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Page 1: HEPATITIS D E G

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HEPATITIS D, E & GPUTRI HARDYANTI

1310211142

D.3

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• Agen delta adalah !"#$ RNA %g aat 'td( leng(a),

ant!gen delta & gen*+ RNA $angat (e!l, #nt#(

(eh!d#)an & "e)l!(a$!n%a )e"l# adan%a !"#$ he)at!t!$ -.

• Ant!gen delta +e"#)a(an )a"t!(el RNA (e!l %g d!la)!$!

*leh H-$AG.

• Pende"!ta !ne($! H/D dan H/- )en%a(!tn%a a(an le!h

e"at !(a d!and!ng(an )ende"!ta dgn !ne($! H/- $aa.

• Ine($! ("*n!$ H/D H/- d!da)at(an adan%a HD Ag

!nt"ahe)at!( dan IgG ant! HD +a$!h te"dete($! $a+)a!

e"tah#ntah#n.

• /!"#$ he)at!t!$ D adalah %ang )al!ng a"ang ta)! )al!ng

e"aha%a da"! $e+#a !"#$ he)at!t!$.

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E)!de+!*l*g!

• Dae"ah ende+!$ H/D Ital!a Selatan, dae"ah A+a5*n

 A+e"!(a Selatan, /ene5#ela, $eag!an A"!(a '6en%a,

Senegal, T!+#" Tengah 'T#"(!, 6#7a!t.

• Dae"ah n*n ende+!$ H/D A+e"!(a Uta"a, E"*)a Uta"a,

 A#$t"al!a.

• D!)e"(!"a(an $e(!ta" 18 #ta *"ang d! d#n!a %ang te"(ena

he)at!t!$ - 'H-$Ag #ga te"!ne($! he)at!t!$ D.

• Ine($! he)at!t!$ D da)at te"ad! e"$a+aan '(*!ne($!

ata# $etelah $e$e*"ang te"(ena he)at!t!$ - ("*n!$

'$#)e"!ne($!.

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9a"a Pen#la"an

1. Pa"ente"al t"an$#$!, he+*d!al!$a, *at !nt"aena %g

te"e+a" H/D.

2. N*n )a"ente"al

.6*nta( adan

.:elal#! l#(a te"#(a

.Sea"a e"t!(al da"! !# ha+!l (e)ada a%!n%a

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Ga+a"an 6l!n!$

• -e"da$a"(an $aat e"ang(!tn%a )en%a(!t da)at e"#)a

$alah $at# da"! 3 a"a

1. He)at!t!$ delta a(#t e"$a+aan he)at!t!$ - a(#t

'(*!ne($! H/D dan H/- a(#t

2. He)at!t!$ delta a(#t )ada )ende"!ta !ne($! H/- ("*n!$

ata# )eng!da) H-$Ag '$#)e"!ne($! H/-

3. He)at!t!$ delta ("*n!$ dan he)at!t!$ - ("*n!$.

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1. He)at!t!$ delta a(#t e"$a+aan he)at!t!$ -

a(#t '(*!ne($! H/D dan H/- a(#t

• Geala t!da( an%a( e"eda dengan ga+a"an (l!n!$

H/- a(#t.

• Ga+a"an )en%a(!t %g !a$!( '28; 2 )#na( geala

(l!n!$ '%g )e"ta+a d!d#ga (a"ena !ne($! H/D, & %g (ed#a

(a"ena !ne($! H/-.

1. +#la+#la t!+#l geala (l!n!$ he)at!t!$, te"ad!

)e"a!(an.

2. Setelah < 1= ha"!, t!+#l lag! geala (l!n!$ %g (ed#a

d!!(#t! dgn )e"a!(an.

•. Adan%a )"ealen$! he)at!t!$ #l+!nan %g t!ngg! '2880;,

a(!at da"! (#+#la$! (e"#$a(an *leh (ed#a !"#$ t$.

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2. He)at!t!$ delta a(#t )ada )ende"!ta !ne($! H/-

("*n!$ ata# )eng!da) H-$Ag '$#)e"!ne($! H/D

• Ga+a"an (l!n!$ $a+a dengan H/- a(#t %g (la$!(.

• E($a$e"a$! a(#t, da)at e"a(!at atal

• Da)at "(e+ang +enad! )en%a(!t hat! ("*n!$, (a"ena

adan%a H-$Ag dala+ da"ah ')en#nang #nt#(h!d#)>"e)l!(a$! da"! H/D.

