Upload
rezka-octaviano
View
233
Download
0
Embed Size (px)
Citation preview
7/26/2019 Presentasi Hepatitis 230213 [Repaired]
http://slidepdf.com/reader/full/presentasi-hepatitis-230213-repaired 1/38
OLEH : DR. DWI BUDI DARMAWATI,SpPD
Apakah itu ...???Bagaimana mencegahnya .
HEPATITIS B
7/26/2019 Presentasi Hepatitis 230213 [Repaired]
http://slidepdf.com/reader/full/presentasi-hepatitis-230213-repaired 2/38
pa topik ini penting dibicarakan?
7/26/2019 Presentasi Hepatitis 230213 [Repaired]
http://slidepdf.com/reader/full/presentasi-hepatitis-230213-repaired 3/38
Peta Global Hepatitis B Kroi! Di"#ia
– Sete$a% pop#lasi "#ia ti$$al "i "aera% "$ti$!at pre&alesi %epatitis B '$ ti$$i
– ( )il'ar "ari * )il'ar +-/ pop#lasi "#ia tela%
"ii0e!si HB1
– 223422 5#ta pe"erita %epatitis B !roi!
– 3( 5#ta pe"erita %epatitis B )ei$$al setiap
ta%#
–
67 8 %i"#p "i Asia Te$$araDi I"oesia + 9(42 5#ta 5ia/
28 +,43(2,8/ pop#lasi a"ala% pe)baa-
;arrier
7/26/2019 Presentasi Hepatitis 230213 [Repaired]
http://slidepdf.com/reader/full/presentasi-hepatitis-230213-repaired 4/38
Dampak Penyakit
Hepatitis B
2 milyar dengan
Hepatitis B1,2
350 juta
HBK 1,2,3
• 620.000 meninggal tiap tahunnya a penyakit hati yang erhuungan de
Hepatitis B3
1. WHO. Hepatitis B 2002; 2. Wright TL. Am J Gastroenterol 2006;101:S1S6; !. "#". $$W% %e&ommen'ations an'%eports 200(;)*:120
• 1) + ,0- mena'isirosis/ gagal hati/'anata aner
hati2
• merpaan
pen3e
4a4
ematian no.101
7/26/2019 Presentasi Hepatitis 230213 [Repaired]
http://slidepdf.com/reader/full/presentasi-hepatitis-230213-repaired 5/38
Alasa lai :
- M#"a% pe#lara'a
-Seri$ ti"a! ber$e5ala 'ata se%i$$a ti"a!
ter"ete!si
-Mei)b#l!a !e"ala sosial s#lit )e;ari
!er5a
- IRO<IS<=A ....>>>>
PE<=AKIT I<I MUDAH DI?EGAH...>>>
7/26/2019 Presentasi Hepatitis 230213 [Repaired]
http://slidepdf.com/reader/full/presentasi-hepatitis-230213-repaired 6/38
Pe)a%a)a Aal :
Istila%: Hati @ Li&er @ Hepar
Berat : (22 *22 $ra)
7/26/2019 Presentasi Hepatitis 230213 [Repaired]
http://slidepdf.com/reader/full/presentasi-hepatitis-230213-repaired 7/38
Sir!#lasi Hepar :
7/26/2019 Presentasi Hepatitis 230213 [Repaired]
http://slidepdf.com/reader/full/presentasi-hepatitis-230213-repaired 8/38
isiolo$i Hepar :
Mer#pa!a )etaboli! terbesar "a terpeti$ t#b#%
Pe)bet#!a"a e!sresi
e)pe"#
"eto!si!asi
0a$ositosis"a i)#itas
se%#b#$a "e$ape)be!#a "ara%
)etabolis)eprotei
metabolismelemak
)etabolis)e
!arbo%i"rat
7/26/2019 Presentasi Hepatitis 230213 [Repaired]
http://slidepdf.com/reader/full/presentasi-hepatitis-230213-repaired 9/38
Spe!tr#) pe'a!it pa"a %epar :
. Hepatitis +@Ra"a$ %ati/
A"a ( sebab : a. 1ir#s "a b. b#!a 1ir#s
A"a ( tipe : a. A!#t "a b. Krois
(. Sirosis %ati
. Ka!er %ati
4. Abses %ati
7. ?o$esti&e %epatopat%'
7/26/2019 Presentasi Hepatitis 230213 [Repaired]
http://slidepdf.com/reader/full/presentasi-hepatitis-230213-repaired 10/38
Pe"ala)a :
Pe'ebab :
- 1ir#s Hepatitis
Hepatitis A,E, pe#lara 0e;al3 oral
Hepatitis B,?,D,G
pe#lara )ell "ara%ata# ;aira t#b#%
7/26/2019 Presentasi Hepatitis 230213 [Repaired]
http://slidepdf.com/reader/full/presentasi-hepatitis-230213-repaired 11/38
Pe"ala)a :
Pe'ebab :
- B#!a 1ir#s
3 Perle)a!a %ati
3 A#toi)#
3 Rea!ti0 seri$ )e'ertai proses
i0e!si "i te)pat lai
+ ;oto% : DH, t%'poi" /
7/26/2019 Presentasi Hepatitis 230213 [Repaired]
http://slidepdf.com/reader/full/presentasi-hepatitis-230213-repaired 12/38
7/26/2019 Presentasi Hepatitis 230213 [Repaired]
http://slidepdf.com/reader/full/presentasi-hepatitis-230213-repaired 13/38
Str#!t#r 1ir#s HB)e$a"#$ D<A, DNA polymerase, "aprotei 'a$ ber!aps#l.
