\GCG\AP

F un
una
ak I nnukh
ukh`
`gci bi
biggkby S i r us (FIS)

Zgnlinlikm4

`r. Miri Adi, Rp.Z@

@isusuk hogf4

1. @gsi Ayu \afna`iaki (01<:12931::::0)

<. @gwi Rgtiawati (01<:12931::::7)

EGZAKIPG\AAK EOIKIE IONW ZGKYAEIP @AOAN

\WNAF RAEIP WNWN ZWRAP CAPNA]API

CAEWOPAR EG@HEPG\AK

WKISG\RIPAR IROAN KGMG\I RYA\IC FI@AYAPWOOAF

FI@AYAPWOOAF DAEA\PA

<:<1
 

EAPA ZGKMAKPA\

Lisniooafirrafnakirrafin.

Assaoanu’aoaieun, ]r. ]l. 

]l. 

Zudi syueur eani pakdateak egpa`a Aooaf R]P atas sgmaoa lgreaf, rafnat, `ak
egnu`afak yakm tgoaf `ilgrieak sgfikmma eani `apat ngkygogsaieak rgcgrat yakm lgrdu`uo
FIS iki. Rfaoawat sgrta saoan tae oupa saya sanpaieak egfa`irat Kali Lgsar, \asuouooaf
Nufanna`
Nufanna` RA] sgnhma eita sgkaktiasa ngk`apat syaca’atkya fikmma `i fari aefir kakti.
kakti.  

Wbapak tgrina easif ti`ae oupa eani sanpaieak puoa egpa`a `r. Miri Adi, Rp.Z@ yakm
tgoaf ngnlinlikm eani `aoan prhsgs pgkmgrdaik rgcgrat iki `ak duma egpa`a sgnua tgnak-
tgnak yakm tgoaf ngk`ueukm eani uktue ngkygogsaieak
ngkygogsaieak oaphrak iki.

\gcgrat iki eani luat `aoan rakmea ngkygogsaieak tumas Egpakitgraak Eoikie Ionu
Zgkyaeit @aoan \RWZ Catnawati. Eani ngkya`ari lafwa `aoan pgkyusukak rgcgrat iki
nasif tgr`apat lakyae egeurakmak. Wktue itu, eani sakmat ngkmfarapeak eritie `ak sarak
yakm ngnlakmuk amar `apat eani da`ieak pgnlgoadarak `gni egsgnpurkaak pgkyusukak
rgcgrat iki.
@gnieiak rgcgrat iki eani susuk, sgnhma `apat lgrnakcaat lami eani sglamai pgkuois
efususkya sgrta sgdawat CE WIK <:1= `ak nasyaraeat ouas pa`a ununkya.
]assaoanu’aoaieun, ]r. ]l. 
]l.  
Pakmgrakm Rgoatak, <= Aprio <:<1

Zgkyusuk

i 
 

@ACPA\ IRI

EAPA ZGKMAKPA\
ZGKMAKPA\ ....................................................
................................................................................
.........................................................
.............................................i
................i
@ACPA\
@ACPA\ IRI ...................
.................................................
.......................................................
....................................................
.................................................................ii
......................................ii
LAL I ZGK@AFWOWAK
ZGK@AFWOWAK .........................................................
.....................................................................................
..............................................................1
..................................1
LAL II PIKDAWAK
PIKDAWAK ZWRPAEA ..........................................................................................
............................................................................................................
.................. <
<.1 @gciki
@gcikisi
si .....................................
..................................................................
.......................................................
...........................................................................
................................................. <
<.< Gpi`gn
Gpi`gnihohmi
ihohmi .......................................................................
............................................................................................
.....................................................…….
................................…….<
<
<.2 Gtihohmi .....................................
..................................................................
.......................................................
...................................
.........................................…….
................................…….2
2
<.0. Sirhohmi.................................
...............................................................
.........................................................
............................................................................0 
.................................................0

<.0.1. Eoasicieasi FIS…………………………………………………………………

FIS………………………………………………………………….0
.0
<.0.<. Nhrchohmi FIS ………………………………………………………………....
………………………………………………………………....0
0
<.0.2. Rieous \gpoieasi FIS …………………………..……………………………….
…………………………..……………………………….7
7
<.7 Praksn
Praksnisi..................................
isi..............................................................................
.....................................................................................
.............................................................3
....................3
<.3 Zathmgkg
Zathmgkgsis
sis `ak Zathcisihohmis .................................................................
.......................................................................................................
........................................6
..6

<.=. Mgdaoa `ak @iamkhsis.....................................

...................................................................................................................1< 
..............................................................................1<
<.=.1. Mgdaoa FIS.....................................
............................................................
..............................................................................1< 
.......................................................1<

<.=.<. @iamkhsis FIS..............................

........................................................
...............................................................................12 
.....................................................12

<.=.<.1. Ehksgoikm FIS ...........................................................................................12 

<.=.<.< Pgs @iamkhsis FIS ......................................................................................12 
<.6. Pataoaesaka....................................
...................................................................
...............................................................................................<: 
...............................................................<:
<.6.1 Ik`ieasi Ngnuoai A\P.................................................
A\P...........................................................................................
...................................................<1
.........<1
<.6.< Zgnaktauak
Zgnaktauak pa`a H@FA yakm Lgoun
Lgoun Ngk`apat A\P ................................................<<
................................................<<
<.6.2 Zioifak pak`uak A\P oiki pgrtana....................................
pgrtana................................................................
..............................................<2
..................<2

<.6.0 Zgnaktauak
Zgnaktauak Rgtgoaf
Rgtgoaf Zgnlgriak A\S..............................................................................<2
A\S..............................................................................<2
<.6.7 Zgnaktauak tgrfa`ap gcge sanpikm A\S `ak sulstitusi A\S...................................
A\S.. .....................................<0
....<0
<.6.3 @iamkhsis
@iamkhsis egmamaoak
egmamaoak tgrapi A\S...........................................................
A\S.....................................................................................<7
..........................<7
<.6.= Za`uak A\S oiki eg`ua pa`a rgnada `ak `gwasa...........................................................<3 
`gwasa...........................................................<3
<.6.6 Za`uak A\P Oiki Egtima.................................
Egtima.............................................................................
................................................................<=
....................<=
<.6.9 Zgkbgm
Zgkbgmafak
afak pasba padakak (ZZZ) ...................................................
...................................................................................<=
................................<=
<.9. Ikcgesi Hphrtukis pa`a Zasigk FIS/AI@R ...............................................................................<6 

LAL III EGRINZWOA

EGRINZWOAK
K .................................................................
......................................................................................................................
......................................................21
.21
@ACPA\
@ACPA\ ZWRPAE
ZWRPAEA
A ...............................................
............................................................................
.......................................................
...............................................2<
.....................2<

ii 
 

LAL 1

ZGK@AFWOWAK

1.1. Oatar Lgoaeakm

FIS ( Funak
 Funak Innukh`gcibigkby
Innukh`gcibigkby Sirus)
Sirus) a`aoaf virus yakm tgrnasue canioi rgtrhviri`ag
yakm `apat ngkmikcgesi sgo oinchsit `ak ngkyglaleak pgkurukak egeglaoak tuluf.
Rgngktara itu, AI@R ( Abquirg` Innukg @gcibigkby Ryk`rhng)
Ryk`rhng) sgk`iri `i`gcikisieak sglamai
eunpuoak mgdaoa atau pgkyaeit yakm `isglaleak hogf pgkurukak egeglaoak tuluf aeilat
ikcgesi FIS.1

<
Easus AI@R pgrtana eaoi `itgnueak `i Angriea Rgrieat pa`a tafuk 1961.  
Rg`akmeak `i Ik`hkgsia AI@R pgrtana eaoi `ioaphreak sgbara rgsni hogf @gpartgngk
Egsgfatak pa`a tafuk 196= `i Zrhviksi Laoi. 1 @i sgouruf `ukia tgr`apat 27 duta hrakm yakm
2
ngk`grita FIS `ak 19 duta hrakm `iaktarakya ti`ae ngkmgtafui ehk`isi tgrsglut.  @i eawasak

Asia Zasicie `ioaphreak tgr`apat 27:.::: hrakm yakm ngk`grita FIS `ak sgeitar 30% yakm
tgrikcgesi a`aoaf oaei-oaei. 0 Za`a tafuk <:1=, tgr`apat 06.2:: easus FIS phsitic `i Ik`hkgsia
`ak 9.<6: hrakm `iaktarakya tgoaf ngnasuei tafap aefir `ari ikcgesi tgrsglut yaitu AI@R. 7 

Zgkyaeit iki `apat `ituoareak ngoaoui lgrlamai bairak tuluf. Hrakm-hrakm yakm
 lgrgsieh tikmmi tgregka pgkyaeit iki a`aoaf pgkmmuka karehtiea `gkmak darun suktie sgbara
 lgrmaktiak, pgegrda sges ehngrsiao, pgkgrina `hkhr `araf `ari hrakm yakm
yakm tgrikcgesi, `ak layi
<
`gkmak ilu yakm tgrikcgesi FIS.  

Pikmmikya dunoaf pgk`grita pgkyaeit iki sgrta lakyaekya hrakm yakm lgrgsieh

tgrpapar ngkda`ieak FIS/AI@R sglamai saoaf satu pgkyaeit ikcgesi yakm farus tgrus
`ipgoadari. Pgs `iamkhstie FIS, upaya pgkbgmafak `ak pgkmhlatak sgrta g`ueasi pa`a
nasyaraeat awan tgktakm pgkyaeit iki ngkda`i pgktikm uktue `iegtafui amar ngnikinaoisir
rgsieh pgkuoarak. Raat iki, laie pgngriktaf Ik`hkgsia naupuk `ukia sg`akm tgrus
ngkmgnlakmeak bara paoikm gcgetic uktue ngkmfanlat pgkyglarak pgkyaeit sgrta
ngkikmeateak egsgnlufak pasigk `gkmak bara ngkmeanpakygeak pgkmmukaak aoat
1
ehktrasgpsi sgrta pgkmhlatak ngkmmukaeak
ngkmmukaeak A\S.

