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.