Ha)pir se)#a protei&ir#s HB "apat )e)i;#respo i)#, ole%!area it# "ia$$apseba$ai ati$e: Protei iti: HB;A$ Protei per)#!aa:
HBsA$ Protei lai "ari iti:
HBeA$
Struktur Virus Hepatitis B
7/26/2019 Presentasi Hepatitis 230213 [Repaired]
http://slidepdf.com/reader/full/presentasi-hepatitis-230213-repaired 14/38
Sumber Infeksi virus :
• Dara%
• Sali&a, air )ata, ASI, se)e
• Kota! "e$a )#!osa pe"erita &ir#s
%epatitis B +Se!s#al/• e;es "a #rie
• Lai3lai: Sisir, pisa# ;#!#r,
alat )a!a, alat !e"o!tera 'a$ ter!ota)iasi&ir#s %epatitis B.
7/26/2019 Presentasi Hepatitis 230213 [Repaired]
http://slidepdf.com/reader/full/presentasi-hepatitis-230213-repaired 15/38
?ARA PE<ULARA<
• PARE<TERAL-<O< PARE<TERAL
• 1ERTIKAL-HORICO<TAL
7/26/2019 Presentasi Hepatitis 230213 [Repaired]
http://slidepdf.com/reader/full/presentasi-hepatitis-230213-repaired 16/38
Tras)isi 1ir#s Hepatitis B
Pe5a)# Peeri)a
Tras)isi %oriotal Tras)isi &erti!al
Ib#
I0at
• ar#) ter!ota)iasi
• Se!s#al
• Pe!er5a pela'a !ese%ata
• Tras0#si
*8 'a$ teri0e!si setela% #sia
7 ta%# )e5a"i i0e!si !rois
F28 i0at 'a$ teri0e!si
)e5a"i i0e!si !rois
Periatal
CDC Fact Sheet. 2!" #ee. N Engl J Med. $%%&" #avanch'. J Viral Hepat. 2!.
7/26/2019 Presentasi Hepatitis 230213 [Repaired]
http://slidepdf.com/reader/full/presentasi-hepatitis-230213-repaired 17/38
Ge5ala !liis Hepatitis B A!#t
– Demam ( )aran* ter)a+i, – -elelahan
– afsu makan menurun
– /ual0 muntah – Flu like1s'n+rome (batuk0 pusin*0mial*ia,
– Ikterik
–rine ber3arna *elap
– #iver membesar +an n'eri tekan
– #impa membesar rin*an0 pembesaran kel)
limfono+i +i leher
"#". $$W% %e&ommen'ations an' %eports 200(;)*:120
7/26/2019 Presentasi Hepatitis 230213 [Repaired]
http://slidepdf.com/reader/full/presentasi-hepatitis-230213-repaired 18/38
4e)ala klinis hepatitis B kronis
Asi)pto)ati!
Ko"isi aal: ti"a! spesi0i! + les#, 'eri
se"i, 'eri per#t !aa atas /Ko"isi la5#t: )#ta% "ara%, per#t
)e)besar, !a!i be$!a!
