Hepatitis pada

Anak
Nenny SM
 Hepatitis
(Inflamasi Hati)
Etiologi:

• Virus: hepatotropik dan non- hepatotropik

• Toksin

• Autoimun

• Obat

• Sistemik

• Dll
VIRUS HEPATOTROPIK
Epidemiologi Hepatitis Virus
 Hepatitis Virus

• Akut

• Kronis: terutama B dan C

Hepatitis is an inflammation of the liver.
The condition can be self-limiting or can
progress to fibrosis (scarring), cirrhosis or
liver cancer.
PETANDA SEROLOGI
 Topic

Chronic hepatitis B in children

 Hepatitis B
• Hepatitis: A, B, C, D and E—> B and C: chronic hepatitis

• Despite vaccination, hepatitis B is still out there

• The chronicity of hepatitis B depends on the age of infection

• The majority of children with chronic hepatitis B (CHB) infection are

asymptomatic( immune- tolerant phase) and they may develop
progressive liver disease —> liver cancer before their third decade

• All children with chronic HBV infection should be regularly monitored

for disease progression
 Virus Hepatitis B dalam darah
Discovered in 1963
BLUMBERG,
NOBEL PRIZE IN 1976

Virus DNA

HBsAg positive
dalam darah
TRANSMISSION

Vertical
Horizontal
In infants and children:
80–90% of infants infected during the first year of life develop chronic infections
30–50% of children infected before the age of 6 years develop chronic infections.
 Partikel Dane
Fokus: Antigen c dan e
PHASES
Immune- tolerant Phase

HBA DNA > 20.000 IU/L

ALT normal
No significant inflammation/
fibrosis on liver histology
HBeAg positive
Ringkasan Chronic Hepatitis
Management
(Monitoring)
 Ringkasan
• Hepatitis B masih menjadi masalah meski sudah ada
program vaksin, 2021 SDGs: musnahnya hepatitis

• Penting difahami perjalanan hepatitis B terutama

penularan vertikal

• Hepatitis B kronis, Fase imuntoleran, Asimptomatik,

menjadikan tidak terpantau pada masa anak

• Jangan lupa: SDGs capaian hepatitis virus tahun

2021
 Bahan Bacaan
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Years After the Primary Vaccination in Early Infancy. Journal of Pediatric Gastroenterology and Nutrition. Volume 31, Supplement 2, 2000, Abstract #513 from the World Congress
of Pediatric Gastroenterology, Hepatology and Nutrition.
Ando T, Sugiyama K, Goto K, Pediatrics, Nagoya City University Medical School, Nagoya, Aichi, Japan. Emergence of Core Promoter or Precore Gene Mutations is Associated
with Genotype but Rather with Age at Seroconversion from HbeAg to Anti-Hbe in Anti-Hbe-Positive Japanese Children. Journal of Pediatric Gastroenterology and Nutrition.
Volume 31, Supplement 2, 2000, Abstract #197 from the World Congress of Pediatric Gastroenterology, Hepatology and Nutrition.
Ballauf A, Baumann U, Koehler H, Ross S, Wirth S, Pediatric Gastroenterology, University Children's Hospital, Essen; University Children's Hospital, Duesseldorf; Dpt. of
Virology, University Hospital, Essen; Children's Hospital, Wuppertal, Germany. Lamivudine Pretreatment to Standard Interferon in Children with Chronic Hepatitis B-A Pilot
Study. Journal of Pediatric Gastroenterology and Nutrition. Volume 31, Supplement 2, 2000, Abstract #200 from the World
Bortolotti F, et al. Long Term Effect of Alpha Interferon in Children with Chronic Hepatitis B. Gut. 2000; 46:715-718(May).

Brunetto MR, Calvo PL, Pace M, Baldi M, Maina A, Barbera C, Pediatric Gastroenterology, University, Torino; Gastroenterology and Hepatology, S. Chiara Hospital, Cinasello,
Pisa, Italy. Pre-core Heterogeneity: A Favourable Course of Chronic Hepatitis B Despite a Prevalent HBeAg Defective HBV Infection. Journal of Pediatric Gastroenterology and
Nutrition. Volume 31, Supplement 2, 2000, Abstract #202 from the World Congress of Pediatric Gastroenterology, Hepatology and Nutrition.
Chang MH. Towards Control of Hepatitis B in the Asia-Pacific Region: Natural History of Hepatitis B Virus Infection in Children. Journal of Gastroenterology and Hepatology. 15
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Chang MH, Shau WY, Chen CJ, Wu TC, Kong MS, Liang DC, Hsu HM, Hsu HY, Chen HL, Chen DS, Taiwan Childhood Hepatoma Study Group; Pediatrics, National Taiwan
University Hospital, Taipei, Taiwan. The Gender Effect of Universal Hepatitis B Vaccination on Hepatocellular Carcinoma in Children: Gender Difference. Journal of Pediatric
Gastroenterology and Nutrition. Volume 31, Supplement 2, 2000, Abstract #516 from the World Congress of Pediatric Gastroenterology, Hepatology and Nutrition.
Chu CM, Liaw YF. Chronic Hepatitis B Virus Infection Acquired in Childhood: Special Emphasis on Prognositc and Therapeutic Implication of Delayed HBeAg Seroconversion.
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