UTDP-ENT-L5-078 20/04/2015

HEPATITIS B

Yuyun SM Soedarmono

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UTDP-ENT-L5-078 20/04/2015

TUJUAN PEMBELAJARAN
• Menjelaskan penyakit hepatitis B
• Menjelaskan virus hepatitis B

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Hepatitis B in Indonesia

19.5%
4%
10.5%
5.8%

4.0% 4%

5.0% 7.3% 7.1%

11.3% 11.3% 9.2%
20.3% 11.7%
*Before vaccination program

A major public health problem worldwide: • Moderately-to-highly endemic for hepatitis B

• 400 million carriers (WHO)
• 75% living in East-Asia to South-east Asia • HBsAg prevalence:
• 10% (3.4-20.3%) in healthy population
• 37-76% in liver cirrhosis
• 37-68% in HCC

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Natural history of
chronic HBV infection
Compensated
Resolution Stabilisation cirrhosis

Acute Chronic Liver

infection hepatitis Cirrhosis cancer Death

Chronic Progression Decompensated

Carrier Cirrhosis
(Death)
30–50 years

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PERJALANAN PENYAKIT
Liver failure (6.9%)

Decompensated
cirrhosis only (62.5%)

Compensated cirrhosis
(10%)

No HBV TTI Chronic HBV Decompensated:

(20%) ascites (6.4%)

Transfused
blood Other (3.9%)
screened for Acute Hepatitis
HBsAg (20%)
(100%) Hepatocellular
carcinoma (10.3%)

No Progression
HBV TTI
Beyond Acute
(80%)
Asymptomatic
(80%)
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LIFE CYCLE OF HEPATITIS B VIRUS

IN PERSISTENT INFECTION
ICP

 No proof reading
during reverse
transcription

ICP = Intra cellular pathway

of cccDNA formation

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ELECTRON MICROGRAPH OF HBV

Dane particle (: 42 nm) Spheric HBsAg Tubular HBsAg 7

: 18-25 nm : 18-25 nm, l: 50-500 nm

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Hepatitis B Virus
(Dane particle)

 Etiology of hepatitis B in
human
 Smallest human DNA virus,
a member of Hepadna
viridae
 42-nm double shelled DNA
virus
 outer component:
HBsAg
 Inner component:
HBcAg (27 nm)
 Circular double stranded
DNA
 DNA polymerase
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HBV Genotypes in Indonesia AF121244(B2)

AF121245(B2)
AB121246(B2)
AB121247(B2)
AF121248(B2) B2
AF121251(B2)
AF282917(B2)
AF282918(B2)
EIH21A(B2)
Neighbour-joining phylogenetic tree 2061(B2)
78
EIH45A(B2)
constructed from whole genome sequences. AB031266(B4) B4
Four HBV/B subgenotypes (B2, B3, B5 and 82 AB073835(B4)
AB031267(B4)
N7) exist in Indonesia), D00329(B1)
D50521(B1)
D50522(B1)
D23678(B1) B1
D23679(B1)
79 AB010292(B1)
AB010290(B1)
AB010291(B1)
AB219426(B5)
AB219429(B5) B5
AB241117(B5)
AB219427(B5)
100
AB219428(B5)
Alr049(B7)
B7
99
KD048(B7)
90 AB219430(B3)
AB033554(B3)
2059(B3)
B3
M54923B3
1839(B3) DQ463789(B6)
100 DQ463794(B6)
99
DQ463788(B6)
DQ463793(B6)
B6
DQ463792(B6)
DQ463791(B6)
DQ463787(B6)
DQ463790(B6)
AB241112(C5)
AB241113C5
C5
AB241110(C5)
AB241109(C5)
AB048704(C4) C4
100 AB048705(C4)
HHVBC(C3) C3
72 67 HHVCCHA(C3)
X01587(C2) C2
46 AB033553(C2)
AB115417(C2)
AB111946(C1)
92 AB112063(C1)
AB112065(C1)
AB112472(C1)
C1
AB112471(C1)
AB112066(C1)
AB112348(C1)
AB112408(C1)
X70185(A)
98 X68292(D)
X75664(E)
79 AF160501(G)
X75663(F)
100 AB059660(H)
0.01

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GAMBARAN SEROLOGI PADA

INFEKSI HBV AKUT

WP 1 WP 2

Hr Hr
24* 38*

Gambaran serologis, biokimia dan virologis Hepatitis B Akut

(Bowden, 2002)
* Busch et al (2006), Kleinman et al (2007)
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GAMBARAN SEROLOGI PADA

INFEKSI HBV KRONIS

WP

Hr Hr
24,6* 38,3*

Gambaran serologis, biokimia dan virologis Hepatitis B kronis

(Bowden, 2002)
* Busch et al (2006), Kleinman et al (2007)
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KESIMPULAN
• Hepatitis B disebabkan oleh virus hepatitis
B yang merupakan virus DNA
• Penyakit cenderung kronis
• Tingginya prevalensi HBsAg positif pada
populasi umum merupakan ancaman
terhadap keamanan darah

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HASIL PEMBELAJARAN
• Peserta pelatihan mampu:
– Menjelaskan penyakit hepatitis B
– Menjelaskan karakteristik virus hepatitis B

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