7/26/2019 Presentasi Hepatitis 230213 [Repaired]
http://slidepdf.com/reader/full/presentasi-hepatitis-230213-repaired 19/38
?ara )e$eta%#i'a :
"#". $$W% %e&ommen'ations an' %eports 200(;)*:120
S!rii$ Tes
- ?e! HBsA$ + )eli%at &ir#s'a/
- ?e! I$MHB; + respo atibo"i /3 ?e! GOT-GPT + ta"a a"a'a proses
ra"a$ "i %ati /
7/26/2019 Presentasi Hepatitis 230213 [Repaired]
http://slidepdf.com/reader/full/presentasi-hepatitis-230213-repaired 20/38
I0e!si Hepatitis B A!#t
7/26/2019 Presentasi Hepatitis 230213 [Repaired]
http://slidepdf.com/reader/full/presentasi-hepatitis-230213-repaired 21/38
I0e!si Hepatitis B Krois
7/26/2019 Presentasi Hepatitis 230213 [Repaired]
http://slidepdf.com/reader/full/presentasi-hepatitis-230213-repaired 22/38
Risi!o ber!e)ba$'a %epatitis B !rois
+ber"asar #sia teri0e!si/
• #e5asa imnoompeten )-
•
#e5asa imnoompromise
7 )0-
• $asa ana ana )0-
• Ba3i 4ar lahir 80-
7/26/2019 Presentasi Hepatitis 230213 [Repaired]
http://slidepdf.com/reader/full/presentasi-hepatitis-230213-repaired 23/38
5er)alanan klinis Hepatitis B
• F2 8 Pop#lasi aa!
78 Pop#lasi DeasaI0e!si Hepatitis B A!#t
Se)b#%
I)#itas Prote!ti0
Trasplatasi ata#
Mei$$al
I0e!si Hepatitis B Krois
Karsio)a Hati Sirosis
6isiko 71!8
7/26/2019 Presentasi Hepatitis 230213 [Repaired]
http://slidepdf.com/reader/full/presentasi-hepatitis-230213-repaired 24/38
Kala# s#"a% teri0e!si...
Diberi!a terapi
Terapi B#t#% a!t# ;#!#p la)a
Keber%asila ti"a! 228
B#t#% bia'a ;#!#p )a%al
"#". $$W% %e&ommen'ations an' %eports 200(;)*:120
Oleh karena itu ....
7/26/2019 Presentasi Hepatitis 230213 [Repaired]
http://slidepdf.com/reader/full/presentasi-hepatitis-230213-repaired 25/38
LEBIH BAIK ME<?EGAH...>>>
7/26/2019 Presentasi Hepatitis 230213 [Repaired]
http://slidepdf.com/reader/full/presentasi-hepatitis-230213-repaired 26/38
?ara pe;e$a%a :
• Me5a$a perila!# %i"#p se%at "a Jse%at
Me$!os#)si )a!aa '$ se%at "a
%i$ieis
Me;#;i ta$a ter#ta)a setela% "ari toilet Ti"a! ber$ati $ati pasa$a Ber%ati %ati pa"a saat bera!ti0itas '$
)e)#$!i!a )#;#l'a l#!a + pe)a!aia
pisa# ;#!#r, a!#p#!t#r, tatto, 0a;ial a5a%/
7/26/2019 Presentasi Hepatitis 230213 [Repaired]
http://slidepdf.com/reader/full/presentasi-hepatitis-230213-repaired 27/38
/en)a*a baran* baran* priba+i t+k
terkontaminasi
• Bagi tenaga me'is selal 4eera sesai
!"P 9!tandard #perasi#nal pr#sedur,
• Selal 4ersaha hi'p seim4ang/ sehat asmani ro&hani/ mengelola stress 'g
4iasana 'an 4er'amai 'g 'iri sen'iri/peeraan 'an orang orang 'iseitar ita
7/26/2019 Presentasi Hepatitis 230213 [Repaired]
http://slidepdf.com/reader/full/presentasi-hepatitis-230213-repaired 28/38
?ara pe;e$a%a :
1a!siasi I)#isasi
I)#isasi :
I"#!si a$ar terbet#! s#at# i)#itas "e$a
berba$ai ;ara bai! pasi0 )a#p# a!ti0
1a!siasi :
Ti"a!a )e)beri!a s#at# &a!si-
i)#isasi +a!ti0/
7/26/2019 Presentasi Hepatitis 230213 [Repaired]
http://slidepdf.com/reader/full/presentasi-hepatitis-230213-repaired 29/38
I)#isasi Pasi0 :
Me)beri!a atibo"i "ala) bet#!i)#o$lob#li "ala) 5#)la% besar 'a$
bert#5#a #t#! )e;e$a% ata#
)e$%ila$!a e0e! "ari i0e!si ata# to!si
pe'ebab
I)#isasi A!ti0 :
Me)beri!a papara ati$e "ari !#)a !e
siste) i)#itas t#b#% se%i$$a terbet#!
