Penentuan Serotipe Virus Dengue dan Gambaran Manifestasi Klinis serta Hematologi Rutin pada Infeksi Virus Dengue

Abstract

Setiap serotipe virus dengue dapat menimbulkan manifestasi klinis mulai dari demam dengue (DD) sampai demam berdarah dengue (DBD) dan sindrom syok dengue (SSD). Sulit untuk menilai karakteristik klinis dan hasil hematologi yang khas untuk setiap serotipe. Tujuan penelitian ini untuk menentukan serotipe virus dengue dan gambaran manifestasi klinis DD, DBD, SSD serta hasil pemeriksaan hematologi rutin yaitu hemoglobin, hematokrit, leukosit, dan trombosit pada setiap serotipe virus dengue. Penelitian dilakukan di Rumah Sakit Dr. Hasan Sadikin Bandung sejak Maret 2010 sampai Juli 2011. Subjek penelitian adalah penderita infeksi dengue usia >14 tahun dengan riwayat demam <5 hari. Sampel darah diambil untuk penentuan serotipe dengue dengan teknik reverse transcription polymerase chain reaction (RT-PCR) dilanjutkan dengan seminested PCR. Data manifestasi klinis dan hematologi rutin diperoleh dari penelusuran rekam medis. Penelitian ini merupakan penelitian deskriptif. Sebanyak 75 penderita ikut dalam penelitian. Serotipe virus dapat dideteksi pada 27 (36%) sampel dengan dominasi DENV-3 (13) diikuti DENV-2 (8), DENV-4 (4), dan DENV-1 (2). Kasus DBD ditemukan paling banyak pada infeksi DENV-3. Infeksi DENV-2 memberikan penurunan hemoglobin tertinggi, persentase peningkatan hematokrit tertinggi, leukosit terendah, dan trombosit terendah dibandingkan dengan serotipe lainnya. Kesimpulan penelitian ini adalah ditemukan keempat serotipe di RS Dr. Hasan Sadikin Bandung yang didominasi serotipe DENV-3. Kasus DBD terutama disebabkan DENV-3. Hasil hematologi rutin paling abnormal ditemukan pada infeksi DENV-2. [MKB. 2012;44(4):253–60]

Dengue Virus Serotyping and Its Clinical Manifestation and Routine
Haematology in Dengue Infections

All DENV serotypes can cause a spectrum of disease from dengue fever (DF) to dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). It is difficult to differentiate clinical characteristicand hematologic result for each serotype. Aim of this study were to determine dengue serotype and describe clinical manifestation of DF, DHF, DSS and routine hematologic results, i.e.haemoglobin, hematocrit, leukocyte, and thrombocyte in each serotype. This study was conducted at Dr. Hasan Sadikin Hospital Bandung from March 2010 until July 2011. Subjects were dengue patients aged >14 years with a history of fever <5 days. Blood samples were taken for serotype determination by reverse transcription polymerase chain reaction (RT-PCR) followed by semi-nested PCR. Clinical manifestation data and haematologic result were obtained from medical records. This was a descriptive study. Seventy five patients were included in this study. Dengue serotype can be detected in 27 (36%) samples with DENV-3 (13) were dominating followed by DENV-2 (8), DENV-4 (4), and DENV-1 (2). DHF was mainly found in DENV-3. DENV-2 gavethe highest decrease in hemoglobin, highest percentage increase in haematocrit, lowest leukocyte, and lowest thrombocyte. In conclusion, all 4 serotypes are found in RSUP Dr. Hasan Sadikin Hospital Bandung with DENV-3 domination. DHF is mainly caused by DENV-3.

DOI: http://dx.doi.org/10.15395/mkb.v44n4.138