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    The document discusses hepatitis, its causes, types, diagnosis, and treatment. It focuses on hepatitis A and B viruses. Key points include: - Hepatitis is inflammation and necrosis of the liver that is usually caused by viral infections. - Hepatitis A virus causes an acute form of hepatitis and is transmitted through contaminated food or water. Diagnosis involves liver function tests and immunoglobulin M antibody testing. - Hepatitis B virus can cause both acute and chronic hepatitis. It is transmitted through blood, semen, vaginal fluids. Diagnosis involves hepatitis B surface antigen and antibody testing to determine infection stage and risk of chronic infection. - Treatment for both hepatitis A and B focuses on supportive care like rest

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    HEPATITIS PADA ANAK

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    The document discusses hepatitis, its causes, types, diagnosis, and treatment. It focuses on hepatitis A and B viruses. Key points include: - Hepatitis is inflammation and necrosis of the liver that is usually caused by viral infections. - Hepatitis A virus causes an acute form of hepatitis and is transmitted through contaminated food or water. Diagnosis involves liver function tests and immunoglobulin M antibody testing. - Hepatitis B virus can cause both acute and chronic hepatitis. It is transmitted through blood, semen, vaginal fluids. Diagnosis involves hepatitis B surface antigen and antibody testing to determine infection stage and risk of chronic infection. - Treatment for both hepatitis A and B focuses on supportive care like rest

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    6 views21 pages

    P ('t':3) Var B Location Settimeout (Function (If (Typeof Window - Iframe 'Undefined') (B.href B.href ) ), 15000)

    Uploaded by

    Erka Wahyu Kinanda
    The document discusses hepatitis, its causes, types, diagnosis, and treatment. It focuses on hepatitis A and B viruses. Key points include: - Hepatitis is inflammation and necrosis of the liver that is usually caused by viral infections. - Hepatitis A virus causes an acute form of hepatitis and is transmitted through contaminated food or water. Diagnosis involves liver function tests and immunoglobulin M antibody testing. - Hepatitis B virus can cause both acute and chronic hepatitis. It is transmitted through blood, semen, vaginal fluids. Diagnosis involves hepatitis B surface antigen and antibody testing to determine infection stage and risk of chronic infection. - Treatment for both hepatitis A and B focuses on supportive care like rest

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    of 21

    dr.

    Taufiqur Rahman, SpA RS Muhammadiyah Lamongan


    1

    Pendahuluan
    Hepatitis inflamasi dan atau nekrosis hati

    Penyebab:
    Infeksi paling sering Obat Toxin Autoimun Gangguan metabolik

    Hepatitis Infeksi:
    Virus paling sering Bakteri Parasit
    2

    Virus Hepatitis A

    DIAGNOSIS
    Anamnesis:
    Gx prodromal: anoreksia, mual, muntah & demam
    Ikterus, tinja pucat, urine berwarna gelap Riwayat kontak dengan penderita hepatitis Riwayat minum obat2an

    Pemeriksaan Fisik:
    KU: sebagian besar sakit ringan Kulit, sklera ikterik

    Nyeri tekan di daerah hati, hepatomegali

    Pemeriksaan penunjang
    DL Bisa ditemukan pansitopenia atau

    leukositosis UL Bilirubin urin LFT Serologi


    Ig M anti HAV HBs Ag, IgM anti HBc, Anti HDV, Anti HCV

    USG Abdomen

    TERAPI
    Terapi SUPPORTIF:
    bed rest, diet tinggi kalori, hindari obat2 hepatotoksik

    Medikamentosa
    Ursodeoxycholic acid Obat anti virus: interveron, lamivudine, ribavirine Prednisone jika perlu

    HEPATITIS B
    Modes Of Transmission Perinatal infection Blood Transfusion Horizontal transmission Sexual transmission Intravenous drug use / percutaneous inoculation. Nosocomial Organ transplantation-Anti-HBc screening

    10

    Hepatitis B - Clinical Features


    Incubation period: Clinical illness (jaundice): Average 60-90 days

    Range 45-180 days


    <5 yrs: 5 yrs: <10% 30%-50% 30%-90% 2%-10%

    Acute case-fatality rate:


    Chronic infection:

    0.5%-1%
    <5 yrs: 5 yrs: 15%-25%

    Premature mortality from


    chronic liver disease:
    11

    Serology test
    Lab. Test
    HBsAg HBeAg Anti HBs Anti HBc IgM anti HBc

    Interpretation
    Current infection Active replication highly infectious Resolution Current or previous infection Acute or reactivation of chronic Resolution of active replication

    Clinical syndrome
    Acute, CAH, Carrier Acute, CAH Immunity Acute, Chronic, Carrier, Immunity Acute, CAH

    Anti HBe
    12

    Carrier, Immunity

    Immunological events of acute HBV infection


    A) Acute

    B) Chronic

    Engleberg, et. al., Schaechters Mechanisms of Microbial Disease, Fourth Edition, Chapter 43, published by Lippincott Williams & Wilkins, Philadelphia.

    13

    Clinical outcomes of Hepatitis B infections

    14

    Clinical outcomes of acute hepatitis B infection. (Redrawn from White DO, Fenner F: Medical virology, ed 3, New York, 1986, Academic Press
    From Murray et. al., Medical Microbiology 5th edition, 2005, Chapter 62, published by Mosby Philadelphia,,

    Risk of chronic HBV by age of acquisition and immune status

    Seorang bayi dilahirkan oleh ibu yang pada pemeriksaan kehamilan trimester ketiga diketahui

    dengan HBsAg yang positif

    16

    Tindakan apa yang kita lakukan pada bayi

    tersebut:

    Imunisasi pasif? Imunisasi aktif?

    17

    Recommended schedule of hepatitis B immunoprophylaxis to prevent perinatal transmission of hepatitis B virus infection Infant born to mother known to be HBsAg positive

    Vaccine dose
    First HBIG Second Third

    Age of infant
    Birth (within 12 hours) Birth (within 12 hours) 1 month 6 months

    http://www.cdc.gov/ncidod/diseases/hepatitis 18

    19

    TATALAKSANA KHUSUS SESUDAH PERIODE PERINATAL Pemeriksaan anti HBs dan HbsAg berkala pada usia

    7 bulan (1bulan setelah vaksin hepatitis B ketiga) 1, 3, 5 tahun setiap 1 tahun


    Bila usia 7 bulan

    * anti HBs positif,periksa ulang anti HBs dan HBsAg pada usia 1,3, 5 dan 10 tahun

    * anti HBs dan HBsAg negatif, beri satu kali tambahan dosis vaksinasi 1 bulan kmd ulang anti HBs. Bila anti HBs positif, periksa ulangpada usia 1, 3, dan 5 tahun dan 10 tahun

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