1 
 

LAL <

PIKDAWAK ZWRPAEA

<.1. @gcikisi

FIS ( Funak
 Funak Innukh`gcibigkby Sirus)
Sirus) a`aoaf virus yakm ngkygrakm sgo oinchsit
sgfikmma ngkurukeak egeglaoak tuluf tgrfa`ap pgkyaeit. Rgngktara AI@R ( Abquirg`
( Abquirg`
 Innukg @gcibigkby Ryk`rhng)
Ryk`rhng) `i`gcikisieak sglamai tafap aefir `ari ikcgesi FIS yakm
`itak`ai `gkmak lgrlamai mgdaoa atau pgkyaeit yakm tinluo aeilat pgkurukak egeglaoak
tuluf.1

<.<. Gpi`gnihohmi

Zhpuoasi tgrikcgesi FIS tgrlgsar `i `ukia a`aoaf `i lgkua Acriea (<7,= duta hrakm),
egnu`iak `i Asia Pgkmmara (2,6 duta), `ak `i Angriea (2,7 duta). Rg`akmeak yakm tgrgk`af
a`a `i Zasicie Larat sglakyae 1,9 duta hrakm. Pikmmikya
Pikmmikya phpuoasi hrakm tgrikcgesi FIS `i Asia
Asi a
Pgkmmara ngkmfaruseak Ik`hkgsia uktue oglif waspa`a tgrfa`ap pgkyglarak `ak pgkuoarak
virus iki.

Manlar <.1 Rglarak FIS sgbara Mohlao

Runlgr4 Wkitg` Katihks Zrhmranng hk FIS ak` AI@R (WKAI@R), <:19  

Ngseipuk bgk`grukm couetuatic, `ata easus FIS AI@R `i Ik`hkgsia tgrus ngkikmeat
`ari tafuk eg tafuk. Rgoana sglgoas tafuk tgraefir dunoaf easus FIS `i Ik`hkgsia ngkbapai
 pukbaekya pa`a tafuk <:19, yai
yaitu
tu sglakyae 7:.<6< easus. Lgr`asareak `ata ]FH tafuk
<:19, tgr`apat =6% ikcgesi FIS laru `i rgmihkao Asia Zasicie. Wktue easus AI@R tgrtikmmi
9

sgoana sglgoas tafuk

t afuk tgraefir pa`a tafuk <:12, yaitu 1<.<10 easus.

< 
 

Za`a tafuk <:19 oina prhviksi `gkmak dunoaf easus FIS tgrlakyae a`aoaf Dawa
Pinur, @EI Daearta, Dawa Larat, Dawa Pgkmaf, `ak Zapua. Zrhviksi `gkmak dunoaf easus
AI@R tgrlakyae a`aoaf Dawa Pgkmaf, Zapua, Dawa Pinur, @EI Daearta, `ak Egpuoauak \iau.
Easus AI@R `i Dawa Pgkmaf a`aoaf sgeitar <<% `ari thtao easus `i Ik`hkgsia. Prgk easus
FIS `ak AI@R tgrtikmmi `ari tafuk <:1= sanpai `gkmak <:19 nasif sana, yaitu sglamiak

 lgsar `i puoau Dawa.

Manlar <.< Mracie FIS `ak AI@R `i Ik`hkgsia

Runlgr4 @itdgk Z<Z (Ristgn Ikchrnasi FIS/AI@R `ak INR (RIFA), Oaphrak Pafuk <:19

Manlar <.2 @istrilusi Zgk`grita FIS Laru

Lgr`asareak Zhpuoasi Lgrisieh Rgbara Mohlao  

Runlgr4 Wkitg` Katihks Zrhmranng hk FIS ak` AI@R (WKAI@R), <:19  

<.2. Gtihohmi

Zgkyglal AI@R a`aoaf ikcgesi FIS. Sirus iki tgrnasue eg `aoan canioi rgtrhviri`ag
`ak sulcanioi ogktivirus. Pgr`apat < tipg FIS yakm `iegtafui yaitu FIS-1 `ak FIS <.
Zgrlg`aakkya pa`a moiehprhtgik eapsuo.  

2 
 

<.0. Sirhohmi

FIS tgrnasue `aoan canioi funak rgtrhvirusgs (rgtrhviri`ag

rgtrhviri`ag)) `ak sulcanioi
ogktivirusgs.. Sirus iki `imhohkmeak `aoan canioi rgtrhviri`ag eargka `apat ngkmulaf \KA
ogktivirusgs
virus ngkda`i @KA ngkmmukaeak gkzin rgvgrsg traksbriptasg sgfikmma @KA virus tgrsglut
`apat lgrmalukm `gkmak @KA fhst `gkmak laktuak gkzin iktgmrasg. Pgr`apat 0 dgkis virus
yakm tgrmhohkm `aoan sulcanioi ogktivirus yakm `apat ngkyglaleak ikcgesi pa`a nakusia
yaitu Funak
yaitu  Funak P-Oynpfhtrhpib virusgs (FPOS-1 `ak FPOS-<) yakm lgrsicat hkehmgkie sgrta
1,<
 Funak Innukh`gcibigkby Sirusgs
Sirusgs (FIS-1 `ak FIS-<) yakm lgrsicat khk-hkehmgkie.  

<.0.1. Eoasicieasi FIS

Pgr`apat < dgkis virus FIS yakm `ilami lgr`asareak pgrlg`aak rakmeaiak
kueoghti`a pa`a nasikm-nasikm virus yaitu FIS-1 `ak FIS-<. Raat iki, FIS oglif
 1,<
sgrikm `isglaleak hogf dgkis virus FIS-1.  

FIS-1 `ilami eg`aoan 2 egohnphe yaitu Nadhr (N), Hutoikgr (H), khk-N `ak
khk-H (K). Egohnphe yakm paoikm sgrikm ngkyglaleak ikcgesi FIS a`aoaf egohnphe
N, naea `ari itu `ioaeueak pgnlamiak sultypg uktue ngkmgtafui pgkyglarak, sicat,
`ak earaetgristie virus muka egpgktikmak `iamkhsis `ak pgkmhlatak. Rultypg
egohnphe N tgr`iri `ari 9 sultipg yaitu A-E. Rgngktara itu sultypg uktue dgkis virus
FIS-< fakya a`a < yaitu A `ak L. 1

<.0.<. Nhrchohmi
Nhrchohmi FIS

FIS ngrupaeak dgkis virus \KA yakm lgr`iangtgr 1::-1<: kn. Pgr`apat `ua

ehnphkgk pgktikm pa`a virus iki yaitu eapsuo `ak ikti virus. Eapsuo tgr`iri `ari `ua
oapis chschoipi` `ak moiehpgpti`a, sgngktara ikti virus tgr`iri `ari mgkhn virus yakm
ngkmatur lgrlamai aetivitas virus sgpgrti pgnlgktueak prhtgik, `aya ikcgesi, sgrta
rgpoieasi virus.1

0 
 

Manlar <.0. Rtruetur FIS-1

 Iktgrkao Ng`ibikg (<:tf g`.)

Runlgr4 Caubi AR., gt. ao. <:10. Farrishk’s Zrikbipog hc  Iktgrkao

FIS ngnioiei 2 `hnaik mgkgtie, yaitu mgk mam, pho, `ak gkv. Mgk mam yakm
 lgrcukmsi uktue ngkmeh`g
ngkmeh`g prhtgik aktimgk atau prhtgik eapsi`. Mgk pho lgrcukmsi

uktue ngkmgk`aoieak gkzin yaitu gkzin prhtgasg, rgvgrsg traksbriptasg yakm

 lgrcukmsi uktue ngkmulaf natgri mgkgtie virus yakm sglgounkya a`aoaf \KA
ngkda`i @KA, `ak iktgmrasg uktue
u ktue ngkmmalukmeak @KA prhvirus `gkmak @KA fhst.
Rgngktara itu, mgk gkv lgrcukmsi uktue ngkmeh`g `ak ngkmgk`aoieak < prhtgik
eapsuo, yaitu mp1<: yakm lgrcukmsi uktue lgrieatak `gkmak rgsgpthr pa`a B@0 `ak
mp01 yakm lgrcukmsi uktue ngkmmalukmeak (cusi) ngnlrak virus `ak B@0 sgfikmma
natgri mgkgtie virus `apat nasue eg sgo fhst. 1,< 

<.0.2. Rieous \gpoieasi FIS

Rieous rgpoieasi FIS `iawaoi `gkmak lgrieatakkya prhtgik eapsuo mp1<:

`gkmak rgsgpthr yakm a`a `i pgrnueaak sgo B@0. Rgtgoaf lgrieatak, mp1<: aeak
 lgrulaf lgktue uktue
uktue lgrieatak `gkmak saoaf satu `ari eh-rgsgpthr yakm duma a`a pa`a
 pgrnueaak B@0 yaitu BVB\0 atau BB\7 yakm aeak ngnluat ieatak aktara
a ktara FIS-1
`ak B@0 naeik euat. Rgtgoaf lgrieatak aeak tgrda`i cusi `ari eg`ua ngnlrak sgo yakm
`ipgraktarai hogf prhtgik traksngnlrak mp01. Rgtgoaf eg`ua ngnlrak sgo ngkyatu,
eapsi` virus tgrluea yakm ngkyglaleak \KA, gkzin, `ak prhtgik ( prgiktgmratihk
bhnpogx)) yakm sglgounkya a`a `i ikti sgo virus egouar ngkudu sithpoasna sgo fhst. Fao
bhnpogx
tgrsglut aeak ngkmaeticeak gkzin rgvgrsg traksbriptasg `ak ngkmulaf \KA virus

ngkda`i @KA. Rgtgoaf itu @KA virus aeak ngkyatu `gkmak @KA fhst ngkmmukaeak

7 
 

 laktuak gkzin iktgmrasg sgfikmma tgrlgktue @KA laru yakm ngrupaeak malukmak
aktara natgri mgkgtie virus `ak fhst. <

Manlar <.7. Rieous \gpoieasi FIS

Runlgr4 Caubi AR., gt. ao. <:10. Farrishk’s Zrikbipog hc Iktgrkao Ng`ibikg (<:tf g`.)

