Pengaruh polimorfisme gen Interferon-gamma +874T/A dan gen Interleukin-10 -1082G/A terhadap konversi biakan sputum pasien TB-MDR suku Jawa

ABSTRACT The Influence of Interferon-γ+874 and Interleukin-10 -1082 Gene Polymorphisms to Culture Conversion Among Javanese MDR-TB Patient. Interferon-γ expression was influenced by SNP +874, and Interleukin-10 by SNP -1082. As we know, Interferon-γ & Interleukin-10 have important roles in Tuberculosis. Based on this fact, polimorfism of Interferon-γ +874 and Interleukin-10 -1082 are assumed have roles in MDR-TB, especially in sputum culture conversion. The objective of this study was to find out the influence of Interferon-γ +874T/A and Interleukin-10 -1082G/A gene polymorphisms to the sputum culture conversion of Javanese MDR-TB patients. This clinical non-interventional retrospective and prospective cohort study were conducted from January 2011 to April 2014 in Central Jawa with total sampling technique. Epidemiology and clinical data of patients were collected including their sputum conversion status and being analyzed. Blood sample was taken for Interferon-γ and Interleukin-10 polimorfism examination molecularly using PCR methods. This study involved outpatients MDR TB suspected in Moewardi hospital from January 2011 until April 2014. All MDR TB suspected were being evaluated since early detection until cured or die. During the study period of January 2011 to April 2014, 179 patients with suspected MDR met the inclusion criteria and 120 patients willing to sign the informed consent. Seven of the 120 patients drop out and 6 patients died during the observation, 61 patients were confirmed as MDR TB and 46 patients confirmed resistant to Rifampicin alone. Genotype of +874 A/A, T/A and T/T utk SNP Interferon-γ was found in 27,21,13, patients. Genotype of -1082 A/A, G/A and G/G utk SNP Interleukin-10 was found in 10, 50, 1, patients. Genotype of A/A utk Interferon-γ was found in the most patients with MDR-TB compared resistant R (OR: 2.38, 95% CI: 0.661 to 6.086, p: 2.19). Genotype of -1082 G/A Interleukin-10 was found most widely in MDR-TB patients compared to resistant-R (OR: 2.38, 95% CI: 0.209 to 27.188, p: 0.485). The pair of +874 A/A Interferon-γ gene and -1082 G/A Interleukin-10 was found most widely than other genotypes partner (OR = 2.11; 95% CI: 0.660 to 46.734; p = 0.208). Patients with mixed genotypes of +874 A/A Interferon-γ and -1082 A/A Interleukin-10 took the longest sputum culture conversion (HR = 2.88; 95% CI: 1.030 -8.028; p = 0.040). Patients with mixed genotypes of +874 T/T Interferon-γ and -1082 G/A Interleukin-10 have the fastest time culture conversion (HR = 0.441; 95% CI: 0.223 to 0.870; p = 0.018). The conclusion was influence of -1082 G/A Interleukin-10 gene polymorphism to culture conversion of MDR TB patients. There were influence of +874 T/T Interferon-γ and -1082 A/A Interleukin-10 gene polymorphism to decelerate culture conversion and +874 T/T Interferon-γ and -1082 G/A Interleukin-10 gene polymorphism to accelerate the culture conversion of Javanese MDR-TB patients. Keywords: Multi Drugs Resistant Tuberculosis, Interferon-γ, Interleukin-10, culture conversion