Acute Viral

Hepatitis
PRECEPTOR : DR. LUKAS MULYONO SAMUEL,
SP. PD-KGEH.
Definisi
Hepatitis berarti peradangan hati yang ditandai :
◦ Inflamasi sel mononuclear ( Limfosit dan Sel Plasma)
◦ Nekrosis hepatoseluler (Apoptosis)
◦ Regenerasi Hepatoseluler
Hepatitis virus : Infeksi hati yang disebabkan oleh kelompok
virus yang memiliki afinitas tertentu terhadap hati
Viral Hepatitis
Infectious : Hepatitis A
Serum : Hepatitis B, D
NANB : Hepatitis C
Hepatitis E
Viral Hepatitis
Virus Source Transmission Chronicity Prevention

A Stool Feco-oral No Immunoglobulin

Vaccination

B Parentral Percutanous Yes Immunoglobulin

Vaccination
per mucosal
Immunoglobulin
Vaccination

C Parentral Percutanous Yes Blood donor

screening
per mucosal
Risk behavior
modification

D Parentral Percutanous Yes HBV Prevention

per mucosal

E Stool Feco-oral No Safe water

cleaning
Clinical Features
Sub clinical
Clinical
◦ Non specific (fever, myalgea, arthralgia, fatigue..)
◦ Gastrointestinal (jaundice, itching, anorexia, pain..)
Hepatitis A
Incubation Period: 15-50 days
Clinical Hepatitis
-<6y : <10%
-6-14y : 40-50%
-14y : 70-80%
Hepatitis B
Incubation Period: 45-180 days
Clinical Hepatitis
-<5y : <10%
->5y : 30-50%
Chronic Infection:
-<5y : 30-90%
->5y : 2-10%
Hepatitis C
Incubation Period: 2-26 Weeks
Clinical Hepatitis: 20%
Chronic Infection: 80%
Hepatitis D
HBV Co infection
-Severe acute hepatitis
-Low risk of chronic infection
HBV Super infection
-High risk of chronic liver disease
Hepatitis E
Incubation Period: 15-60 days
Case fatality: 20% in pregnancy
Illness severity: Increase with age
Diagnosis
Biochemical tests
◦ Serum aminotransferases
◦ Serum bilirubin
◦ Albumin
Serology
◦ Serum antigens / antibody
◦ Nucleic acid detection (PCR)
Diagnosis
Serology
◦ HAV-Ab IgM
◦ HBsAg, HBeAg, HBcAb IgM
◦ HCV Ab
◦ HDV Ab IgM
◦ HEV Ab IgM
HEPATITIS A
HEPATITIS B
HEPATITIS C
HEPATITIS D
HEPATITIS E
Treatment
Supportive management
Prevent infection spread
Specific antiviral therapy (may be considered for HBV & HCV)
Liver transplant for Fulminant hepatitis
THANK YOU