Rgtgoaf tgrda`i pgkmmalukmak natgri mgkgtie, virus aeak lgrgpoieasi `i `aoan

sgo fhst, `iawaoi `gkmak prhsgs trakseripsi uktue ngnlgktue natgri mgkgtie virus
 laru lgrupa n\KA atau \KA, sgoakdutkya tgrda`i prhsgs traksoasi yakm lgrtuduak
ngnlgktue prhtgik-prhtgik virus laru.
laru. Rgtgoaf itu, natgri
natgri mgkgtie `ak prhtgik virus
aeak ngkyatu `ak ngkmaeticeak gkzin prhtgasg uktue ngnlgktue virus yakm natur
`ak siap `iriois.<

3 
 

Manlar <.3. Aour \gpoieasi Sirus FIS-1

Runlgr4 Caubi AR., gt. ao. <:10. Farrishk’s Zrikbipog hc Iktgrkao Ng`ibikg (<: tf g`.) (tgoaf `ihoaf
egnlaoi)

Za`a prhsgs rgpoieasi, sistgn inuk tuluf eita sglgkarkya tgraetivasi,

bhkthfkya pa`a saat tgrda`i cusi eg`ua ngnlrak sgo, sgo fhst aeak ngriois P\IN7-α
P\IN7- α 
yakm aeak lgrieatak `gkmak eapsi` virus yakm ngkyglaleak virihk tgr`gmra`asi `ak
ngkmaeticeak rgsphk inuk ikkatg, kanuk sayakmkya ieatak aktara ehnphkgk iki
sakmat ognaf sgfikmma sgrikmeaoi ti`ae `apat ngnibu rgsphk inuk sglamainaka
ngstikya. Rgoakdutkya, sgo fhst duma aeak ngriois AZHLGB2 yakm tgrnasue `aoan
mhohkmak aphprhtgik yakm aeak lgrieatak `gkmak @KA virus `ak ngnibu nutasi
sgfikmma prhsgs ikcgesi ti`ae lgroakdut, kanuk virus ngnioiei prhtgik Sic yakm
ngnibu `gmra`asi `ari AZHLGB2.<

<.7. Praksnisi Sirus

Zgkyglarak virus FIS paoikm lakyae `isglaleak hogf fulukmak sgesuao, laie
fgtgrhsgesuao naupuk fhnhsgesuao eargka virus iki tgr`apat pa`a bairak sgnikao, saat tgrda`i
ikcoanasi pa`a `agraf mgkitao, ehksgktrasi oinchsit `ak nhkhsit `aoan bairak sgnikao aeak
 lgrtanlaf sgfikmma rgsieh pgkuoarak sgnaeik lgsar. Fulukmak akhmgkitao oglif rgktak
ngkda`i daour pgkyglarak virus eargka nuehsa akao oglif tipis sgfikmma oglif rgktak tgrda`i
<
trauna nikhr.  

= 
 

Daour pgkyglarak oaikkya a`aoaf ehktae `gkmak `araf pgk`grita bhkthfkya pgkgrina
`hkhr `araf `ari pasigk yakm tgrikcgesi naupuk pgkmmukaak darun suktie sgbara lgrmaktiak.
Daour traksnisi sgoakdutkya a`aoaf pgkuoarak `ari ilu yakm tgrikcgesi eg dakik (iktrapartun5
nuoai `ari tringstgr pgrtana fikmma eg`ua) atau eg layikya (eargka ARI atau eargka prhsgs
ngoafireak) tgrutana diea virao oha`   ilu
ilu ;1::: ehpi/no, kanuk rgsieh pgkuoarak `ari ilu eg

 dakik atau eg layi `apat ngkuruk diea ilu ngkkmhksunsi

ngkkmhksunsi A\S. Lgr`asareak pgkgoitiak,
pgkyglarak virus iki sgoaik yakm tgoaf `isgluteak `iatas. <
 lgoun a`a daour traksnisi oaik uktue pgkyglarak

<.3. Zathmgkgsis `ak Zathcisihohmi

Zgrdaoakak ikcgesi FIS `apat `ilami ngkda`i tima casg yaitu Ikcgesi aeut, ikcgesi
erhkie (asinthnatie `ak sinthnatie), `ak AI@R. @ari egsgourufak easus FIS, 3:-=:%
 lgregnlakm ngkda`i sta`iun AI@R `aoan waetu 1:-11 tafuk (tipieao prhmrgsshr), 1:-<:%
 lgregnlakm ngkda`i AI@R `aoan waetu eurakm `ari 7 tafuk (rapi` prhmrgsshr), sglamiak
egbio 7-17% lgrdaoak sakmat oanlat, nasif lgoun ngkbapai sta`iun AI@R `aoan waetu oglif

`ari 17 tafuk (sohw prhmrgsshr) `ak sgeitar 1% ikcgesi FIS `iegkao sglamai lamiak oaik `ari
sohw prhmrgsshr yakm `isglut ohkm tgrn khk prhmrgsshr (OPKZ).1
Zgrlg`aak prhmrgsivitas ikcgesi FIS `itgktueak hogf dunoaf virus `aoan poasna (virao
oha`), dunoaf oinchsit B@0 `ak rgsphk inuk spgsicie laie sgouogr naupuk funhrao.
Pikmmikya \KA FIS sgtgoaf ngkuruk `ari pukbaekya saat sgrhehkvgrsi `isglut sgrhohmie sgt
 phikt, ngkgktueak prhmkhsis egbgpatak prhmrgsivitas pgky
pgkyaeit.
aeit.
AI@R (sik`rhn inukh`gcisigksi `i`apat) `isglaleak hogf FIS-1 atau FIS-< ( Funak
 Funak
innukh`gcibigkby virus).
virus). Mgkhn rgtrhvirus iki `isak`i `aoan `ua nhogeuo \KA uktai-
tukmmao (RR\KA) yakm kyaris i`gktie. Zrhtgik mp1<: tgr`apat `i sgoulukm virihk (partiego

virus ogkmeap) yakm sinuotak pa`a B@0 `ak rgsgpthr egnheik (BB\7 pa`a awao ikcgesi5
BVB\0 pa`a tafap aefir) ngnlrak sgo pgdanu `ak aoat laktu ngnlrak sgrta gk`hsithsis
virihk (Hrakm `gkmak `gcge BB\7 ununkya tgroik`ukm `ari ikcgesi FIS). Rgoaik sgo B@6,
sgo P B@0 oaf yakm tgrutana `ipgkmarufi ss\KA `itrakseripsieak ngkda`i B@KA hogf
rgvgrsg traksbriptasg `i virihk `ak aefirkya `imalukmeak sglamai `s@KA uktai mak`a
(prhvirus) eg `aoan mgkhn sgo pgdanu (sta`iun oatgk). Aetivasi sgo B@0 (pa`a awitak ikcgesi
`ak tafap oakdut) ngnibu gesprgsi prhvirus. Zrhtgik yakm tgrlgktue
tgr lgktue `ari prhsgs iki, tat `ak rgv
sgrta KCEL `ari prhsgs sgo pgdanu, lgrpgrak `aoan pgnlgktueak virihk laru egnu`iak
ngkmaoani geshsithsis (virgnia). Rgo B@0 nukmeik fakbur sgoana tafap-tafap iki, tgrutana

sgwaetu `isgrakm hogf pgrtafakak inukkya sgk`iri (akti-mp1<:-ImM+ehnpogngk5 pgkmgkaoak

 pgpti`a virus hogf sgo P siththesie). Rgo B@0 yakm ti`ae tgrikcgesi duma `apat nati (aphpthsis

6 
 

ik`gpgk`gkt-FOA) sgfikmma pa`a tafap oakdut tgrda`i `gcisigksi sgo B@0 yakm sgrius.
Zgrulafak `aoan sitheik
sitheik ehksgktrasi ngrusae sgo Pf1
Pf1 `ak sgo P siththesie. Puluf ngkda`i
oglif ti`ae lgr`aya saat tgrpadak eg nierhla oaik yakm liasakya ti`ae lgrlafaya (nisaokya
 danur) `ak sgo tunhr tgrtgktu (sarehna Eaphsi, oinchna) (sgo
(s go B@0 ?7::/uO `araf4 A\B
(AI@R-rgoatg` bhnpogx)5
bhnpogx)5 ?<::/uO4
?<::/uO4 AI@R tafap aefir/sakmat paraf). Nukmeik `ipgroueak

waetu lgrtafuk-tafuk aktara virgnia awao (ea`ar aktimgk p<0 yakm tikmmi, `isgrtai
 pgnlgktueak ImN) fikmma A\B `isgrtai virgnia laru (ti`ae oami a`a ImN), yaitu saat
sgo-s go B@0 ikaetic yakm rgoatic sg`ieit (1:3) (rgrutana `i sisi
 prhvirus lgrtafak fi`up `aoan sgo-sgo
oincg).11

Manlar <.= Zathcisihohmi AI@R

Runlgr 4 Pges `ak Atoas Lgrwarka Zathcisihohmi, siolgrkamo,
siolgr kamo, <:13.
AI@R lgregnlakm sgoana lgrtafuk-tafuk sgdae awao ikcgesi FIS. Zrh`uesi virus
ngkmaeilateak egnatiak sgo-sgo yakm tgrikcgesi, naupuk egnatiak oinchsit yakm ti`ae

9 
 

tgrikcgesi, `gcisigksi inuk, sgrta AI@R sgbara eoikis. Ikcgesi FIS `i`apateak ngoaoui
fulukmak sgesuao, pgkmmukaak darun yakm tgrehktanikasi sgbara lgrmaktiak yakm `imukaeak
hogf pgkmmuka hlat-hlatak iktravgka, trakscusi `araf atau prh`ue `araf yakm tgrikcgesi.
Rgtgoaf ikcgesi, `apat tgrda`i suatu virgnia aeut yakm sikmeat, egtiea virus tgr`gtgesi `i `aoan
`araf, `ak ikakm `apat ngnlgrieak rgsphks sgpgrti pa`a ikcgesi virus rikmak yakm oaik..

