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TUGAS PRAKTIKUM

KKPMT 5

SKEMA PERJALANAN PENYAKIT HEPATITIS VIRUS

Oleh :

Paramita Maharani

(G!!"#$#!%

PROGRAM STU&I &IV REKAM ME&IK 

JURUSAN KESEHATAN

POLITEKNIK NEGERI JEM'ER 

#!)

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A. Skema dan Patofisiologi Hepatitis Virus

I. DEFINISI

I*tilah +he,atiti*- .i/0na1an 0nt01 *em0a 2eni* ,era.an/an ,a.a hati (li3er%4

Pene6a6na .a,at 6er6a/ai ma7am8 m0lai .ari 3ir0* *am,ai .en/an 96at96atan8

terma*01 96at tra.i*i9nal4 Vir0* he,atiti* terma*01 3ir0* he,at9tr9,i1 an/ .a,at

men/a1i6at1an he,atiti* A (HAV%8 he,atiti* ' (H'V%8 .elta he,atiti* (H&V%8 he,atiti* ;

(H;V%8 .an he,atiti* E (HEV%4 Selain it0 20/a a1hira1hir ini .item01an 20/a 3ir0*3ir0*

he,atiti* < .an G4 He,atiti* A8 '8 .an ; ,alin/ 6ana1 .item01an4 He,atiti* < 6ar0 a.a

*e.i1it 1a*0* an/ .ila,9r1an4 He,atiti* G mene6a61an he,atiti* .en/an /e2ala *er0,a

he,atiti* ;8 .an *erin/1ali ter2a.i 6er*amaan .en/an he,atiti* ' .an ata0 ;4

He,atiti* an/ .i*e6a61an 9leh 3ir0* memili1i 6e6era,a taha,an (a10t8 =0lminant8 .an

1r9ni*% ter/ant0n/ .ari .0ra*i ata0 1e,arahan in=e1*i4 Yan/ .ima1*0. .en/an hepatitis

akut  in=e1*i 3ir0* *i*temi1 an/ 6erlan/*0n/ *elama 10ran/ .ari ) 60lan8 .an an/

.ima1*0. .en/an hepatitis kronis a.alah /an//0an/an//0an an/ 6erlan/*0n/ le6ih

.ari ) 60lan .an mer0,a1an 1elan20tan .ari he,atiti* a10t4 He,atiti* =0lminant a.alah

 ,er1em6an/an m0lai .ari tim60lna he,atiti* hin//a 1e/a/alan hati .alam >a1t0 10ran/

.ari min//08 9leh 1arena it0 hana ter2a.i ,a.a 6ent01 a10t (Y0linah .118 ##$%4

II. PATOFISIOLOI

Vir0* he,atiti* an/ meneran/ hati mene6a61an ,era.an/an .an in=iltrat ,a.a

he,at97te* 9leh *el m9n9n01le90*4 Pr9*e* ini mene6a61an .e/renera*i .an ne1r9*i*

*el ,eren1in hati (Gille*,ie et all8 ##?%4 Re*,9n ,era.an/an mene6a61an ,em6e1a1an

.alam mem6l91ir *i*tem .raina/e hati8 *ehin//a ter2a.i .e*tr01*i ,a.a *el hati4 Kea.aan

ini men2a.i *tati* em,e.0 (6iliar% .an em,e.0 ti.a1 .a,at .ie1re*i1an 1e.alam 1ant9n/

em,e.0 6ah1an 1e.alam 0*0*8 *ehin//a menin/1at .alam .arah *e6a/ai

hi,er6ilir06inemia8 .alam 0rine *e6a/ai 0r96ilin9/en .an 10lit ha,at97el0ler 2a0n.i7e

(Gille*,ie et all8 ##?%4

He,atiti* ter2a.i .ari an/ a*im,t9mati1 *am,ai .en/an tim60na *a1it .en/an /e2ala

rin/an4 Sel hati men/alami re/enera*i *e7ara 19m,lit .alam *am,ai " 60lan le6ih

/a>at 6ila .en/an ne1r9*i* hati .an 6ah1an 1ematian4 He,atiti* .en/an *06 a10t .an

1r9ni1 .a,at ,ermanen .an ter2a.ina /an//0an ,a.a =0n/*i hati4 In.i3i.0 .en/an 1r9ni1 

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a1an *e6a/ai .i*e60t *e6a/ai 1arier ,ena1it .an re*i19 6er1em6an/ 6ia1 men2a.i

 ,ena1it 1r9ni1 hati ata0 1an1er hati (Gille*,ie et all8 ##?%4

! Hepatitis A

Vir0* He,atiti* A 6ia*ana mene6a61an *0at0 ,ena1it ,em6ata*an .iri *en.iri .en/an

tin/1at 1e=atalan 1a*0* an/ ren.ah4 Pena1it ter*e60t a.alah *0at0 in=e1*i 3ir0* *i*temi1 *am,ai

