7/29/2019 01 Virus Hepatitis 2 2

1/18

Purnomo H, Mikrobiologi FK UNDIP

7/29/2019 01 Virus Hepatitis 2 2

2/18

Mahasiswa memahami tentang hepatitis dalam hal:

Diferensial diagnosis

Etiologi, patogenesis, diagnosis hepatitis virus A

Etiologi, patogenesis, diagnosis hepatitis virus B

Etiologi, patogenesis, diagnosis hepatitis virus C

Etiologi, patogenesis, diagnosis hepatitis virus D

Etiologi, patogenesis, diagnosis hepatitis virus E

7/29/2019 01 Virus Hepatitis 2 2

3/18

Inflammation of Liver:

Viral, immune, Drugs, Toxins & other.

Viral Hepatitis: Specific Heptitis A, B, C, D, E, & other

Systemic - CMV, EBV, other.

7/29/2019 01 Virus Hepatitis 2 2

4/18

virus yang menyebabkan infeksi sistemikdengan target utama pada sel-sel hepar

(hepatosit). tidak termasuk: virus-virus yang menyerang

sel hati sebagai serangan sampingan, mis.Mononucleosis, Cytomegalo, Herpes simplex,Rubella

7/29/2019 01 Virus Hepatitis 2 2

5/18

5 kelompok, + kelompok baru (GB virus)1. HAV : Hepatitis A Virus.2. HBV : Hepatitis B Virus.

3. HDV : Hepatitis Delta Virus.4. HCV (PT-NANB) : Par. trans. n-A, n-B5. HEV (ET-NANB) : Ent. trans n-A, n-B The GB hepatitis viruses:

GBV-A GBV-B

GBV-C

7/29/2019 01 Virus Hepatitis 2 2

6/18

AInfectious

Serum

Viralhepatitis

Enterically

Transmitted

(1983)

Parenterally

Transmitted

(1989)other

E

NANB

(1975)

B

D

C

VIRAL HEPATITIS

HISTORICAL PERSPECTIVE

7/29/2019 01 Virus Hepatitis 2 2

7/18

7/29/2019 01 Virus Hepatitis 2 2

8/18

Viral Hepatitis Overview

Source ofvirus

Route oftransmission

Chronic

infection

Prevention

modification

feces blood/

blood-derived

body fluids

blood/

blood-derived

body fluids

blood/

blood-derived

body fluids

feces

fecal-oral percutaneous

permucosal

percutaneous

permucosal

percutaneous

permucosal

fecal-oral

no yes yes yes no

pre-

exposure

immunization

pre/post-

exposure

immunization

blood donor

screening;

risk behavior

modification

pre/post-

exposure

immunization;

risk behavior

ensure safe

drinking

water

Types of Viral Hepatitis

A B C D E

7/29/2019 01 Virus Hepatitis 2 2

9/18

Estimates of Acute and Chronic Disease

Burden for Viral Hepatitis, United States

Estimated infections(x 1000)/year* 93 78 25 6-13

Fulminantdeaths/year 100 150 ? 35

Chronicinfections

0 1-1.25million

2.7million 70,000

Chronic liver diseasedeaths/year 0 5,000 8-10,000 1,000

* Range based on estimated annual incidence, 2001.

HAV HBV HCV HDV

7/29/2019 01 Virus Hepatitis 2 2

10/18

Carrier state / Asymptomatic phase Acute hepatitis Chronic Hepatitis

Chronic Persistent Hepatitis

Chronic Active Hepatitis

Fulminant hepatitis

Cirrhosis

7/29/2019 01 Virus Hepatitis 2 2

11/18

1. Incubation phase.2. Symptomatic pre-icteric phase.3. Symptomatic icteric phase.

4. Convalescence.

7/29/2019 01 Virus Hepatitis 2 2

12/18

Symptoms (if present) are the same, regardless ofcause (e.g., A, B, C, other viruses, toxins) Nausea, vomiting

Abdominal pain Loss of appetite Fever Diarrhea

Light (clay) colored stools Dark urine Jaundice (yellowing of eyes, skin)

7/29/2019 01 Virus Hepatitis 2 2

13/18

7/29/2019 01 Virus Hepatitis 2 2

14/18

1. Ballooning deg2. Cholestasis3. Apoptosis

4. Periportal Necrosis5. Macrophages6. Inflammation7. Portal inflammation

8. Fatty change(C)

Ground glass (B) Apoptosis Periportal Necrosis

Macrophages Portal Lymphoid

infiltrate Bridging fibrosis Fatty change(C)

7/29/2019 01 Virus Hepatitis 2 2

15/18

7/29/2019 01 Virus Hepatitis 2 2

16/18

Hepatic failure with in 2-3 weeks. Reactivation of chronic or acute hepatitis

Massive necrosis, shrinkage, wrinkled Collapsed reticulin network Only portal tracts visible Little or massive inflammation time More than a week

regenerative activity

Complete recovery or - cirrhosis.

7/29/2019 01 Virus Hepatitis 2 2

17/18

7/29/2019 01 Virus Hepatitis 2 2

18/18