Sirus iki ngkmikcgesi sgo P B@0, sgo `gk`ritie, `ak naerhcam pa`a tgnpat nasuekya ngoaoui
gpitgo, `i `aoan hrmak-hrmak oinohi`
oinohi` sgpgrti oincg `ak `i `aoan `araf. Za`a darikmak nuehsa
nuehsa
 pa`a tgnpat nasuekya
nasuekya virus, tinluo lakyae egrusaeak sgo P yakm tgrikcgesi. Hogf eargka
sglamiak lgsar oinchsit `i `aoan tuluf `ak efususkya ngnhri lgra`a `i `aoan darikmak
tgrsglut, aeilat `ari egrusaeak oheao tgrsglut `apat lgrupa suatu makmmuak cukmsi yakm ti`ae
tgroifat `ari eglgra`aak sgo yakm
yakm tgrikcgesi atau pgkurukak sgo P `i `aoan `araf. Rgo
`gk`ritie `apat ngkakmeap virus pa`a saat nasue ngoaoui gpitgo nuehsa `ak ngnlawakya
eg hrmak oinchi` pgricgr, `i naka virus iki ngkmikcgesi sgo P. Pgr`apat sg`ieit hrakm `gkmak
nutasi BB\7 yakm ngkmaeilateak FIS ti`ae `apat nasue eg `aoan sgo P B@0 `apat tgtap

 lglas pgkyaeit lgrtafuk-tafuk sgtgoaf

sgt goaf tgrikcbesi FIS. Zrhvirus yakm tgoaf tgriktgmrasi `apat
tgraetivasi `i `aoan sgo yakm tgrikcgesi, sgpgrti yakm `idgoaseak sglgounkya, lgr`anpae pa`a
 prh`uesi partiego-partiego virus `ak pgkyglarak ikcgesi. Rgoana pgrdaoakak ikcgesi FIS,
sunlgr utana partiego virus yakm ikcgesius a`aoaf sgo P B@0 yakm tgraetivasi, sgo `gk`ritie,
`ak naerhcam yakm ngrupaeak rgsgrvhir ikcgesi.
@gpogsi sgo P B@0 sgtgoaf ikcgesi FIS `isglaleak hogf suatu gcge sithpatie virus,
aeilat `ari prh`uesi partiego virus pa`a sgo tgrikcgesi, sgrta egnatiak sgo-sgo yakm ti`ae
tgrikcgesi. Gesprgsi mgk virus yakm aetic `ak prh`uesi prhtgik `apat ngkmakmmu prhsgs
siktgsis `i sgo P. Hogf eargka itu, sgo P yakm tgrikcgesi ngkmak`ukm virus yakm sg`akm

 lgrgpoieasi `ilukuf `aoan

`aoa n prhsgs iki. Dunoaf sgo P yakm fioakm sgoana pgregnlakmak AI@R
oglif lgsar `ilak`ikmeak `gkmak dunoaf sgo yakm tgrikcgesi, Ngeakisng `ari egfioakmak sgo
P iki nasif suoit `idgoaseak. Raoaf satu egnukmeikakınya a`aoaf sgo P tgrsglut `iaetivasi
sgbara erhkie, nukmeik hogf ikcgesi yakm liasa tgrda`i pa`a pasigk tgrsglut, `ak rakmakmak
tgrus-ngkgrus tgrsglut lgrudukm pa`a aphpthsis.
aphpth sis.
Rgo-sgo tgrikcgesi yakm oaikkya, sgpgrti sgo `gk`ritie `ak naerhcam, duma `apat nati,
ngkmaeilateak egrusaeak hrmak-hrmak oinchi`. Lakyae pgkgoitiak tgoaf ngkukdueak lafwa
`gcisigksi inuk ti`ae fakya lgrasao `ari `gpogsi sgo P, tgtapi duma lgrasao `ari alkhrnaoitas
cukmsihkao sgo oinchsit P `ak sgo inuk oaikkya (sgo `gk`ritie `ak naerhcam). Aeak tgtapi

naeka `ari `gcge cukmsihkao tgrsglut nasif lgoun `ipafani lgtuo, `ak fioakmkya sgo P

1: 
 

(`iieuti pgkurukak dunoaf sgo P B@0 `araf) tgtap ngkda`i ik`ieathr yakm paoikm tgrpgrbaya
uktue prhmrgsivitas pgkyaeit.1<

Manlar <.6. Zathmgkgsis AI@R

Runlgr 4 Inukhohmi `asar Allas, <:13

11 
 

<.=. Mgdaoa `ak @iamkhsis

<.=.1. Mgdaoa FIS

Rglamiak lgsar easus FIS lgrfasio `i `iamkhsis eargka a`akya ikcgesi

1
hphrtukis atau ikcgesi oaik yakm `isglaleak
`isgla leak eargka pgkurukak sistgn inuk tuluf.

Lgrieut a`aoaf talgo mgdaoa eoikis yakm paoikm sgrikm `itgnui pa`a pasigk
pas igk FIS.

Palgo <.1. Mgdaoa Eoikis Ikcgesi FIS

Egoufak Egnukmeikak Zgkyaeit (Ikcg

(Ikcgesi
esi Hphrtukis atau
Egmakasak)
Zgnlgsarak
Zgnlgsarak egogkdar mgtaf lgkikm  Zgrsistgkt mgkgraoizg`
mgkgraoizg` oynpfa`gkhpatfy
Zgkurukak lgrat la`ak yakm ti`ae lisa `idgoaseak ]astikm syk`rhng
Ikcgesi saourak kapas atas lgruoakm Phksioitis, sikusitis, htitis ng`ia, carikmitis
Egoaikak euoit Fgrpgs zhstgr,  papuoar pruritib gruptihk
gruptihk,,
`grnatitis sglhrhie

Egoufak `i rhkmma nuout `ak saourak naeak atas  Akmuoar bfgoitis,

bfgoitis, bak`i`iasis
Egoufak `i mimi mgoimi Mikmivitis, pgrih`hktitis
Ikcgesi danur `i eueu
@iarg erhkie oglif `ari satu luoak Eripthsphri`ihs
Eripthsphri`ihsis
is
@gnan lgregpak
lgregpakdakmak
dakmak WCH
 Kacsu naeak
naeak ngkuruk
Mgdaoa ikcgesi PL paru `ak gestra paru
Ikcgesi lgrat Zkgunhkia, gnpyg
gnpygna,
na, ngkikmitis, ZI@
Egoaikak `araf Akgnia yakm ti`ae dgoas pgkyglalkya,
trhnlhsithpgkia erhkis
Danur paru  Zkgunhkia dirhvgrbii
INR Fgrpgs sinpogx, siciois
Rarehna Eaphsi
Ikcgesi danur sistgnie Fisthpoasnh
Fisthpoasnhsis
sis
Makmmuak pgkmoifatak Ikcgesi sithngmaohv
sithngmaohvirus
irus
Ikcgesi `i iktrabrakiao Ngkikmitis, thxhpoasnhsis, gksgc
gksgcaohpatfy
aohpatfy FIS
Eglas atau egsgnutak pa`a takmak `ak eaei
Egognafak htht

Runlgr4 Riti Rgtiati, gt., ao. <:17. Lueu Adar Ionu Zgkyaeit
Zgkyaeit @aoan (G
(G`isi
`isi 3) (tgoaf `ihoaf egnlaoi).

1< 
 

<.=.<. @iamkhsis FIS

<.=.<.1. Ehksgoikm FIS

Wktue ngkmgtafui status FIS sgsghrakm, naea pasigk farus ngoaoui

tafapak ehksgoikm `ak tgs FIS (EP FIS). Raat iki, `ipgreiraeak sgtgkmaf
H@FA `i sgouruf `ukia ti`ae ngkmgtafui status FIS-kya. Rglaoiekya, ngrgea
yakm tafu sgrikm tgroanlat `ipgriesa. Eurakmkya aesgs ngkyglaleak
 pgkmhlatak `idaoakeak sgtgoaf
sgt goaf pasigk
pas igk su`af ngnasuei sta`iun AI@R. Puduak
ehksgoikm `ak tgs FIS a`aoaf farus nanpu ngkmi`gkticieasi H@FA sg`iki
nukmeik `ak sgmgra ngnlgri aesgs pa`a oayakak pgrawatak, pgkmhlatak `ak
3
 pgkbgmafak.

Ehksgoikm `ak tgs FIS farus ngkmieuti priksip yakm tgoaf `isgpaeati
sgbara mohlao yaitu 7 ehnphkgk `asar yakm `isglut 7B yaitu ikchrng` bhksgkt
yakm lgrarti pasigk ngnlgrieak pgrsgtuduak uktue ngkdaoakeak sgmaoa

 pgngriesaak tgreait FIS5

FIS5 bhkci`gktiaoity yaitu fasio `ak pgrbaeapak sgoana
ehksgoikm `ak tgs aeak `irafasiaeak5
`irafasiaeak5 bhuksgoikm yaitu ehksgohr aeak
ngnlgrieak ikchrnasi yakm dgoas `ak nu`af `ipafani hogf pasigk5
pasigk 5 bhrrgbt
tgst rgsuots yaitu fasio tgst farus aeurat5
aeurat 5 bhkkgbtihks th barg, trgatngkt ak`
 prgvgktihk sgrvibgs 
sgrvibgs  yaitu pasigk farus `irudue eg oayakak pgkbgmafak,
 pgrawatak, `ueukmak
`ueukmak `ak pgkmhlatak FIS yakm `i`ueukm `gkmak sistgn
3
rudueak yakm laie `ak tgrpaktau.

Za`a Akankgsis, pgktikm `itakyaeak caethr risieh FIS pa`a pasigk

yakm ngkmaoani mgdaoa, `iaktarakya pgkmmukaak darun suktie yakm lgrmaktiak
sgrta riwayat fulukmak sgesuao, bhkthfkya lgrfulukmak sgesuao oglif `ari 1
hrakm, pgrkaf lgrfulukmak sgesuao `gkmak pgegrda sges, fhnhsgesuao, pgrkaf
3
 lgrfulukmak
 lgrfulukmak sgesuao takpa pgkmanak.