• ?a(t*" %g +e+)enga"#h! te"ad!n%a he)at!t!$ #l+!nan

ata# ("*n!$ )ada $#)e"!ne($! H/D adalah a(t!!ta$ !ne($!

H/- $eel#+n%a.

• Ine($! H/- a(t! d!tanda! dgn H-eAg )*$!t!.

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• T!da( ada a($!n he)at!t!$ D, na+#n dengan

+enda)at(an a($!na$! he)at!t!$ - +a(a )ende"!ta a(an

te"l!nd#ng! da"! !"#$ !n! (a"ena H/D t!da( +#ng(!n h!d#)

tan)a H/-.

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HEPATITIS E

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• He)at!t!$ !"#$ E adalah he)at!t!$ !"#$ N*nA N*n- %g

t"an$+!$!n%a )e"*"al.

• T"an$+!$! )e"*"al an%a( d!te+#(an d! nega"a

e"(e+ang %ang $an!ta$!n%a (#"ang ata# t!da( a!(,

%a!t# e"h##ngan e"at dengan a!" %g t!da( e"$!h.

• /!"#$ he)at!t!$ E +#dah d!+at!(an )ada )e+ana$an 40

80 9.ᵒ

• :a$a !n(#a$! le!h )anang da"!)ada H/A '2= +!ngg#,

%a!t# e"(!$a" 4@ +!ngg# '"ata"ata = +!ngg#.

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9a"a Pen#la"an

• /!"#$ he)at!t!$ E +a$#( dala+ t##h +elal#! $al#"an

+a(an d!$e"a) #$#$ +a$#( (e hat! & e+)ed#

t!+#l "ea($! )e"adangan !"#$ e"e)l!(a$! dl+ $el$el

hat! d!$e("e$! e"$a+a e+)ed# (e dala+ #$#$

d!(el#a"(an e"$a+a t!na $e(!ta" 2 +!ngg# $eel#+ &$#$#dah a$e !(te"!(.

• R!$!(* t!ngg! #nt#( te"t#la" )ada *"ang %g (*nta( lang$#ng

1@B da"!)ada *"ang %g t!da( (*nta( lang$#ng.

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E)!de+!*l*g!

• Ce!h an%a( d!te+#(an )ada #$!a de7a$a +#da '1840

tah#n, a"ang )ada ana(ana(.

• P"!a 7an!ta 1,8 1

6e+at!an H/E )ada 7an!ta ha+!l #(#) t!ngg! '0,=;,te"#ta+a )ada t"!+e$te" (et!ga.

• H/E a(an le!h ende"#ng $e"!ng +enad! he)at!t!$

#l+!nan $e(!ta" 0,1; dan an%a( d!te+#(an )ada )"!a.

• Da"! ha$!l )enel!t!an, H/E a(#t a(an $e+#h $e+)#"na,

t!da( )e"nah d!te+#(an e"(e+ang +enad! ("*n!$ ata#

+en!nggal(an $!$a geala.

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Geala 6l!n!$

• Fase pra-ikterus : 1-10 hari (rata-rata 3,5 hari).

De+a+

6el#han ga$t"*!nte$t!nal 'n%e"! d! e)!ga$t"!#+, na#$ea,

*+!t#$, an*"e($!a

• Fase ikterus : 12-15 hari

U"!ne $e)e"t! teh )e(at

I(te"#$ Ce+a$

:#dah lelah

-ee"a)a (el#han ga$t"*!nte$t!nal

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• Setelah $e+!ngg# t!+#ln%a !(te"#$, $eag!an e$a"

(el#han t$ +#la! e"(#"ang.

6el#han (*le$tat!( gatalgatal, t!na al(*h*l!$ '20;

)ende"!ta.

He)at*+egal! '@8,2;

S)len*+egal! '11,8;

• ?a$e "e(*nale$en$! 'a$e )en%e+#han 1 #lan

U+#+n%a )ende"!ta H/E a(an +engala+! )en%e+#han$e+)#"na.

• T!da( $e+#a )ende"!ta H/E +e+)e"l!hat(an tandatanda

!(te"#$ %g ela$, le!h an%a( an!(te"!(.

• I(te"#$ an!(te"!( 1 13.