(teta,i ti.a1 mele6ihi% ) 60lan .i .alam 2an/1a >a1t08 men/ha*il1an ne1r9*i* in=lammat9r .ari

hati4 Se7ara alami ,r9*e* in=e1*i ,a.a he,atiti* A .i6a/i men2a.i " taha, 6er.a*ar1an ,enan.a*er9l9/i hati ait0 taha, in106a*i8 he,atiti* a10t .an 79n3ale*7en7e (,em0lihan%4 Taha, in106a*i

.im0lai ti.a1 lama *etelah 3ir0* ma*01 1e .alam t060h 6ai1 *e7ara ,arenteral ma0,0n *e7ara

9ral4 Setelah 3ir0* men7a,ai *i*tem *ir10la*i8 3iri9n an/ in=e1ti= 6era10m0la*i .alam *in0*9i.

he,ati7 .an 6er*at0 .en/an he,at9*it4 Re,li1a*i HAV ter2a.i *e7ara e1*1l0*i= ,a.a he,at9*it .an

*el e,itel /a*tr9inte*tinal4 Anti/en 3iral .item01an ,a.a *it9,la*ma he,at9*it *elama in106a*i4

Se*0.ah it0 mere1a .ile,a*1an 1e.alam em,e.0 .an =e*e*4 Vir0* men/alami 1em0n.0ran

1em0n.0ran 1eti1a /e2ala/e2ala 1lini* m0n70l4 Selama taha, in106a*i8 t0an r0mah ti.a1 

menam,a11an /e2ala4 He,atiti* a10t .im0lai .en/an =a*e ,rei1teri1 an/ mana *etara .en/an

ini*ia*i re*,9n im0n h9*t .an ter2a.i *e6el0m *el li3er men/alami 1er0*a1an an/ *i/ni=i1an4

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arna /ela,8 tin2a 6er>arna /ela,8 .an mem60r01na /e2ala

*i*temi14 Ge2ala 1lini1 .i*ertai .en/an menin/1atna *er0m 6ilir06in8 γ /l960lin .an

tran*amina*e he,ati7 .ari !# 1ali .iata* n9rmal4 Ke6ana1an ,a*ien .en/an ani1teri1 a10t ata0

he,atiti* a10t 20/a a1an men/alami =a*e ,enem60han 0nt01 menele*ai1an ,r9*e* re793er

tan,a menim60l1an 19m,li1a*i ata0 men2a.i 1r9ni14

" Hepatitis #

H'V ti.a1 ,at9/eni1 terha.a, *el8 teta,i re*,9n* im0n terha.a, 3ir0* ini an/ 6er*i=at

he,at9t91*i14 Ker0*a1an he,at9*it mene6a61an ,enin/1atan 1a.ar ALT an/ ter2a.i a1i6at li*i*

he,at9*it melal0i me1ani*me im0n9l9/i*4 Ke*em60han .ari in=e1*i H'V 6er/ant0n/ ,a.a

inte/rita* *i*tem im0n9l9/i* *e*e9ran/4 In=e1*i 1r9ni1 ter2a.i 2i1a ter.a,at /an//0an re*,9n

im0n9l9/i* terha.a, in=e1*i 3ir0*4 Vir0* he,atiti* ' .a,at menim60l1an he,atiti* a10t ma0,0n

1r9ni* (6erlan/*0n/ *e7ara men.a.a1 .an 7e,at mem60r01%4 Selain it0 Vir0* he,atiti* ' .an

he,atiti* ; mem,0nai re*i19 ,en.erita ter1ena 1an1er hati4

Vir0* He,atiti* ' ma*01 1e .alam t060h *e7ara ,arenteral4 &ari ,ere.aran .arah8 ,arti1el&ane ma*01 1e .alam hati .an ter2a.i ,r9*e* re,li1a*i 3ir0*4 Selan20tna *el*el hati a1an

mem,r9.01*i .an men*e1re*i ,arti1el &ane 0t0h8 ,arti1el H6*A/ 6ent01 60lat .an t060ler8 .an

H6eA/ an/ ti.a1 i10t mem6ent01 ,arti1el 3ir0*4 H'V meran/*an/ re*,9n im0n t060h8 an/

 ,ertama 1ali .iran/*an/ a.alah re*,9n im0n n9n *,e*i=i1 ( innate immune response% 1arena .a,at

teran/*an/ .alam >a1t0 ,en.e18 .alam 6e6era,a menit *am,ai 6e6era,a 2am4 Pr9*e* elimina*i

n9n*,e*i=i1 ini ter2a.i tan,a re*tri1*i HLA8 ait0 .en/an meman=aat1an *el*el NK .an NKT4

Unt01 ,r9*e* era.i1a*i H'V le6ih lan20t .i,erl01an re*,9n im0n *,e*i=i18 ait0 .en/an

men/a1ti3a*i *el lim=9*it T .an *el lim=9*it '4 A1ti3a*i *el T ;&$ ter2a.i *etelah 19nta1 

re*e,t9r *el T ter*e60t .en/an 19m,le1* ,e,ti.a H'VMH; 1ela* I an/ a.a ,a.a ,erm01aan