<.=.<.<. Pgs @iamkhsis FIS

a. Ik`ieasi tgs FIS

Ik`ieasi sgsghrakm farus ngoaeueak tgs FIS, yaitu4

1. Rgtiap hrakm `gwasa, akae, `ak rgnada `gkmak ehk`isi ng`is yakm `i`uma
tgrda`i ikcgesi FIS tgrutana `gkmak riwayat tulgreuo
t ulgreuohsis
hsis `ak INR.

12 
 

<. Asufak aktgkatao pa`a ilu fanio `ak ilu lgrsaoik

2. Oaei-oaei `gwasa yakm ngnikta sireunsisi sglamai tik`aeak pgkbgmafak

FIS.3

Rgngktara itu, layi `ak akae ngngroueak tgs FIS pa`a ehk`isi `i

 lawaf iki4

1. Akae saeit (dgkis pgkyaeit yakm lgrfulukmak `gkmak FIS sgpgrti PL lgrat
atau ngk`apat HAP lgruoakm, naokutrisi, atau pkgunhkia lgruoakm `ak `iarg
erhkis atau lgruoakm)

<. Layi yakm oafir `ari ilu tgrikcgesi FIS `ak su`af ngk`apateak tik`aeak
 pgkbgmafak pgkuoarak `ari ilu
ilu eg akae

2. Wktue ngkmgtafui status layi/akae eak`ukm `ari ilu yakm `i`iamkhsis

tgrikcgesi FIS (pa`a unur lgrapa sada)

0. Wktue ngkmgtafui status sghrakm akae sgtgoaf saoaf satu sau`ara

eak`ukmkya `i`iamkhsis FIS5 atau saoaf satu atau eg`ua hrakmtua ngkikmmao
hogf sglal yakm ti`ae `iegtafui tgtapi nasif nukmeik eargka FIS

7. Pgrpadak atau phtgksiao tgregka ikcgesi FIS ngoaoui darun suktie yakm
tgrehktanikasi, ngkgrina trakscusi lgruoakm `ak sglal oaik

3. Akae yakm ngkmaoani egegrasak sgesuao. 3

Rgsuai `gkmak pgregnlakmak prhmran Rtratgmib Wsg Hc Aktirgtrhvirao ,

naea tgs FIS duma farus `itawareak sgbara rutik
rut ik egpa`a4

1. Zhpuoasi Eukbi (Zgegrda sges, Hrakm yakm ngnioiei pasakmak sges oglif
`ari 1, Fhnhsgesuao, ]aria) `ak `iuoakm nikinao sgtiap 3 luoak sgeaoi

<. Zasakmak H@FA

2. Ilu fanio `i wioayaf gpi`gni ngouas `ak gpi`gni tgrehksgktrasi

0. Zasigk PL

7. Rgnua hrakm yakm lgreukdukm

lgreukdukm eg casyakegs `i `agraf gpi`gni FIS ngouas

10 
 

3. Zasigk INR

=. Zasigk Fgpatitis

6. ]arma Likaak Zgnasyaraeatak

9. Ogoaei Lgrgsieh Pikmmi (OLP) 3 

l. Dgkis-dgkis Pgs @iamkhsis FIS

@iamkhsis FIS `itgmaeeak `gkmak pgngriesaak oalhrathriun. Dgkis

 pgngriesaak oalhrathriun FIS `apat lgrupa4

1. Pgs sgrhohmi

Pgs sgrhohmi tgr`iri atas4

1). Pgs Bgpat (\api` Innukhbfrhnathmrapfy Pgst)

<). Pgs Gkzyng I nnukha

nukhassay
ssay (GIA)

Rgbara unun tuduak pgngriesaak tgs bgpat `ak GIA a`aoaf sana, yaitu
ngk`gtgesi aktilh`i sada (mgkgrasi pgrtana) atau aktimgk `ak aktilh`i
(mgkgrasi egtima `ak eggnpat). Ngth`g wgstgrk loht su`af ti`ae `imukaeak
sglamai stak`ar ehkcirnasi `iamkhsis FIS oami `i Ik`hkgsia. 3,= 

<. Pgs virhohmis Z hoyn

oyng
gr asg B fai
faikk \g
\ gab
abtihk
tihk (ZB\)

Pgs virhohmis `irgehngk`asieak uktue ngk`iamkhsis akae lgrunur  

eurakm `ari 16 luoak. Pgs virhohmis yakm `iakdureak4 FIS @KA   euaoitatic `ari
`araf ogkmeap atau @rig`
atau @rig` Lohh` Rpht (@LR), `ak FIS \KA euaktitatic `gkmak
ngkmmukaeak poasna `araf. Layi yakm  `iegtafui tgrpadak FIS sgdae oafir
`iakdureak uktue `ipgriesa  `gkmak tgs virhohmis paoikm awao pa`a unur 3
nikmmu. Za`a easus   layi `gkmak pgngriesaak virhohmis pgrtana fasiokya
 phsitic, naea tgrapi A\S farus sgmgra `inuoai5 pa`a saat yakm sana `ioaeueak  
 pgkmanlioak sanpgo `araf eg`ua
eg`ua uktue pgngriesaak tgs virhohmist eg`ua. 

17 
 

Pgs virhohmis tgr`iri atas4  

1). FIS @KA euaoitatic (GI@)

Pgs iki ngk`gtgesi eglgra`aak virus `ak ti`ae lgrmaktukm pa`a  

eglgra`aak aktilh`i FIS. Pgs iki `imukaeak uktue `iamkhsis pa`a  layi.
layi. 

<). FIS \KA euaktitatic

Pgs iki uktue ngngriesa dunoaf virus `i `aoan `araf, `ak `apat  
`imukaeak uktue pgnaktauak tgrapi A\S pa`a `gwasa `ak   `iamkhsis pa`a
ti`ae tgrsg`ia. 3
 layi diea FIS @KA ti`ae

Rgoaik `apat `imukaeak pa`a layi `ak `gwasa, pgngriesaak virhohmis

`apat puoa `imukaeak uktue ngk`iamkhsis FIS pa`a easus tgrnikao `gkmak
fasio pgngriesaak aktilh`i kgmatic kanuk mgdaoa eoikis sakmat ngk`ueukm eg
araf AI@R `ak duma uktue ngkmhkcirnasi fasio ikehkeousic atau ehkcirnasi
uktue `ua fasio oalhrathriun yakm lgrlg`a. =

Fasio pgngriesaak FIS `ieataeak phsitic apalioa4

1) Pima fasio pgngriesaak sgrhohmis `gkmak tima ngth`g atau rgamgk

 lgrlg`a ngkukdueak fasio
fasio rgaetic.

3,=
<) Zgngriesaak virhohmis euaktitatic atau euaoitatic
euaoitat ic tgr`gtgesi FIS.

 
b. @iamkhsis FIS pa`a layi lgrunur eurakm `ari 16 luoak

@iamkhsis FIS pa`a layi `apat `ioaeueak `gkmak bara tgs

t gs virhohmis, tgs
aktilh`i, `ak prgsuntic lgr`asareak mgdaoa `ak tak`a eoikis. Za`a layi `ak
akae unur eurakm `ari 16 luoak yakm nasif ngk`apat ARI, prhsg`ur
`iamkhstie awao `ioaeueak takpa pgrou ngkmfgktieak pgnlgriak ARI. Layi
La yi `ak
akae unur usia eurakm `ari 16 luoak tgrpadak FIS yakm tanpae sgfat `ak
 lgoun `ioaeueak
` ioaeueak tgs virhohmis, `iakdureak uktue `ioaeueak tgs sgrhohmis pa`a
unur 9 luoak (saat layi `ak akae ngk`apateak inukisasi `asar tgraefir). Lioa
fasio tgs tgrsglut4

a. \gaetic, farus sgmgra `iieuti `gkmak pgngriesaak tgs virhohmis uktue

ngkmi`gkticieasi easus yakm ngngroueak tgrapi A\S.

13 
 

 l. Khk rgaetic, farus `iuoakm lioa nasif ngk`apateak ARI. Zgngriesaak uoakm
`ioaeueak paoikm bgpat 3 nikmmu
nikmmu sgsu`af layi `ak akae lgrfgkti ngkyusu.

b. Diea tgs sgrhohmis rgaetic `ak tgs virhohmis lgoun tgrsg`ia, pgrou `ioaeueak
luoak. 3
 pgnaktauak eoikis egtat `ak tgs sgrhohmis `iuoakm pa`a usia 16 luoak.

Layi `ak akae unur eurakm `ari 16 luoak `gkmak mgdaoa `ak tak`a
`i`uma `isglaleak hogf ikcgesi FIS farus ngkdaoaki tgs sgrhohmis `ak diea
fasio tgs tgrsglut4

a. \gaetic, `iieuti `gkmak tgs virhohmis.

 l. Khk rgaetic, tgtap

tgt ap farus `iuoakm `gkmak pgngriesaak tgs sgrhohmis pa`a usia
3
16 luoak.

@iamkhsis FIS pa`a layi lgrunur eurakm `ari 16 luoak, i`gaokya `ioaeueak
 pgkmuoakmak udi virhohmis
virhohmis FIS pa`a spgsingk yakm lgrlg`a
lgrlg`a uktue ikchrnasi ehkcirnasi fasio
lawaf iki.3  
 phsitic yakm pgrtana sglamainaka lamak `i lawaf

Manlar <.0. Aour @iamkhsis Layi

Layi ? 16 luoak

Runlgr4 Egng
Egngktriak
ktriak Egsgfatak \I. <:17. Zgratur
Zgraturak
ak ngktgri egsgfatak \I khnhr 6=
tafuk <:10 tgktakm pg`hnak
p g`hnak pgkmhlatak akti rgtrhvirao.
rgtrhvirao.

1= 
 

Za`a layi `ak akae unur eurakm `ari 16 luoak yakm saeit `ak `i`uma
`isglaleak hogf ikcgesi FIS tgtapi tgs virhohmis ti`ae `apat `ioaeueak,
`iamkhsis `itgmaeeak ngkmm
ngkmmukaeak
ukaeak `iamkhsis prgsuntic .

Palgo <.<. @iamkhsis FIS prgsuntic pa`a layi `ak akae unur eurakm
3,=
`ari 16 luoak.  

