01 Virus Hepatitis 2 2
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Purnomo H, Mikrobiologi FK UNDIP
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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
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Inflammation of Liver:
Viral, immune, Drugs, Toxins & other.
Viral Hepatitis: Specific Heptitis A, B, C, D, E, & other
Systemic - CMV, EBV, other.
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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
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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
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AInfectious
Serum
Viralhepatitis
Enterically
Transmitted
(1983)
Parenterally
Transmitted
(1989)other
E
NANB
(1975)
B
D
C
VIRAL HEPATITIS
HISTORICAL PERSPECTIVE
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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
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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
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Carrier state / Asymptomatic phase Acute hepatitis Chronic Hepatitis
Chronic Persistent Hepatitis
Chronic Active Hepatitis
Fulminant hepatitis
Cirrhosis
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1. Incubation phase.2. Symptomatic pre-icteric phase.3. Symptomatic icteric phase.
4. Convalescence.
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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)
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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)
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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.
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