.in.in/ *el hati .an ,a.a ,erm01aan .in.in/  Antigen Presentating Cell   (AP;% .an .i6ant0

ran/*an/an *el T ;& an/ *e6el0mna *0.ah men/alami 19nta1 .en/an 19m,le1* ,e,ti.a

H'VMH; 1ela* II ,a.a .in.in/ AP;4 Pe,ti.a H'V an/ .itam,il1an ,a.a ,erm01aan .in.in/

*el hati .an men2a.i anti/en *a*aran re*,9n im0n a.alah ,e,ti.a 1a,*i. ait0 H67A/ ata0

H6eA/4 Sel T ;&$ *elan20tna a1an men/elimina*i 3ir0* an/ a.a .i .alam *el hati an/

terin=e1*i4 Pr9*e* elimina*i ter*e60t 6i*a ter2a.i .alam 6ent01 ne1r9*i* *el hati an/ terin=e1*i

melal0i a1ti3ita* inter=er9n /amma .an Tissue Necrotic Factor   (TN

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A1ti3ita* *el lim=9*it ' .en/an 6ant0an *el ;& a1an mene6a61an ,r9.01*i anti69.i

antara lain antiH'*8 antiH'7 .an antiH6e4 a*a

.i.0/a .i*e6a61an 9leh 1elelahan *el T 1arena tin//ina 19n*entra*i ,arti1el 3ir0*4 Per*i*ten*i

in=e1*i H'V .a,at .i*e6a61an 1arena m0ta*i ,a.a .aerah  pre-core .ari &NA an/ mene6a61an

ti.a1 .a,at .i,r9.01*ina H6eA/ ,a.a m0tan ter*e60t a1an men/ham6at elimina*i *el an/

terin=e1*i4

Per$alanan Pen%akit Hepatitis # &ronik 

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A.a =a*e ,a.a ,er2alanan ,ena1it he,atiti* ' 1r9ni18 ait0 =a*e im0n9t9leran*8 =a*e

im0n1liren* (im0n9a1ti=%8 ina7ti3e 7arrier *tate8 .an =a*e rea1ti3a*i4

• a*a m0.a8 *i*tem im0n t060h t9leran terha.a, H'V

*ehin//a 19n*entra*i 3ir0* .alam .arah .a,at *e.emi1ian tin//ina8 teta,i ti.a1 ter2a.i

 ,era.an/an hati an/ 6erarti4 &alam 1ea.aan it0 H'V a.a .alam =a*e re,li1ati= .en/an titer 

H'*A/ an/ *an/at tin//i8 H'eA/ ,9*iti=8 antiH'e ne/ati=8 titer &NA H'V tin//i .an

19n*entra*i ALT (alanin amin9tran*=era*e% an/ relati= n9rmal4 Pa.a =a*e im0n9t9leran* ,ra1ti*

ti.a1 a.a re*,9n im0n terha.a, ,arti1el 3ir0* he,atiti* ' *ehin//a ti.a1 a.a *it9li*i* *el*el hati

an/ terin=e1*i .an ti.a1 a.a /e2ala4

• ala0,0n H'eA/ ne/ati= .an anti H'e ,9*iti=8 teta,i

re,li1a*i 3ir0* he,atiti* ' 6el0m 6erhenti4 Pa*ien,a*ien ini men/i.a, in=e1*i he,atiti* ' .en/an

m0tant ,re 79re8 3ir0* an/ telah men/alami m0ta*i ini ti.a1 mam,0 mem60at H'eA/ teta,i anti

H'e teta, .i6ent01 9leh h9*t 1arena ,a.a tin/1at *el T re*,9n im0n9l9/i1 terha.a, H'7A/ .an

H'eA/ *ama4 Pa.a ,a*ien .en/an VH' ti,e liar8 *er919n3er*i H'eA/ men2a.i anti H'e

mer0,a1an ,ertan.a 6ai1 .an 1em0n/1inan 0nt01 ter2a.i *ir9*i* .an he,at9ma 1e7il4 Pa.a

 ,a*ien,a*ien .en/an in=e1*i VH' m0tant ,re 79re 1arena ma*ih a.ana a1ti3ita* ,ena1it .an

 20mlah ,arti1el 3ir0* ma*ih tin//i8 ma1a le6ih *erin/ ter2a.i *ir9*i* .an he,at9ma

•

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ter2a.ina in=e1*i ini a.alah a.ana ,e,ti.a *tr01t0ral .an n9n*tr01t0ral an/ 6ertan//0n/2a>a6

.alam re,li1a*i 3ir0* RNA 1h0*0*na ,e,ti.a NS54 Ter.a,at enam /en9ti,e (n9m9r ! *am,ai )%