Lioa a`a 1 eritgria lgrieut Atau Nikinao < mgdaoa lgrieut

   Zkgunhkia Zkgunhby
Zk gunhbystis
stis    Hrao tfrusf
(ZBZ), ngkikmitis, (Eak`i`iasis hrao)
eriptheheus, eak`i`iasis    Zkgunhkia lgrat
gshpfamus    Rgpsis lgrat
   Pheshpoasnhsis    Egnatiak ilu
   Naokutrisi lgrat yakm yakm lgreaitak
ti`ae ngnlaie `gkmak `gkmak FIS atau
 pgkmhlatak stak`ar  pgkyaeit FIS
yakm oakdut pa`a
ilu
   Dunoaf pgrsgktasg
B@0 ? <:%

Runlgr4 Egng
Egngktriak
ktriak Egsgfatak \I. <:17. Zgratur
Zgraturak
ak ngktgri egsgfatak \I khnhr 6=
tafuk <:10 tgktakm pg`hnak
p g`hnak pgkmhlatak akti rgtrhvirao.

`. @iamkhsis FIS pa`a Akae ; 16 luoak, \gnada, `ak @gwasa

Pgs uktue `iamkhsis FIS `ioaeueak `gkmak tgs aktilh`y ngkmmukaeak

stratgmi III (pgngriesaak `gkmak ngkmmukaeak 2 dgkis tgs aktilh`i yakm

 lgrlg`a sgksitivitas `ak spgsivisitaskya).3,=,6

Egputusak eoikis `ari fasio pgngriesaak akti FIS `apat lgrupa phsitic,
kgmatic, `ak ik`gtgrnikatg. Lgrieut a`aoaf iktgrprgtasi fasio `ak tik`ae oakdut
yakm pgrou `ioaeueak. 3,=,6

Palgo <.2. Eritgria iktgrprgtasi tgs akti-FIS `ak tik`ae oakdutkya

Fasio tgs Eritgria Pik`ae Oakdut

Zhsitic Lioa fasio A1 rgaetic, A< rgaetic `ak A2 \udue eg Zgkmhlatak FIS
rgaetic
 Kgmatic 
  Lioa fasio A1 khk rgaetic 
  Lioa ti`ae ngnioiei pgrioaeu lgrisieh,

16 
 

 
 Lioa fasio A1 rgaetic tapi pa`a `iakdureak pgrioaeu fi`up sgfat
 pgkmuoakmak A1 `ak A< khk-  
 Lioa lgrisieh, `iakdureak pgngriesaak
rgaetic uoakm nikinun 2 luoak, 3 luoak `ak 1<
 
 Lioa saoaf satu rgaetic tapi ti`ae  luoak `ari pgngriesaak
pgngriesaak pgrtana
 lgrisieh
 Ik`gtgrnikatg  
 Lioa `ua fasio tgs rgaetic  
 Pgs pgrou `iuoakm `gkmak spgsingk laru

  Lioa fakya 1 tgs rgaetic
r gaetic tapi nikinao sgtgoaf `ua nikmmu `ari
ngnpukyai risieh atau  pgngriesaak yakm
yakm pgrtana.
 pasakmak lgrisieh  
 Lioa fasio tgtap ik`gtgrnikatg, `ioakduteak
`gkmak pgngriesaak ZB\.
 
 Lioa saraka pgngriesaak ZB\ ti`ae
ngnukmeikeak, rapi` tgs `iuoakm 2 luoak,
3 luoak, `ak 1< luoak `ari pgngriesaak
yakm pgrtana. Lioa sanpai satu tafuk
fasio tgtap ‟ik`gtgrnikatg„ `ak caethr
risieh rgk`af, fasio `apat `ikyataeak
sglamai kgmatic

Runlgr4 Egng
Egngktriak
ktriak Egsgfatak \I. <:17. Zgratur
Zgraturak
ak ngktgri egsgfatak \I khnhr 6=
tafuk <:10 tgktakm pg`hnak
p g`hnak pgkmhlatak akti rgtrhvirao.
rgtrhvirao.

19 
 

Manlar <.7. Aour @iamkhsis Akae ; 16 luoak, \gnada, `ak @gwasa

Runlgr4 Egng
Egngktriak
ktriak Egsgfatak \I. <:17. Zgratur
Zgraturak
ak ngktgri egsgfatak \I khnhr 6= tafuk <:10
r gtrhvirao. 
tgktakm pg`hnak pgkmhlatak akti rgtrhvirao.

<.6. Pataoaesaka

Manlar <.9. Aour tataoaesaka FIS `i casyakegs

Zriksip pgnlgriak A\S a`aoaf farus ngkmmukaeak 2 dgkis hlat yakm egtimakya farus

tgrsgrap `ak lgra`a `aoan `hsis tgrapgutie `aoan `araf, `iegkao `gkmak fimfoy abtivg
aktirgtrhvirao tfgrapy (FAA\P) atau Aktirgtrhvirao
Aktirgtrhvirao (A\S). Zgngriktaf ngkgtapeak
ngkgtapeak pa`uak
pa`uak
yakm `imukaeak `aoan pgkmhlatak A\S `gkmak lgr`asareak pa`a 7 aspge yaitu gcgetivitas,
gcge sanpikm/thesisitas, iktgraesi hlat, egpatufak, `ak farma hlat.

Ehksgoikm tgrapi yakm ngna`ai sakmat pgktikm uktue tgrapi sgunur fi`up `ak
eglgrfasioak tgrapi dakmea pakdakm. Isi `ari ehksgoikm tgrapi iki
iki tgrnasue4 egpatufak nikun
nikun
hlat, phtgksi/egnukmeikak risieh gcge sanpikm atau gcge yakm ti`ae `ifarapeak atau
tgrda`ikya sik`rhn puoif inuk (Innukg \gbhkstitutihk Ikcoannathry Ryk`rhng/I\IR)
sgtgoaf ngnuoai tgrapi A\S, tgrutana pa`a H@FA `gkmak sta`iun eoikis oakdut atau dunoaf
 dunoaf B@0.

<: 
 

Za`a akae `gkmak FIS, pgrou `ioaeueak eadiak efusus uktue egsiapak tgrapi A\S, `i
aktarakya4

1. Eadi situasi egouarma tgrnasue dunoaf hrakm yakm tgregka atau lgrisieh tgrikcgesi
FIS `ak situasi egsgfatakkya.

<. I`gkticieasi hrakm yakm ngkmasuf akae `ak egsg`iaakkya uktue ngnatufi
 pgkmhlatak A\S
A\S `ak pgnaktauakkya.

2. Eadi pgnafanak egouarma ngkmgkai ikcgesi FIS `ak pgkmhlatakkya sgrta

ikchrnasi ngkmgkai status ikcgesi FIS `aoan egouarma.

0. Eadi status gehkhni, tgrnasue egnanpuak uktue ngnliayai pgrdaoakak eg eoikie,

egnanpuak ngnlgoi atau ngkyg`iaeak tanlafak naeakak uktue akae yakm saeit
`ak egnanpuak ngnlayar lioa a`a pgkyaeit yakm oaik.

Palgo <.0. \gehngk`asi tgs oalhrathriun uktue pgrsiapak ikisiasi A\P

Casg nakadgngk FIS \gehngk`asi Wtana \gehngk`asi oaik (lioa a`a)

Rgtgoaf `iamkhsis FIS Dunoaf B@0 FLsAm
Rerikikm PL Akti-FBS
Aktimgk eriptheheus diea
 dunoaf B@0 ≠ 1:: sgo/nn2
sgo/nn2  
Rerikikm ikcgesi ngkuoar
sgesuao Zgngriesaak pgkyaeit
khk ehnukiealgo erhkie `ak
ehnhrli`

Choohw-up sglgoun A\S Dunoaf sgo B@0

Ikisiasi A\S Dunoaf sgo B@0 Rgrun ergatikik `ak/atau

gMC\, `ipstie urik uktue
 pgkmmukaak P@C
Fgnhmohlik RMZP uktue
 pgkmmukaak KSZ

<.6.1 Ik`ieasi Ngnuoai A\P

Ikisiasi A\P sgbara `iki tgrlueti lgrnakcaat sgbara eoikis, lgrmuka uktue pgkbgmafak,
ngkikmeateak farapak fi`up `ak ngkurukeak iksi`gk ikcgesi tgreait
tgrea it FIS `aoan phpuoasi.

Palgo <.7. \gehngk`asi Ikisiasi A\P pa`a @gwasa `ak Akae ; 7 tafuk
t afuk
Zhpuoasi \gehngk`asi
@gwasa `ak akae ; 7 ta
tafuk
fuk Ikisiasi A
A\P
\P pa`a h
hrakm
rakm tgr
tgrikcgesi
ikcgesi FIS sta`iun eo
eoikis
ikis 2 `ak 0, atau
 diea dunoaf B@0 ≠ 27: sgo/nn
sgo/nn
Ikisiasi A\P takpa ngoifat sta`iun eoikis ]FH `ak lgrapapuk

<1 
 

 dunoaf B@0
• Ehikcgesi PL*
• Ehikcgesi Fgpatitis L
• Ilu fanio `ak ngkyusui tgrikcgesi FIS
• Hrakm tgrikcgesi FIS yakm pasakmakkya FIS kgmatic (pasakmak
sgrh`isehr`ak), uktue ngkmurakmi risieh pgkuoarak
• ORO, ZR, ]aria, atau Zgkasuk
• Zhpuoasi unun pa`a `agraf `gkmak gpi`gni FIS ngouas

Akae ? 7 tafuk Ikisiasi A\P takpa ngoifat sta`iun eoikis ]FH `ak lgrapapuk
 dunoaf B@0

Egtgrakmak 4
*Zgkmhlatak PL farus `inuoai oglif `afuou, egnu`iak hlat A\S `ilgrieak `aoan <-
6 nikmmu sgdae nuoai hlat PL, takpa ngkmfgktieak tgrapi PL. Za`a H@FA `gkmak
B@0 ?7: sgo/nn2, A\S farus `inuoai `aoan < nikmmu sgtgoaf nuoai pgkmhlatak
PL. Wktue H@FA `gkmak ngkikmitis eriptheheus, A\S `inuoai sgtgoaf 7 nikmmu
eriptheheus 
 pgkmhlatak eriptheheus

