[The Profile of Interferon-ɣ and BCG Scar as an Immune Response Reflection in Children with Leprosy]

Background: Leprosy in children are commonly found in Madura, Indonesia. Bacillus Calmette-Guerin (BCG) vaccination and interferon--γ (IFN-γ) level associated with severity of leprosy. Purpose: To evaluate IFN-γ level and BCG scar due to leprosy in child. Methods: A descriptive observational cross sectional research, with leprosy in patients in Bangkalan, Madura as subjects. Subjects has been collected through consecutive sampling, then BCG scars were observed and blood vein samples were taken to measure IFN-γ level. Results: IFN-γ level were below normal range in almost all subjects. Mean level in patients with BCG scar (10,07 pg/ml) were higher than patients with non-scar (6,9 pg/ml). Seventy percents patients without BCG scar tend to be MB type based on percentage BCG scar due to type of leprosy. Conclusion: Immunity status as a result of BCG vaccination measured from IFN-γ level has many confounding factor. BCG vaccination seems to have an important role in severity of leprosy. Patients with BCG scar tend to be PB type. BCG vaccination can be benefits to make milder symptoms of leprosy.

Latar Belakang: Penyakit kusta pada anak masih banyak ditemukan di Madura, Indonesia. Vaksinasi Bacillus Calmette-Guerin (BCG) dilaporkan dapat meningkatkan respons imunologis pada pasien kusta yang ditandai dengan peningkatan kadar interferon-γ (IFN-γ). Tujuan: Mengevaluasi kadar IFN-γ dan skar BCG pada pasien kusta anak. Metode: Penelitian deskriptif observasional dengan subjek pasien kusta anak di Bangkalan, Madura, dikumpulkan secara consecutive sampling, selanjutnya skar BCG diobservasi dan dilakukan pengambilan darah vena untuk pemeriksaan kadar IFN-γ. Hasil: Kadar IFN-γ pada hampir seluruh subjek berada di bawah normal, dengan rerata kadar IFN-γ pada pasien dengan skar BCG (10,07 pg/ml) lebih tinggi dari pasien tanpa skar (6,9 pg/ml). Berdasarkan prosentasi skar BCG terhadap tipe kusta, 70% pasien tanpa skar BCG cenderung menjadi tipe MB. Simpulan: Status imunitas sebagai hasil vaksinasi BCG yang dipastikan dengan kadar IFN-γ mempunyai banyak faktor perancu. Vaksinasi BCG diduga berperan penting pada tingkat keparahan penyakit kusta. Pasien dengan skar BCG cenderung memiliki gejala klinis kusta tipe PB.