.an le6ih .ari ?# *06ti,e (/en9ti,e !a8 !68 a8 "68 .ll% ter1ait .en/an he,atiti* ;4 Anti69.i H;V

(antiH;V% .i .alam .arah men/in.i1a*i1an a.ana in=e1*i .en/an H;V4 Ji1a in=e1*i ter2a.i

*elama le6ih .ari ) 60lan .an re,li1a*i 3ir0* ter19n=irma*i 9leh le3el RNA H;V8 ma1a 9ran/

ter*e60t ter.ia/n9*i* he,atiti* ; 1r9ni*4 Pena1it 1r9ni* tim60l a1i6at **tem im0n t060h ti.a1 

e=e1ti= terha.a, H;V4 Lim=9*it T *it9t91*i1 ti.a1 e=e1ti= .alam mem6a*mi H;V8 *ehin//a 6i*a

mer0*a1 *el hati4 Oleh 1arena it08 *i*tem im0n *e*e9ran/ *an/at 6er,en/ar0h .alam

men/elimina*i H;V4

Pen//0na nar196a *0nti1an (I&U% an/ mema1ai 2ar0m *0nti1 .an alat *0nti1 lain *e7ara

 6er/antian 6eri*i19 ,alin/ tin//i ter1ena in=e1*i H;V4 Antara 5# .an ?# ,er*en I&U .en/an HIV

 20/a terin=e1*i H;V4 Hal ini 1arena 1e.0a 3ir0* men0lar .en/an m0.ah melal0i h060n/an .arah

1e.arah4 H;V .a,at mene6ar .ari .arah 9ran/ an/ terin=e1*i an/ ma*01 1e .arah 9ran/ lain

melal0i 7ara an/ 6eri10t:

Mema1ai alat *0nti1 (2ar0m *0nti18 *em,rit8 .a,0r8 1a,a*8 air% *e7ara 6er/antianC

Ke7ela1aan 1et0*01 2ar0mC

L01a ter601a ata0 *ela,0t m019*a (mi*alna .i .alam m0l0t8 3a/ina8 ata0 .060r%C .an

Pr9.01 .arah ata0 tran*=0*i .arah an/ ti.a1 .i*1rinin/4

'er6e.a .en/an HIV8 0m0mna .ian//a, 6ah>a H;V ti.a1 .a,at men0lar melal0i air mani

ata0 7airan 3a/ina 1e70ali men/an.0n/ .arah4 Ini 6erarti ri*i19 terin=e1*i H;V melal0i

h060n/an *e1* a.alah ren.ah4 Nam0n ma*ih .a,at ter2a.i8 ter0tama 6ila 6era.a in=e1*i men0lar 

*e1*0al *e,erti her,e* ata0 h060n/an *e1* .ila101an .en/an 7ara an/ menin/1at1an ri*i19 l01a

 ,a.a *ela,0t m019*a ata0 h060n/an .arah1e.arah8 mi*alna a1i6at 1e1era*an4 &i0*0l1an 9ran/

.en/an H;V mela101an *e1* le6ih aman .en/an ,en//0naan 19n.9m 0nt01 melin.0n/i

 ,a*an/anna4 Perem,0an .en/an H;V mem,0nai ri*i19 .i 6a>ah ) ,er*en men0lar1an

3ir0*na ,a.a 6aina >a1t0 hamil ata0 *aat melahir1an8 >ala0,0n ri*i19 ini menin/1at 6ila

3iral l9a. H;Vna tin//i4 Kem0n/1inan H;V ti.a1 .a,at men0lar melal0i men0*0i4 'ila 1ita

 6el0m .ite* H;V8 ata0 ti.a1 men/etah0i a,a1ah 1ita ,ernah .ite*8 1ita *e6ai1na

mem6i7ara1anna .en/an .91ter4 Te* H;V *an/at .i*aran1an 0nt01 *ia,a ,0n an/ HIV,9*iti=4

) Hepatitis D

H&V ma*01 1e.alam t060h .en/an 7ara an/ *ama .en/an H'V4 ;ara ter*e60t at0 melal0i

.arah .an ,r9.01 .arah8 terma*01 ,ema1aian 6er*ama 6aran/6aran/ ,ri6a.i *e,erti *i1at /i/i

ata0 ,i*a0 7010r8 menent0h .arah terin=e1*i8 .ll4 Pen0laranna 2aran/ le>at h060n/an *e1*0al

.an 20/a melal0i i60 1e,a.a 6aina *elama ,r9*e* melahir1an4 Pen0laran VH& 20/a melal0i

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 2ar0m *0nti1 .an tran*=0*i .arah4 Oran/ .en/an he,atiti* & 1r9ni1 .a,at men0lar1an 3ir0* ,a.a

9ran/ lain

He,atiti* & 6ertin.a1 *an/at miri, *e,erti he,atiti* '4 Vir0* ini ma*01 1et060h .en/an 7ara an/