<.6.< Zgnaktauak pa`a H@FA yakm Lgoun Ngk`apat A\P

H@FA yakm lgoun ngngkufi syarat uktue ngk`apat tgrapi A\S pgrou `inhkithr

 pgrdaoakak eoikis pgkyaeit

pg kyaeit `ak
`a k dunoaf B@0-kya sgtiap 3 luoak sgeaoi,
sgeao i, at
atau
au oglif sgrikm
sgr ikm pa`a
akae `ak layi yakm oglif nu`a. Gvaouasi eoikis ngoiputi parangtgr sgpgrti pa`a gvaouasi awao
tgrnasue pgnaktauak lgrat la`ak `ak nukbuokya tak`a `ak mgdaoa eoikis pgregnlakmak
ikcgesi FIS. Za`a akae, duma `ioaeueak pgnaktauak tunluf egnlakm `ak pgnlgriak oayakak
rutik oaikkya, sgpgrti inukisasi. Zarangtgr eoikis `ak B@0 iki `imukaeak uktue ngkbatat
 pgregnlakmak sta`iun
st a`iun eoikis
e oikis ]FH pa`a
pa` a sgtiap eukdukmak `ak
`a k ngkgktueak apaeaf H@FA
nuoai ngngkufi syarat uktue pgkmhlatak pgkbgmafak ehtrinhesazho (ZZE) `ak/atau A\S.
Gvaouasi eoikis `ak dunoaf B@0 pgrou `ioaeueak oglif egtat egtiea nuoai ngk`geati anlakm
`ak syarat uktue ngnuoai A\P.

<.6.2 Zioifak Zak`uak A\P Oiki Zgrtana

Zioifak pak`uak A\P oiki pgrtana lgrieut iki lgroaeu uktue H@FA yakm lgoun
 pgrkaf ngk`apateak A\S
A\S sglgounkya (kaivg A\S).

Palgo <.3. A\P oiki pgrtana uktue akae usia 7 tafuk eg atas `ak `gwasa  

A\S oiki pgrtana uktue `gwasa 

Za`uak pioifak P@Ca + 2PB (atau CPB) + GCS `aoan lgktue E@P
Za`uak aotgrkatic ATPl + 2PB + GCS (atau KSZ)
P@Ca + 2PB (atau CPB) + KSZ

<< 
 

Egtgrakmak4 Dakmak ngnuoai P@C diea brgatikg bogarakbg tgst (BBP) fitukm ? 7: no/ngkit,
atau pa`a easus `ialgtgs oana, fipgrtgksi tae tgrehktrho `ak mamao mikdao, Dakmak ngnuoai
`gkmak ATP diea Fl ? 1: m/`O sglgoun tgrapi, Ehnlikasi 2 `hsis tgtap
tgt ap (E@P) yakm tgrsg`ia4
P@C + 2PB + GCS.

Za`uak A\P oiki pgrtana pa`a akae sana sgpgrti hrakm `gwasa, yaitu ngkmmukaeak
ehnlikasi < K\PI `ak 1 KK\PI `gkmak pioifak
pioifak sgpgrti pa`a talgo <.=. 

Palgo <.=. A\P oiki pgrtana pa`a akae ?7 tafuk

K\PI eg-1 Zioifak K\PI eg-< Zioifak KK\PI

Ti`hvu`ik (ATP) a Oanivu`ik
Oanivu` ik (2PB) Kgvirapik (KSZ)
Rtavu`ik (`0P) l Gcavirgkz (GCS)`
Pgkhchvir (P@C) b

Egtgrakmak 4 Ti`hvu`ik (ATP) ngrupaeak pioifak utana. Kanuk lioa Fl akae ? =,7 m/`o
naea `ipgrtinlakmeak pgnlgriak Rtavu`ik(`0P). pgrtinlakmeak ngkmulaf `0P eg ATP
(lioa Fl akae ; 1: mr/`o) sgtgoaf pgnaeaiak 3  ‒  1<
 1< luoak. Lioa tgr`apat gcge akgnia lgruoakm
naea `apat egnlaoi eg `0P. Pgkhchvir saat iki `apat `imukaeak pa`a akae usia `i atas <
tafuk. GCS `apat `imukaeak  pa`a akae ≧ 2 tafuk atau LL ≧ 1: em, dakmak `ilgr ieak
`ilgr ieak pa`a
akae `gkmak makmmuak psieiatrie lgrat. GCS a`aoaf pioifak pa`a akae `gkmak PL. Diea lgrat
 la`ak akae ngnukmeikeak,
ngnukmeikeak, sglaiekya mukaeak
mukaeak E@P.

<.6.0 Zgnaktauak Rgtgoaf Zgnlgriak A\S

Zgnaktauak sgtgoaf pgnlgriak A\S lgrtuduak uktue ngkmgvaouasi rgsphks

 pgkmhlatak. Gvaouasi H@FA sgoana `aoan pgkmhlatak `ioaeueak lgrsana-sana aktara
`hetgr, pgrawat, `ak ehksgohr. Gvaouasi ti`ae fakya `ioaeueak uktue ehk`isi cisie, kanuk
 duma psiehohmis, uktue ngnlaktu H@FA `ak egouarmakya sgoana ngkdaoaki pgkmhlatak.
Da`wao Zgnaktauak Rgtgoaf Zgnlgriak A\S Zgkioaiak eoikis `ak tgs oalhrathriun lgrpgrak
 pgktikm uktue ngoifat ehk`isi H@FA sglgoun ikisiasi A\P `ak lgrmuka uktue ngnhki
ngnhkithr
thr
rgsphks pgkmhlatak `ak egnukmeikak thesisitas hlat A\S. Zgnaktauak eoikis `aoan
 pgkmawasak `hetgr `ioaeueak rutik nikinao sgluoak sgeaoi `aoan 3 luoak pgrtana sgtgoaf
ikisiasi A\P. Zgnaktauak hogf `hetgr sgoakdutkya `apat `ioaeueak nikinao 2 luoak sgeaoi
atau oglif sgrikm, sgsuai
sgsua i `gkmak ehk`isi `ak egpatufak pgkmhlatak.

Palgo <.6 \gehngk`asi tgs oalhrathriun sgtgoaf pgnlgriak tgrapi A\S

Casg Zgkataoaesakaak \gehngk`asi Yakm `ipgroueak

FIS (lioa a`a atau atas ik`ieasi)

Rgoana ngkmmukaeak Dunoaf Rgo B@0 (tiap 3 luoak) -  Rgrun ergatikik tiap 3 luoak

<2 
 

A\S pa`a pgkmmukaak P@C Fl pa`a

 pgkmmukaak ATP (`aoan 2
 luoak pgrtana pgrou
 pgngriesaak
 pgngriesaak iktgksic)
-  Cukmsi fati (RMHP/RMZP) tiap
3 luoak
-  FIS \KA 3 luoak sgtgoaf
ikisiasi A\S
Mamao Pgrapi Dunoaf sgo B@0 -  FIS \KAl
-  FLsAm (lioa sglgoun switbf
 lgoun pgrkaf `i tgs, atau diea
fasio lasgoikg sglgounkya
kgmativg.)

Egtgrakmak 4  Za`a H@FA `gkmak egpatufak `ak fasio pgkmhlatak A\S yakm laie, crgeugksi
 pgn
 pgnaktauak
aktauak B@0
ngkgktueak `ak FIS
egmamaoak \KA
\K A `apat `ieurakmi. Pgs FIS \KA (virao oha`) sakmat `iakdureak uktue
tgrapi

<.6.7 Zgnaktauak tgrfa`ap gcge sanpikm A\S `ak sulstitusi A\S

Raat iki pa`uak A\P yakm `iakdureak (E@P) `aoan oiki pgrtana ngnpukyai gcge
sanpikm nikinao (darakm tgrda`i), eurakm thesie `ak sg`grfaka (sgeaoi sgfari), sgfikmma aeak
ngkikmeateak egpatufak pgkmhlatak. Gcge sanpikm (thesisitas) A\S `apat tgrda`i `aoan
 lglgrapa nikmmu pgrtana sgtgoaf ikisiasi fikmma thesisitas pa`a pgnaeaiak oana.
Eglakyaeak rgaesi thesisitas A\S ti`ae lgrat `ak `apat `iatasi `gkmak ngnlgri tgrapi
suphrtic. Gcge sanpikm nikhr `apat ngkyglaleak H@FA ti`ae
t i`ae patuf nikun hlat, eargkakya

tgkama egsgfatak farus tgrus ngkmehksgoikm H@FA `ak ngk`ueukm tgrapi. Zriksip
sanpikm aeilat A\S a`aoaf sglamai lgrieut43
 pgkakmakak gcge sanpikm

a. Pgktueak lgratkya thesisitas

 l. Gvaouasi hlat yakm `inikun

`inikun lgrsanaak, `ak tgktueak apaeaf thesisi
thesisitas
tas tgrda`i
t grda`i eargka (satu
atau oglif) A\S atau eargka hlat oaikkya

b. Zgrtinlakmeak prhsgs pgkyaeit oaik (sgpgrti fgpatitis virus atau sunlatak lioigr diea tinluo
ietgrus)

`. Pata oaesaka gcge sanpikm lgrmaktukm pa`a lgratkya rgaesi.

<0 
 

Zgkakmakak sgbara unun a`aoaf4

1) @gradat 0, rgaesi yakm ngkmakban diwa4 sgmgra fgktieak sgnua hlat A\S, lgri
tgrapi suphrtic `ak sinthnatis5 lgrieak oami A\S `gkmak pa`uak yakm su`af `inh`icieasi
(bhkthf4 sulstitusi 1 A\S uktue hlat yakm ngkyglaleak
ngkyglaleak th
thesisitas)
esisitas) sgtgoaf H@FA stalio

<) @gradat 2, rgaesi lgrat4 makti hlat yakm `iburimai takpa ngkmfgktieak pgnlgriak
A\S sgbara egsgourufak

2) @gradat <, rgaesi sg`akm4 lglgrapa rgaesi (oiph`istrhci `ak kgurhpati pgricgr)
ngngroueak pgkmmaktiak hlat. Wktue rgaesi oaik, pgrtinlakmeak uktue tgtap ngoakduteak
 pgkmhlatak5 diea ti`ae a`a pgrulafak `gkmak tgrapi sinthnatis, pgrtinlakmeak uktue
ngkmmakti 1 dgkis hlat A\S.