atibo"i +!e!ebala t#b#%/
7/26/2019 Presentasi Hepatitis 230213 [Repaired]
http://slidepdf.com/reader/full/presentasi-hepatitis-230213-repaired 30/38
I)#isasi Hepatitis B
I)#isasi Pasi0 Diberi!a I)#o$lob#li Hepatitis B
+HBI$/
I"i!asi :
- Ba'i 'a$ "ila%ir!a "ari ib# 'a$)e"erita %epatitis B
- Kota! "e$a "ara% 'a$ teri0e!si &ir#s
%epatitis B-
Pro0ila!si pas;a papara 5ar#) s#ti!'a$ terpapar ;aira t#b#% pasie 'a$
teri0e!si &ir#s %epatitis B- Kota! se!s#al "e$a ora$ "e$a
HBSA$
7/26/2019 Presentasi Hepatitis 230213 [Repaired]
http://slidepdf.com/reader/full/presentasi-hepatitis-230213-repaired 31/38
I)#isasi Hepatitis B
I)#isasi Pasi0 (lanjutan)
E0e!ti0itas'a 678
Prote!si 'a$ "i%asil!a %a'a
berta%a sela)a beberapa b#la
7/26/2019 Presentasi Hepatitis 230213 [Repaired]
http://slidepdf.com/reader/full/presentasi-hepatitis-230213-repaired 32/38
I)#isasi Hepatitis B
I)#isasi A!ti0 I"i!asi :- Pe!er5a "i bi"a$ !ese%ata- Pet#$as !ea)aa 'a$ reta ter%a"ap
papara "ara%- Pasie %e)o"ialisa- Pasie 'a$ )e)b#t#%!a tra0#si "ara%- Kota!-%#b#$a se!s#al "e$a !arier
%epatitis B- Pe$$#a obat3obata s#ti!- Pria %o)ose!s#al-bise!s#al- Ora$ 'a$ )ela!#!a %#b#$a se!s#al
lebi% "ari sat# pasa$a
- Pasie 'a$ bere;aa trasplatasi or$a
7/26/2019 Presentasi Hepatitis 230213 [Repaired]
http://slidepdf.com/reader/full/presentasi-hepatitis-230213-repaired 33/38
I)#isasi Hepatitis B
I)#isasi A!ti0
S'arat sebel#) &a!si :- HBsA$
- I$M ati HB;- Ati HBs
1 11
7/26/2019 Presentasi Hepatitis 230213 [Repaired]
http://slidepdf.com/reader/full/presentasi-hepatitis-230213-repaired 34/38
Te!i! pe)beria
1a!si "iberi!a itra)#s!#ler "i )."eltoi" -
le$a
Pa5a$ 5ar#) 'a$ "i$#a!a ,7 i;%i#t#! )e)asti!a &a!si )as#! !e otot
1a!si %epatitis B "iberi!a "osis pa"a
b#la 2, "a *
7/26/2019 Presentasi Hepatitis 230213 [Repaired]
http://slidepdf.com/reader/full/presentasi-hepatitis-230213-repaired 35/38
E0e!ti0itas &a!si
Deasa se%at #)#r 42 t% F28
Deasa se%at #)#r 42 t% F28
Lasia *2 t% *7 6*8
7/26/2019 Presentasi Hepatitis 230213 [Repaired]
http://slidepdf.com/reader/full/presentasi-hepatitis-230213-repaired 36/38
- Di;e! : Ati3HBs
- I"i!asi :
. I"i&i"# 'a$ resi!o ti$$i
(. I"i&i"# 'a$ )e)b#t#%!a pro0ila!sis pas;apapara &ir#s
-.Dila!#!a ( b#la setela% i)#isasi %epatitis B
"osis !e
-. Titer 2 )l#-)l s#"a% e0e!ti0
Respo atibo"i
7/26/2019 Presentasi Hepatitis 230213 [Repaired]
http://slidepdf.com/reader/full/presentasi-hepatitis-230213-repaired 37/38
E0e!ti0itas respo
T#r# sa)pai 2)l#-)l pa"a :
6 728 i"i&i"# setela% 7 ta%#
2 *28 i"i&i"# F ta%#
Seba$ia !e;il pasie ti"a! )e#5#!!a
respo pe)bet#!a atibo"i setela%i)#isasi s#ti!a ....
IMU<ISASI DIULA<G LAGI ...
7/26/2019 Presentasi Hepatitis 230213 [Repaired]
http://slidepdf.com/reader/full/presentasi-hepatitis-230213-repaired 38/38
$%&'()K)!'H