*ama .an .a,at mene6a61an ,ena1it 2an/1a ,en.e1 (a10t% ata0,0n ,ena1it 2an/1a ,an2an/

(1r9ni1%4 Dala0,0n .mei1ian8 1arena 3ir0* ini hi.0, 6er*amaan .en/an H'V8 ,ena1it 1r9ni1 

.an a10t an/ .i*e6a61an H&V 7en.er0n/ le6ih ,arah ,a.a 9ran/ an/ hana ter2an/1it H'V4

In=e1*i ini mene6a61an ,em6en/1a1an .an ,era.an/an ,a.a hati4

* Hepatitis E

In=e1*i HEV ti.a1 .a,at .i6e.a1an .ari in=e1*i HAV4 In=e1*i .en/an HEV ti.a1 6er6ahaa8

1e70ali >anita hamil4 Danita an/ terin=e1*i HEV *elama trime*ter 1eti/a amat 6ere*i19 0nt01 

 6er1em6an/na 2anin8 *ehin//a .a,at mene6a61an he,atiti* ata0 /a/al hati4

Pa.a *aat ter2a.i 1er0*a1an hati8 an/ 6ertan//0n/ 2a>a6 a.alah *i*tem im0n4 Ke2a.ian ini

meli6at1an re*,9n* ;&$ .an ;& *el T *erta ,r9.01*i *it91in .i hati .an *i*temi14 Selain it08

e=e1 *it9,ati1 lan/*0n/ .ari 3ir0* 20/a 6er,eran .alam ,at9=i*i9l9/i he,atiti*4 E=e1 *it9,ati1 ini

 6er,en/ar0h ,a.a ,a*ien im0n9*0,re*i .en/an re,li1a*i tin//i8 a1an teta,i ti.a1 a.a 601ti

lan/*0n/4 Kelainan hi*t9,at9l9/i1 ,a.a he,atiti* 3ir0* ini men.a.a1 men0n2011an 6ah>a

1er0*a1an ter0tama men/enai *el hati an/ .i*e6a61an 9leh *e2eni* 3ir0* an/ men/a1i6at1an

ter/an//0na =0n/*i 3ital .an 19ntin0ita* *el ,aren1im4 Kem0n/1inan 1er0*a1an *el hati ter2a.i

*e7ara en@imati14

+ Hepatitis

He,atiti* 3ir0* G (HVG% .i*e6a61an 9leh VHG an/ miri, .en/an 3ir0* he,atiti* ;4 Pena1it

HVG *e6a/ian 6e*ar 6er*ama .en/an in=e1*i VH' .an VH;4 Kira1ira !#B ,a*ien .en/an

he,atiti* n9nAE 1r9ni18 ,9*iti= 0nt01 HGV RNA4

Pa*ien .en/an hem9=ilia .an 19n.i*i ,er.arahan lainna an/ mem60t0h1an 6ana1 .arah ata0

 ,r9.01 .arah mem,0nai ri*i19 he,atiti* G4 Ri*i19 an/ *ama 20/a .ialami ,a*ien .en/an

 ,ena1it /in2al4 Da1t0 hem9.iali*i*8 1e60t0han tran*=0*i .an tran*,lanta*i /in2al a.alah =a1t9r ri*i19 in=e1*i VHG ,a.a ,a*ien .alam ,era>atan hem9.iali*i* .an in2e1*i 96at intra 3ena4

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Pen0laran VHG a.alah melal0i .arah ata0 ,r9.01 .arah8 h060n/an *e1*8 alat *0nti1 (,a.a

 ,en.erita an/ *erin/ men//0na1an 96at96at a.i1ti= melal0i *0nti1an%8 tran*=0*i .arah 2ar0m

*0nti18 .an *e7ara 3erti1al .ari i60 an/ terin=e1*i 1e,a.a ana1na ,a.a ,r9*e* 1elahiran4

Ta6el !4 Gam6aran Klini* an/ Pentin/ ,a.a He,atiti* Vir0* (S01an.ar et. al., ##$%4

Hepatitis

A

Hepatitis

#

Hepatitis

(

Hepatitis

D

Hepatitis

EHepatitis

Virus HAV H'V H;V H&V HEV HG'HGV

Famil% Pi79rna3ir0*He,a.na3ir0

*

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3anifest

asi klinis

anak1

anak 

De4asa

Ani1teri1 

I1teri1 

Ani1teri1

F#B

I1teri1 "#B

Ani1teri1

F5B

Se6a/ian

 6e*ar

i1teri1 

I1teri1

5B

Se6a/ian

 6e*ar

ani1teri1 

Ti.a1 2ela*

3ortalit

as akut#4" #4! #4 #

!# (>anita

hamil%

&ronik

-5

Ti.a1 a.a F

 Ne9nater ?#

F#$# F# Ti.a1 a.a

&arsino

ma

0epatose

luler

Ti.a1 a.a A.a A.a A.a Ti.a1 a.a

III. E6ALA DAN 3ANIFESTASI! Hepatitis A

Serin/1ali in=e1*i he,atiti* A ,a.a ana1ana1 ti.a1 menim60l1an /e2ala8 *e.an/1an

 ,a.a 9ran/ .e>a*a mene6a61an /e2ala miri, =l08 ra*a lelah8 .emam8 .iare8 m0al8 neri

