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COMMON SEROLOGIC TESTS

FOR
VIRAL INFECTIONS

Djoko Priyatno
PEMERIKSAAN LABORATORIUM
INFEKSI VIRUS

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PEMERIKSAAAN
PEMERIKSAAN SEROLOGI
HEMATOLOGI (PEMERIKSAAN
VIROLOGI)
PENYAKIT INFEKSI VIRUS
 Demam Dengue
 Demam Berdarah Dengue
 HIV/AIDS
 Infeksi Mononukleosis Infeksiosa
 Morbili
 Varicella
 Hepatitis
 Meningitis Virus
 Chikungunya
 SARS (Severe Acute Respiratory Syndrom)
 Flu Burung (Avian Flu) pada manusia
PEMERIKSAAN VIROLOGIS

PEMERIKSAAN VIROLOGIS SANGAT


JARANG DILAKUKAN KARENA:
 Virus berukuran 0,02-0,3 µm, diperiksa
dibawah mikroskop elektron
 Virus lebih sulit ditumbuh-kembangkan
dibanding bakteri atau mikroorganisme
lain
 Virus hanya dapat bereplikasi pada sel
host
PEMERIKSAAN VIROLOGIS

 Untuk invitro digunakan organ-organ


hewan atau kultur jaringan sebagai
medium karena memerlukan sel hidup
 Memerlukan laboratorium khusus
(sarana lengkap)
 Dalam praktek sehari-hari sulit
mengenal infeksi virus dibandingkan
infeksi bakteri
HIV / AIDS

 Virus HIV-1 dan HIV-2  HIV


 Menyerang sel limfosit T CD4+ bereplikasi
 lisis sel  TCD4+ ↓↓ dalam darah
 Virus HIV  virus RNA untai ganda
 famili retrovirus genus lentivirus
 Sifat sitopatik  merusak sel
 Target  menginfeksi sel sistim imun
 limfosit T CD4 + (Th), makrofag, sel dendrit
Serologic tests for HIV/AIDS
• Several laboratory methods are available
to screen blood, diagnose infection, and
monitor disease progression in individuals
infected by HIV.
• These tests can be classified into those
that: 1) detect antibody, 2) identify
antigen, 3) detect or monitor viral nucleic
acids, and 4) provide an estimate of T-
lymphocyte numbers (cell phenotyping).
DIAGNOSIS LABORATORIUM HIV
Awal, antibodi (-)
 Biakan virus → waktu 4 minggu
 Deteksi antigen → ELISA → protein p24
 Deteksi materi genetik dalam darah
Deteksi antibodi → pemeriksaan serologi
komponen virion HIV

Untuk menentukan saat dimulai pengobatan :


- Jumlah limfosit T CD4+
- Jumlah virus HIV (viral load)
Common HIV Antibody Tests

A. Enzyme Linked Immunosorbent


Assays (ELISA)
B. Rapid Tests
C. Western Blot
Enzyme Linked Immunosorbent Assays
(ELISA)
 Enzyme Linked Immunosorbent Assays are best
performed at a regional or national laboratory since
they require well-trained and skilled laboratory
technicians, technologically advanced equipment
(incubators, washers and spectrophotometers) that
requires maintenance and a constant source of
electricity.
 Enzyme Linked Immunosorbent Assays is most
efficient for laboratories that process a large number of
specimens (100 or more) daily or for batch testing
which is common in HIV sentinel surveillance.
Rapid Tests
Rapid tests are based on four
immunologic principles :
1. Particle agglutination,
2. Immunodot (dipstick),
3. Immunofiltration (flow through
device), and
4. Immunochromatography (lateral
flow).
 Many rapid tests are under evaluation or are
currently in use in developing countries for
screening, diagnostic and surveillance
purposes.
 Rapid tests are useful in settings where
ELISA are not feasible or practical and in
geographic areas with limited laboratory
infrastructure.
 Rapid tests may be appropriate for hard-to-
reach populations (e.g. Injection drug users,
female sex workers) or geographically
remote populations for whom HIV test results
may need to be provided on site on the same
day of specimen collection.
Western Blot
 Western blot is a technique in which proteins are
separated electrophoretically, transferred to
membranes, and identified through the use of labeled
antibodies specific for protein of interest.

 Western blot is the most widely used supplementary


test for confirming HIV ELISA antibody tests.

 The test has certain disadvantages ;


a. it is cumbersome to perform,
b. it requires overnight incubation and
c. interpretation is often difficult.

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