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HEPATITIS VIRUS Cdr. AM. Luthf Parewangi, SpPD

Pro. dr. H. Riai Amiruddin, SpPD-KGEH

Sudi!i"i Ga"troentero-Hepato#ogi$agian %#mu Pen&a'it Da#am, (a'u#ta"

Kedo'teran

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)ama #ain*

Hepatiti" non A non $ +H)A-)$

Pa"a tran"u"i H)A)$ +P-H)A)$

Penemu pertama * Marthin Goldfeld,/012

Suatu agen hepatotropi', !iru" 'ei#,diung'u" #ema', "en"iti terhadap'#oroorm.

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Epidemio#ogi

• Pendudu' dunia 100 – 170 juta pendudu' – 34 5 04 6  Kroni' 'arier

 – /7 5 84 6  Siro"i" hati

 –   9 :4 6  Kar"inoma hepato"e#u#are

• Men&ea'an 1 juta pendudu'meningga# ; tahun

 – Eropa ;AS * / 5 8 6 pendudu' – %ndone"ia * 8,7 5 :,2 6 + 7 5 1,7

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• Donor darah *

 – Su'are#a 7 5 /4 6

 – Komer"ia# /1 5 72 6

• Hepatiti" a'ut     //,76 +Ma'a""ar

• Siro"i" hati    2:,/6 +Ma'a""ar

• Kar"inoma hati     :7,76 +Ma'a""ar

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Penularan

• Parenteral * tran"u"i darah +darah,'omponen darah, hemodia#i"a, oat-oat i.! , pe'er=a medi".

•Konta' per"ona# +e#um =e#a" * "i'atgigi, a#at u'ur

• Se'"ua#• )eonata#

•  atto• Sumpit untu' ma'an• Sa#i!a

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eluhan dan Ge=a#a

Ma"a in'ua"i * 8-8> minggu +rata-rata 1minggu

Ge=a#an&a ringan;"amar "amar  

a"imptomati'Prodroma# mirip dengan !iru" &ang #ain

I!teru"  876 penderita, erarti pen&a'itn&a"udah #an=ut.

#0$ er'emang men=adi 'roni'

?a#aupun ge=a#an&a ringan  pada iop"i hati

%0$ he&atiti" !roni" a!ti' 

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(a)oratoriu*

• SGP er"iat po#ia"i' ; er@u'tua"iuntu' eerapa u#an ; eerapatahun. Ka#au "angat tinggi 9 /444

%;L, ha# ini han&a er"iat"ementara.

• SGP menetap ;norma# dan anti HBC+   > u#an  ARIER SEHAT

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PERJALANAN HVC,PERJALANAN HVC,aa ANTI HCV (+), SGPT 2xNANTI HCV (+), SGPT 2xN

HCV AKUT

KARIERSEMBUH KHRONIK

-HCV –R+A ,-.HCV –R+A ,-.

-I/MaHCV ,-.I/MaHCV ,-.

-SGPTSGPT

+RMA(+RMA(

-HCV –R+AHCV –R+A

,2.,2.

-I/MaHCV ,-.I/MaHCV ,-.

-SGPTSGPT

+RMA(+RMA(

-HCV –R+AHCV –R+A

,2.,2.

-I/MaHCV ,2.I/MaHCV ,2.

-SGPT TI+GGISGPT TI+GGI

20-30 % 20-30 %40-60 %

SIROSIS

HEPATOMA

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Outco!" o# acut! HCV $%#!ct$o%

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• A"imptomati"

• Ma&orita" a'an er'emang men=adi'roni'

• Seara a!ti' )ere&li!a"i pada 046penderita

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PER3A(A+A+ PE+4AIT

HVC

HEP B

AK

KA)KER

HA%

S%RS%S

HA%

HEP B

KR)%K 

80% 4%20%

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K)AK 

%)(EKS%HCB

AS%MPMA%K S%MPMA%K 

C%RS ME)GH%LA)G

VIRUSPERSISTE+

16 % 84 %

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P!&'aa%a% Aa$a H!*at$t$" C

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P!&'aa%a% Aa$a H!*at$t$" C

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PE+ATA(ASA+AA+ HEP C

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Prin"ip terapi Hep B

•  erapi anti !iru" * dieri'an i#a SGP9 8 F )

•  erapi Komina"i Inter'eron ,I5+. dan Ri)afrin * "e#ama /8 u#an

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RI6AVIRI+

Ria!irin dieri'an tiap hari, tergantung eratadan 77 'g   344 mg;hr

7> 5 17 'g  /444 mg;hr9 17 'g  /844 mg;h

I+TER5ER+

%() a#a * : 5 2,7 5 7

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Kontra indi'a"i %)ER(ER)

A"o#ut *P"i'o"i" ; depre"i erat, 'ehami#an,

'e=ang-'e=ang

Re#ati *DM tida' ter'enda#i

Hiperten"i tida' ter'enda#i

RetinopatiP"oria"i"

Pen&a'it =antung "imtomati'

 iroiditi" ; Pen&a'it autoimun #ain &ang a'ti.

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Perhatian Khu"u"%)ER(ER)

• )eutropenia +neutrof# /744;darah

•  romo"itopenia + 3744;

• Penerima tran"p#anta"i organ

• Riwa&at pen&a'it autoimun

• Auto antiodi antitiroid• "ia #an=ut

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Kontra indi'a"i R%$AC%R%)

A$SL *

• Gaga# gin=a#

• Kehami#an

• Pen&a'it

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