 ,er0t8 mata 10nin/ .an hilan/na na=*0 ma1an4 Ge2ala hilan/ *ama *e1ali *etelah )!

min//04 Oran/ an/ terin=e1*i he,atiti* A a1an 1e6al terha.a, ,ena1it ter*e60t4

'er6e.a .en/an he,atiti* ' .an ;8 in=e1*i he,atiti* A ti.a1 6erlan20t 1e he,atiti* 1r9ni14

Ma*a in106a*i "# hari4Pen0laran melal0i ma1anan ata0 min0man an/ ter19ntamina*itin2a ,a*ien8 mi*alna ma1an 60ah60ahan8 *a0r an/ ti.a1 .ima*a1 ata0 ma1an 1eran/

an/ *eten/ah matan/4 Min0m .en/an e* 6at0 an/ ,r9*e*na ter19ntamina*i4 Saat ini

*0.ah a.a 3a1*in he,atiti* A8 mem6eri1an 1e1e6alan *elama min//0 *etelah *0nti1an

 ,ertama8 0nt01 1e1e6alan an/ ,an2an/ .i,erl01an *0nti1an 3a1*in 6e6era,a 1ali4

Pe7an.0 nar19ti1a .an h060n/an *e1* anal8 terma*01 h9m9*e1* mer0,a1an ri*i19 tin//i

tert0lar he,atiti* A4

3anifestasi klinis 7

 6i*a i1teri1 ata0 tan,a /e2ala i1teri1 ( ani1teri1 *061lini*%

8/16/2019 KKPMT 5

11/15

 6ila /e2ala m0n70l 6ent01na 6er0,a in=e1*i *al0ran na=a* ata* an/ rin/an *e,erti

=l0 .en/an ,ana* an/ ti.a1 6e/it0 tin//i

an9re1*ia mer0,a1an /e2ala .ini .an 6ia*ana 6erat

 6ela1an/an .a,at tim60l i1teri1 .an >arna 0rin an/ /ela,

/e2ala .i*,e,*ia .a,at ter2a.i .alam 6er6a/ai .era2at4 &itan.ai 9leh ra*a neri

e,i/a*tri0m8 m0al8 neri 0l0 hati8 .an =lat0len*i

/e2ala/e2ala .i ata* men/hilan/ ,a.a ,0n7a1 i1teri1 ( !# hari *e*0.ah 1em0n70lan

a>al %

*,len9me/ali .an he,at9me/ali *erin/ ter2a.i

7en.er0n/ 6er*i=at *im,t9mati*

" Hepatitis #

Ge2ala miri, he,atiti* A8 ti.a1 2a0h 6er6e.a .en/an =l08 ait0 hilan/na na=*0 ma1an8

m0al8 m0ntah8 ra*a lelah8 mata 10nin/ .an m0ntah *erta .emam4 Pen0laran .a,at melal0i

 2ar0m *0nti1 ata0 ,i*a0 an/ ter19ntamina*i8 tran*=0*i .arah .an /i/itan man0*ia4

Pen/96atan .en/an inter=er9n al=a6 .an lami30.ine8 *erta im0n9/l960lin an/

men/an.0n/ anti69.i terha.a, he,atiti*' an/ .i6eri1an ! hari *etelah ,a,aran4

Va1*in he,atiti* ' an/ aman .an e=e1ti= *0.ah ter*e.ia *e2a1 6e6era,a tah0n an/ lal04

Yan/ mer0,a1an ri*i19 tert0lar he,atiti* ' a.alah ,e7an.0 nar19ti1a8 9ran/ an/mem,0nai 6ana1 ,a*an/an *e1*0al4 Ha*il ,emeri1*aan .arah an/ men0n2011an anti

H'* ,9*iti= 6erarti An.a ,ernah terin=e1*i 3ir0* He,atiti* '8 nam0n 3ir0* ter*e60t *0.ah

ti.a1 a.a la/i .alam .arah An.a (H6*A/ ne/ati=%4 It0 6ah1an men0n2011an 6ah>a An.a

*e1aran/ *0.ah mem,0nai 1e1e6alan terha.a, He,atiti* ' (anti H'* ,9*iti=%4 Karena it0

*elama 1a.ar anti69.i anti H'* An.a tin//i8 ma1a An.a ta1 ,erl0 la/i .i3a1*ina*i4