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D!agn*$!$

• Unt#( +endete($! $e$e*"ang te"$e"ang H/E, )e"l# d!)e"!($a

t!na )ende"!ta )ada $aat a$e a(#t dengan +engg#na(an

+!("*$(*) !+#n*"l"(t"*n #nt#( +ena"! )a"t!(el $e+aa+ !"#$

'/PC 2F34 n+.

• :engg#na(an +et*de ECISA d!)e"!($a t!na )ende"!ta )adaa$e a(#t & *"ang $e(!ta"n%a %g $elal# (*nta( d!te+#(an

HE/ ant!gen ' )ada )ende"!ta $ean%a( 42,3;, dan )ada

(*nta( 33,3;.

• Pada a$e a(#t a(an te"da)at "e$)*n te"hada) ant! HE/ Ig:,

%g (e+#d!an a(an d!$#$#l dengan (ena!(an ant!*d! HE/ IgG.

• Setelah = #lan )a$a!ne($! "ea($! !n! a(an +#la! +engh!lang

ata# e"(#"ang, dan $etelah 12 #lan )a$a!ne($! IgG t!da(

te"dete($! lag!.

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• Saat !n! el#+ ada a($!n he)at!t!$ E %ang te"$ed!a

$ea"a (*+e"$!al. 6!ta han%a da)at +enegahn%a +elal#!

)ene"a)an $tanda" (ee"$!han %ang a!(.

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HEPATITIS G

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• Gen*+ H/G +e+)#n%a! 200 a$a+ a+!n*, dan

$t"#(t#"n%a +!"!) denga !"#$ da"! a+!l! la!!"!dae.

• T"an$+!$! !"#$ H/G +elal#! t"an$#$! da"ah, ata# )"*d#(

da"ah, dan $ea"a )a"ente"al la!nn%a '*at I/.

• H/G da)at d!te+#(an $end!"! ata# $eaga! !ne($!

"ang(a) dengan he)at!t!$ 9 ata# -.

• 6a$#$ te"$e"!ng H/G e"$a+a dengan H/9.

• Se(!ta" 80; )ende"!ta H/9 #ga +engand#ng H/G.

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In$!den

• U+#+n%a e"#$!a +#da

• Ine($! H/G dengan N*n - N*n 9 he)at!t!$ a"ang

d!te+#(an.

• Ine($! H/G $e"!ng d!te+#(an )ada ana( dengan Ant!

H/9 )*$!t!.

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9a"a )en#la"an

1. Pa$at"an$#$! '23;

2. Int"aena '24;

3. T!nda(an )e+edahan ata# a#)#nt#"e '2,=;

4. He+*d!al!$a '10,1;8. T"an$+!$! e"t!(al '33,3;

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Geala (l!n!$

• Gealan%a le!h "!ngan d!and!ng he)at!t!$ - dan 9

• Se"!ng tan)a !(te"#$

• 6ena!(an $e"#+ t"an$a+!na$en%a "endah

•Pende"!ta dengan !ne($! "ang(a) 'dgn H/9 te"da)at(ena!(an $e"#+ t"an$a+!na$e.

• He)at!t!$ #l+!nan #ga da)at d!te+#(an )ada H/G

P"*g"e$!n%a la+at

Se"#+ t"an$a+!na$e e"l#(t#a$! %g te"#$ +eneta) Ang(a (e+at!an %g t!ngg!.

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D!agn*$a

• 6ean%a(an *"ang t!da( +e+!l!(! geala a(#t. Sean%a(

20 ; da"! )ende"!ta he)at!t!$ 9 #ga +ende"!ta he)at!t!$

!n!.

• :et*de %ang d!g#na(an #nt#( +endete($! HG/ $angat

(*+)le( #nt#( +engetah#! adan%a ant!*d! HG/. Na+#n

(et!(a ant!*d! telah d!te+#(an, !"#$ !t# $end!"! telah

+engh!lang.

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Peng*atan

• T!da( ada )e"a7atan $)e$!!( #nt#( )en%a(!t he)at!t!$

a(#t !n!. Pende"!ta ha"#$ an%a( !$t!"ahat, +engh!nda"!

al(*h*l dan +a(an +a(anan e"g!5!.

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Penegahan

• He)at!t!$ G d!t#la"(an +elal#! !ne($! +elal#! da"ah.

Penegahann%a dengan +engh!nda"! (*nta( dengan

da"ah %ang te"(*nta+!na$!. Jangan g#na(an a"#+ $#nt!(

ata# )e"alatan la!n $ea"a e"$a+aan.