Hubungan Gen HLA-DRB1 dan Faktor Lingkungan Terhadap Kejadian Penyakit Jantung Reumatik pada Anak

Abstract

Introduction Rheumatic heart disease (RHD) and RHD reactivation are still the most common cause of acquired heart disease and mortality in developing countries because of the permanent damage to the heart valve tissue. Genetic factor of various human leukocyte antigen (HLA) alleles especially HLA-DRB1 is associated with RHD and RHD reactivation. Objective To find association between HLA-DRB1 alleles and environment factors with incidence of RHD in children in Medan, Sumatera Utara Subjects A total of 78 subjects were equally divided into cases and control groups. Subjects were outpatients and inpatients on April until June 2017 at RSUP Haji Adam Malik Medan. Data Data collected, consisting of age, gender, parental income, parental education, number of occupants in the house, and treatment compliance. Physical examination, echocardiography, CRP, chest X-ray, ECG, and HLA-DR gene examination was performed at Laboratory in School of Medicine, Universitas Sumatera Utara. Data were analyzed using Chi-square and logistic regression test. Categorical and numerical variables were analyzed by t test. Statistical analysis was performed at 95% CI and P value <0.05 was considered significant. Results The presence of alleles other than B*12 compare to B*12 in HLA DR have higher risk of RHD and RHD reactivation by 1,415 times but statistically not significant (P = 0.308). Alleles other than B*15 compare to B*15 have lower risk of RHD and RHD reactivation by 0.764 times, also statistically not significant (P = 0.463). Fathers with elementary and junior high school education have higher risk of having children with RHD and RHD reactivation by 15.75 (P = 0.017) and 28.0 times (P = 0.031) respectively. Family income below minimum wage has higher risk of RHD events by 3,681 times (P = 0.009). Subjects with good treatment compliance, has valve damage with a P value = 0.715 Conclusion HLA DR Alleles B1*12 and B1*15 are not significant related to RHD events statistically. Factors related to RHD are father's education, parents' income, water sources, meat consumption, and capability to buy new clothes. Treatment compliance is not related to the level of valve damage.

Introduction Rheumatic heart disease (RHD) and RHD reactivation are still the most common cause of acquired heart disease and mortality in developing countries because of the permanent damage to the heart valve tissue. Genetic factor of various human leukocyte antigen (HLA) alleles especially HLA-DRB1 is associated with RHD and RHD reactivation. Objective To find association between HLA-DRB1 alleles and environment factors with incidence of RHD in children in Medan, Sumatera Utara Subjects A total of 78 subjects were equally divided into cases and control groups. Subjects were outpatients and inpatients on April until June 2017 at RSUP Haji Adam Malik Medan. Data Data collected, consisting of age, gender, parental income, parental education, number of occupants in the house, and treatment compliance. Physical examination, echocardiography, CRP, chest X-ray, ECG, and HLA-DR gene examination was performed at Laboratory in School of Medicine, Universitas Sumatera Utara. Data were analyzed using Chi-square and logistic regression test. Categorical and numerical variables were analyzed by t test. Statistical analysis was performed at 95% CI and P value <0.05 was considered significant. Results The presence of alleles other than B*12 compare to B*12 in HLA DR have higher risk of RHD and RHD reactivation by 1,415 times but statistically not significant (P = 0.308). Alleles other than B*15 compare to B*15 have lower risk of RHD and RHD reactivation by 0.764 times, also statistically not significant (P = 0.463). Fathers with elementary and junior high school education have higher risk of having children with RHD and RHD reactivation by 15.75 (P = 0.017) and 28.0 times (P = 0.031) respectively. Family income below minimum wage has higher risk of RHD events by 3,681 times (P = 0.009). Subjects with good treatment compliance, has valve damage with a P value = 0.715 Conclusion HLA DR Alleles B1*12 and B1*15 are not significant related to RHD events statistically. Factors related to RHD are father's education, parents' income, water sources, meat consumption, and capability to buy new clothes. Treatment compliance is not related to the level of valve damage