Im0ni*a*i He,atiti* ' .a,at .im0lai *e2a1 6ai4

3anifestasi klinis 7

*e7ara 1lini* *an/at mener0,ai he,atiti* A nam80n ma*a in106a*i 2a0h le6ih lama

/e2ala .a,at *amar .an 6er3aria*i

men/alami ,en0r0nan *elera ma1an

.i*,e,*ia8 neri a6.9men

 ,e/al,e/al an/ menel0r0h8 ti.a1 ena1 6a.an .an lemah

Pana* .an /e2ala ,erna=a*an 2aran/ .i20m,ai

Ge2ala i1teri1 6i*a terlihat ata0 ti.a14

8/16/2019 KKPMT 5

12/15

'ila i1teri1 .i*ertai tin2a 6er>arna 7erah .an 0rin 6er>arna /ela,

 Neri te1an ,a.a hati .an *,len9me/al

' Hepatitis (Ge2ala He,atiti* ; 6ia*ana le6ih rin/an .i6an.in/1an .en/an He,atiti* A ata0 '4

Ke6ana1an ,a*ien *ama *e,erti ti,e lain ti.a1 men/alami /e2ala he,atiti*4 He,atiti* ;

1r9ni* .a,at terin=e1*i *elama !# "# tah0n8 .an *ir9*i* ata0 /a/al hati 1a.an/1a.an/

.a,at 6er1em6an/ *e6el0m ,a*ien men/alami /e2ala an/ 2ela*4 Tan.atan.a 1er0*a1an

hati ,ertama m0n/1in ter.ete1*i 1eti1a te* .arah 0nt01 =0n/*i hati .ila101an4

Ji1a /e2ala a>al an/ ter2a.i8 mere1a 7en.er0n/ *an/at rin/an .an mener0,ai =l0

.en/an tan.atan.a :

Kelelahan

M0al

Kehilan/an na=*0 ma1an

&emam

Sa1it 1e,ala8 .an *a1it ,er0t4

Setelah ter*eran/ He,atiti* A ,a.a 0m0mna ,en.erita *em60h *e7ara *em,0rna8

ti.a1 a.a an/ men2a.i 1r9ni14 He,atiti* ' 20/a *e6a/ian 6e*ar a1an *em60h .en/an 6ai1 .an hana *e1itar 5!# ,er*en an/ a1an men2a.i 1r9ni14 'ila he,atiti* ' men2a.i

1r9ni1 ma1a *e6a/ian ,en.erita he,atiti* ' 1r9ni1 ini a1an men2a.i *ir9*i* hati .an

1an1er hati4 Pa.a He,atiti* ; ,en.erita an/ men2a.i 1r9ni1 2a0h le6ih 6ana14 Se6a/ian

 ,en.erita He,atiti* ; 1r9ni1 a1an men2a.i *ir9*i* hati .an 1an1er hati4 Hana *e6a/ian

1e7il *a2a ,en.erita He,atiti* ' an/ 6er1em6an/ men2a.i 1an1er hati4 'e/it0 ,0la ,a.a

 ,en.erita He,atiti* ; hana *e6a/ian an/ men2a.i 1an1er hati4 'ia*ana .i,erl01an

>a1t0 !F *am,ai .en/an # tah0n *e9ran/ an/ men.erita He,atiti* ; 0nt01  6er1em6an/ men2a.i *ir9*i* hati ata0 1an1er hati4

Anti H;V ne/ati= artina An.a 6el0m ,ernah terin=e1*i He,atiti* ;4 Sam,ai *e1aran/

ini 6el0m a.a 3a1*in 0nt01 He,atiti* ; *ehin//a An.a .ian20r1an a/ar 6erhatihati

*ehin//a ti.a1 tert0lar He,atiti* ;4 Ja.i hin.ari 19nta1 .en/an 7airan t060h 9ran/ lain4

Se1aran/ meman/ a.a 96at 6ar0 0nt01 He,atiti* ' an/ .i*e60t lami30.in4 O6at ini

 6er0,a ta6let an/ .ima1an *e1ali *ehari4 Se.an/1an 2i1a .i,erl01an ,en/96atan 0nt01 

He,atiti* ; ter*e.ia 96at Inter=er9n (*0nti1an% .an Ri6a3irin (1a,*0l%4 Nam0n

 ,en//0naan 96at96at ter*e60t har0* .ila101an .i6a>ah ,en/a>a*an .91ter4

8/16/2019 KKPMT 5

13/15

) Hepatitis D

He,atiti* & Vir0* ( H&V % ata0 3ir0* .elta a.alah 3ir0* an/ 0ni18 an/ ti.a1 len/1a,

.an 0nt01 re,li1a*i memerl01an 1e6era.aan 3ir0* he,atiti* '4 Pen0laran melal0i

h060n/an *e1*0al8 2ar0m *0nti1 .an tran*=0*i .arah4 Ge2ala ,ena1it he,atiti* &

 6er3aria*i8 .a,at m0n70l *e6a/ai /e2ala an/ rin/an (19in=e1*i% ata0 amat ,r9/re*i=4

He,atiti* & *erin/ .i20m,ai ,a.a ,en.erita he,atiti* '8 1arena 3ir0* he,atiti* & ata0

