OBJECTIVE: The incidence of cholestasis in infancy is associated with congenital or viral infection. The most common cause by Cytomegalovirus (CMV) infection. In
Indonesia, diagnosis of cholestasis due to CMV infection is still not optimal. The objective of this study was to evaluate of positive Cytomegalovirus (CMV) serology in infant with cholestasis in Dr. Soetomo Hospital.
METHODS: This was a cross-sectional study, evaluated infant less than 1 years with cholestasis in Januari 2014 to December 2018 at Dr. Soetomo Academic General
Hospital, Surabaya. Cholestasis was based on clinical manifestations (yellow infants and acholic feces) and laboratory test (direct bilirubin was above 2mg/dL if the total bilirubin was less than 5 mg/dL or direct bilirubin was above 20% of total bilirubin if total bilirubin was above 5 mg/dL). Cytomegalovirus serology was assay for immunoglobulin M and immunoglobulin G cytomegalovirus. Biliary atresia and non biliary atresia were differentiated based on result of histopathological liver biopsy examination. Statistical analysis of chi-square was used with p<0.05.
RESULTS: There were 185 infants with cholestasis, consist of 100 (54%) boys. Cholestasis with biliary atresia was 71 (38.4%) and non biliary atresia was 114 (61.6%) subjects. The most common age range with positive CMV serology (IgM) was 1-3 months of age. Cytomegalovirus immunoglobulin M was positive in 47.9% biliary atresia group and 27.2% non biliary atresia group (OR 2.460; p=0.004).
CONCLUSION: The positive CMV serology (IgM) more common in cholestasis infant with biliary atresia than non biliary atresia.