Virus Hepatitis B Mutan

Abstract

It is estimated that there are two billions people ever infected by hepatitis B virus (HBV) and there are around 350 milllions people suffering from chronic hepatitis B; 20-25% of them are going to develop chronic liver diorders and hepatocellular carcinoma (HCC). Development in vaccination programs and therapy of hepatitis B infection might trigger the genom mutation in part of viral adaptation to stress (mutant HBV). The characteristic of mutant HBV cases is negative results of anti-HBs and HBsAg, meanwhile other infection markers showed the occurence of HBV infection. Antigenic determinant mostly used to detect this infection is determinant “a” of HbsAg located in the position of 124-127. Changes in that location will disturb detection of HbsAg caused by decreased reactivity against several comercial kits, therefore, the sensitivity will decrease and be undected. Mutant HBV causes difficulty in patient detection and evaluation of blood donor. Besides that, mutation will influence the result of vaccination or therapy due to uneffectiveness of several managements.Keywords: hepatitis B infection, vaccination and therapy, mutant HBV Abstrak: Diperkirakan sekitar 2 milyar penduduk pernah terinfeksi virus hepatitis B (HBV) dan saat ini sekitar 350 juta penduduk sedang menderita infeksi hepatitis B kronis dan 20-25% diantaranya akan berkembang menjadi penyakit hati kronis serta karsinoma hepatoseluler (HCC). Berkembangnya program vaksinasi serta berbagai terapi untuk infeksi hepatitis B memungkinkan timbulnya mutasi pada genomnya sebagai bagian dari adaptasi virus terhadap tekanan (HBV mutan). Karakteristik untuk kasus HBV mutan ini ialah negatifnya anti-HBs dan HBsAg, sednagkan petanda infeksi yang lain menunjukkan adanya infeksi HBV. Determinan antigenik yang banyak digunakan untuk mendeteksinya ialah determinan “a” dari HbsAg yang terletak di posisi 124-127. Perubahan pada daerah tersebut akan mengganggu deteksi adanya HbsAg, karena berkurangnya reaktivitas terhadap berbagai kit komersial sehingga sensitivitasnya menjadi semakin menurun yang berakibat tak terdeteksi. HBV mutan menyebabkan kesulitan pada deteksi penderita serta penapisan donor darah. Selain itu adanya mutasi akan berpengaruh pada hasil vaksinasi atau terapi karena menyebabkan tidak efektifnya berbagai penanganan yang dilakukan.Kata kunci: infeksi virus hepatitis B, vaksinasi dan terapi, HBV mutan

Painting as a Means of Art Therapy for Children – Children with Autism Spectrum Disorder (Case Study in Kaliwungu Kudus State Extraordinary School)

“…The determination to focus on this research is intended to: (1) M limit the results of the study, and (2) to meet the results of the criteria that have been entered or have issued new information that can be obtained from the field (Suyanto, 2015). The existence of this focus determination is very clear, researchers can also make good decision results from the data that needs to be collected and which other data needs to be separated, although the data is indeed compelling but not so relevant in a way of reducing from the data (Setyawan, 2017).…”