VH& 010ranna *an/at 1e7il .an *an/at ter/ant0n/ ,a.a 3ir0* he,atiti* ' ata0 VH'4

VH& mem60t0h1an *el060n/ VH' 0nt01 .a,at men/in=e1*i *el*el hati (li3er%4 Ta1 

menheran1an 2i1a 7ara ,en0laran VH& *ama .en/an ,en0laran VH'4 Se*e9ran/ .a,at

ter2an/1it he,atiti* ' .an & a10t *e7ara 6er*amaan4 Se6a/ian 6e*ar .a,at *em60h .en/an

*en.irina ter/ant0n/ 1etahanan t060hna4 Pen.erita he,atiti* ' 1r9ni1 .a,at ter1ena

he,atiti* & a10t8 .an 6ia*ana he,atiti* & na 6er06ah men2a.i 1r9ni*4 Ka*0* ter*e60t

.a,at 20/a 6er1em6an/ men2a.i *ir9*i* hati .alam >a1t0 le6ih *in/1at4

* Hepatitis E

Ge2ala miri, he,atiti* A8 .emam ,e/el lin08 lelah8 hilan/ na=*0 ma1an .an *a1it ,er0t4

Pena1it an/ a1an *em60h *en.iri ( *el=limite. %8 1e70lai 6ila ter2a.i ,a.a 1ehamilan8

1h0*0*na trime*ter 1eti/a8 .a,at memati1an4 Pen0laran melal0i air an/ ter19ntamina*i

=e7e*4

He,atiti* E 6er*i=at mener0,ai he,atiti* A 6e/it0 ,0la .en/an 7ara ,en0laranna4

 Nam0n tin/1at 1e,arahanna ,ena1itna le6ih rin/an .i6an.in/ he,atiti* A4 Se,erti

he,atiti* A8 he,atiti* E *erin/ 6er*i=at a10t .en/an ma*a *a1it *in/1at nam0n 2i1a

 ,en.erita .alam 19n.i*i 1etahanan =i*i*1 lemah8 he,atiti* E .a,at ,arah hin//a

menim60l1an 1e/a/alan =0n/*i hati (li3er%4 Vir0* he,atiti* E ata0 VHE mene6ar 

melal0i ma1anan .an min0man an/ ter7emar =e*e* an/ men/an.0n/ VHE4

+ Hepatitis F

'ar0 a.a *e.i1it 1a*0* an/ .ila,9r1an4 Saat ini ,ara ,a1ar 6el0m *e,a1at he,atiti* <

mer0,a1an ,ena1it he,atiti* an/ ter,i*ah4

8 Hepatitis

Ge2ala *er0,a he,atiti* ;8 *erin/1ali in=e1*i 6er*amaan .en/an he,atiti* ' .anata0 ;4

Ti.a1 mene6a61an he,atiti* =0lminan ata0,0n he,atiti* 1r9ni14 Pen0laran melal0i

tran*=0*i .arah 2ar0m *0nti14 Sem9/a ,en/etah0an ini 6i*a 6er/0na 6a/i An.a .an .a,at

An.a ter0*1an 1e,a.a *a0.ara ata0,0n teman An.a

8/16/2019 KKPMT 5

14/15

#. &ODE PEN9A&IT #E:DASA:&AN I(D !;! ;t9me/al93iral He,atiti*

Lea.term : He,atiti*

;t9me/al93iral ('54! KFF4#%

Her,e*3iral He,atiti*Lea.term : He,atiti*

Her,e*3iral ('##4$ KFF4#%

" Se0elae 9= 3iral he,atiti*

Lea.term :

• Se0elae

Viral

He,atiti* ('?4%

• he,atiti* A a10t

Lea.term : He,atiti*

Viral

• T,e

A ('!54?%

Sir9*i* Hati 1arena he,atiti* 3ir0* '

Lea.term : ;irrh9*i* (He,ati7% (KF4)%

5 He,atiti* ' A10t

Lea.term :He,atiti*

Viral

T,e

' ('!)4?%

) He,atiti* 3iral a10t lainlain

Lea.term :He,atiti*

Viral8 Vir0* (A70te% ('!?4?%

F He,atiti* 3ir0* ' *elama F '0lan

Lea.term :He,atiti*

Viral8 Vir0* (A70te%

;hr9ni7

 ' ('!$4!%

$ He,atiti* 3ir0* ' .en/an .elta a/entLea.term :He,atiti*

8/16/2019 KKPMT 5

15/15

Viral8 Vir0* (A70te%

;hr9ni7

 '

  Dith &elta a/ent ('!$4#%

? He,atiti* 3ir0* ; la1ila1i 5 tah0n le6ih .ari ) 60lan

Lea.term :He,atiti* Viral

;hr9ni7

 ; ('!$4%

!# He,atiti* 3ir0* A

Lea.term : He,atiti*

Viral

T,e

A ('!54?%