months. Agreement of CMV IgG compared to CMV PCR of liver tissue showed weak result with kappa value of 0.25. The agreement of CMV IgM compared to CMV PCR of liver tissue was not found with kappa value 0.00. Conclusions: In infants with cholestasis, there is no agreement for CMV serological examination with CMV PCR of liver tissue. CMV serologic examination cannot replace CMV PCR of liver tissue to determine the presence of CMV virus in infant with cholestasis.

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