0) @gradat 1, rgaesi rikmak4 ti`ae ngngroueak pgkmmaktiak

pgkmmaktiak tgrapi.

<.6.3 @iamkhsis egmamaoak tgrapi A\S

Egmamaoak tgrapi `apat `ioifat `ari lgrlamai eritgria, yaitu eritgria virhohmis,
inukhohmis, `ak eoikis. Eritgria tgrlaie a`aoaf eritgria virhohmis, kanuk lioa ti`ae `apat
`ioaeueak pgngriesaak naea `imukaeak eritgria inukhohmis. Rglaiekya ti`ae ngkukmmu
eritgria eoikis tgrpgkufi amar `apat ngoaeueak switbf eg oiki sgoakdutkya oglif `iki. H@FA
farus ngkmmukaeak A\S nikinao 3 luoak sglgoun `ikyataeak mamao tgrapi `aoan ega`aak
egpatufak yakm laie. Eaoau H@FA egpatufak ti`ae laie atau lgrfgkti nikun hlat, pgkioaiak
t gratur nikinao 2-3 luoak3
egmamaoak `ioaeueak sgtgoaf nikun hlat egnlaoi sgbara tgratur

Palgo <.9 @gcikisi Egmamaoak Pgrapi `ak Egputusak uktue Wlaf Za`uak (Rwitbf
( Rwitbf))
A\S

Egmamaoak @gcikisi Egtgrakmak

Mamao Eoikis -  @gwasa `ak rgnada 4 nukbuokya ikcgesi -  Ehk`isi eoikis laru `ilg`aeak
hppurtukistie laru atau lgruoakm `gkmak I\IR yakm nukbuo
(sta`iun eoikis ]FH 0) sgtgoaf ngnuoai A\S
-  Akae 4 nukbuokya ikcgesi hppurtukistie laru -  Wktue `gwasa lglgrapa
atau lgruoakm sta`iun eoikis ]FH 2 (PL
(sta`iun eoikis ]FH 2 atau 0 egbuaoi PL) Zaru atau ikcgesi laetgri lgrat
oaikkya) atau nukbuokya GZZ
egnlaoi `apat
ngkmi`gkticieasieak mamao
tgrapi
Mamao -  @gwasa `ak akae; 7 tafuk B@0 turuk eg kioai -  Pakpa a`akya ikcgesi oaik
Inukhohmis awao atau oglif rgk`af oami yakm ngkyglaleak pgkurukak
p gkurukak
-  Atau B@0

<7 
 

-  B@0 pgrsistgk `ilawaf 1:: sgo/nn2 sgtgoaf -  Eritgria eoikis `ak inukhohmis
satu tafuk pgkmhlatak ngnioiei sgksitivitas rgk`af
-  Atau uktue ngkmi`gkticieasi mamao
-  B@0 turuk ;7:% `ari B@0 tgrtikmmi virhohmis, tgroglif pa`a easus
yakm ngnuoai A\S `ak
ngkmaoani mamao tgrapi pa`a
 dunoaf B@0 yakm tikmmi.
 Kanuk saat iki lgoun a`a
aotgrkatic yakm vaoi` uktue
ngk`gcikisieak mamao
inukhohmis sgoaik eritgria iki.
Akae usia `ilawaf 7 tafuk
B@0 pgrsistgk `i lawaf
<::sgo/nn2 atau ? 1:%
Mamao virhohmis Za`a H@F
H@FA A `gkmak egpatu
egpatufak
fak y
yakm
akm laie, virao oha` `i Latasak uktue ngkmi`gkticieasi
atas 1::: ehpi/nO lgr`asareak <x pgngriesaak FIS egmamaoak virhohmis `ak pgkmmaktiak
\KA `gkmak darae 2-3 luoak  pa`uak A\S lgoun
lgoun `apat `itgktueak

Manlar <.1: Aour Zgngriesaak \KA uktue gvaouasi tgrapi A\S

<.6.= Za`uak A\S oiki eg`ua pa`a rgnada `ak `gwasa  

\gsistgksi sioakm `aoan egoas A\S yakm sana tgrda`i pa`a ngrgea yakm ngkmaoani
egmamaoak tgrapi. \gsistgksi tgrda`i egtiea FIS tgrus lgrprhoicgrasi ngseipuk `aoan tgrapi
A\S. Diea egmamaoak tgrapi tgrda`i `gkmak pa`uak KK\PI atau 2PB, fanpir pasti tgrda`i
rgsistaksi tgrfa`ap sgouruf KK\PI `ak 2PB. Zgkmmukaak A\S ngkmmukaeak ehnlikasi <
 K\PI + lhhstg` ZI ngkda`i rgehngk`asi sglamai tgrapi pioifak oiki eg`ua uktue `gwasa,
rgnada, `ak duma akae `gkmak pa`uak lgrlasis KK\PI yakm `imukaeak
`imukaeak sglamai oiki pgrta
pgrtana.
na.

Palgo <.1: pak`uak A\S oiki eg`ua pa`a rgnada `ak `gwasa

Zhpuoasi tarmgt Zak`uak A\S yakm `imukaeak Zak`uak oiki eg`ua pioifak
 pa`a oiki pgrtaka
pgrtaka
@gwasa `ak rgnada ; 1: tafuk Lgrlasis ATP atau `0P P@C + 2PB (atau CPB) + OZS/r

<3 
 

Lgrlasis P@C ATP + 2PB + OZS/r

FIS `ak ehikcgesi PL Lgrlasis ATP atau `0P P@C+2PB(atau CPB) + OZS/r
`hsis mak`a
Lgrlasis P@C ATP +2PB +OZS/r `hsis mak`a
FIS `ak FLS ehikcgesi Lgrlasis P@C ATP + P@C +2PB + OZS/r
Egtgrakmak4 \incapisik sglaiekya ti`ae
t i`ae `imukaeak
`imukaeak pa`a pgnaeaiak
pg naeaiak OZS/r.

Palgo <.11 pak`uak A\P oiki eg`ua pa`a akae

Oiki pgrtana Oiki eg`ua

ATP (atau `0P)+2PB+KSZ(atau GCS) ALB (atau P@C)+2PB (atau CPB) + OZS/r
P@C (atau `0P)+2PB+KSZ(atau
`0P)+2PB+KSZ(ata u GCS) ATP + 2PB + OZS/r
ALB + 2PB + KSZ (atau GCS)
Egtgrakmak 4 P@C fakya `imukaeak pa`a akae `iatas < tafuk.

<.6.6 Za`uak A\P Oiki Egtima

Diea tgrda`i egmamaoak oiki eg`ua naea pgrou `ioaeueak tgrapi pgkygoanatak yakm
gcgetic. Eritgria yakm `imukaeak uktue pgkgktuak egmamaoak tgrapi oiki eg`ua farus
ngkmmukaeak eritgria virhohmis (pgngriesaak FIS \KA). Rgpgrti pa`a pgkgktuak mamao
tgrapi oiki pgrtana, pgkgktuak egmamaoak tgrapi oiki eg`ua farus `ioaeueak saat H@FA
ngkmmukaeak A\P oiki eg`ua nikinao 3 luoak `aoan ega`aak egpatufak yakm laie. Pgs
rgsistaksi mgkhtypikm `iwadileak sglgoun pik`af eg oiki egtima.

Palgo <.1< Zak`uak A\S oiki egtima pa`a `gwasa `ak akae

\gehngk`asi pak`uak A\P oiki egtima

@gwasa GP\ + \AO + @\S/r

Akae GP\ + \AO + @\S/r

<.6.9 Zgkbgmafak pasba padakak (ZZZ) 

Zgkbgmafak pasba padakak (ZZZ) a`aoaf pgnlgriak A\S `aoan waetu sikmeat uktue
ngkmurakmi egnukmeikak `i`apatkya ikcgesi FIS sgtgoaf tgrpapar egtiea lgegrda atau sgtgoaf
egegrasak sgesuao. ZZZ sglaiekya `itawareak pa`a eg`ua egohnphe padakak tgrsglut `ak
`ilgrieak sgsgmgra nukmeik `aoan waetu =< dan sgtgoaf paparak. 3 ZZZ ti`ae `ilgrieak diea
hrakm yakm lgrisieh tgrpapar sglgkarkya FIS phsitic atau sunlgr paparakkya FIS kgmatic.
Oanakya pgnlgriak ZZZ FIS a`aoaf <6-2: fari. 

<= 
 

Palgo <.12 pioifak pak`uak uktue ZZZ

Hrakm yakm tgrpadak Zak`uak A\S

\gnada `ak @gwasa Zioifak P@C +2PB + OZS/r
Aotgrkativg P@C + 2PB + GCS
ATP + 2PB + OZS/r
Akae ? 1: tafuk Zioifak ATP + 2PB + OZS/r
Aotgrkativg
Aotgrkativg P@C + 2PB + OZS/r
@apat ngkmmukaeak
GCS/KSZ uktue KK\PI

Raat iki ZZZ duma `iakdureak uktue `ilgrieak pa`a easus egegrasak sgesuao.
Ngkmikmat lakyaekya egsuoitak ngkygogsaieak pa`uak ZZZ iki, `ipgroueak `ueukmak `ak
ehksgoikm egpatufak sglgoun `ak sgoana ngkmmukaeak A\S uktue ZZZ.  

<.6.1: Ehksgoikm

G`ueasi uktue pgkmurakmak pgrioaeu lgrisieh `aoan upaya pgkbgmafak traksnisi

FIS. Zgk`grita FIS yakm ngk`apat tgrapi A\S farus ngnioiei hrakm tgr`geat sglamai
 pgkmikmat atau Zgnaktau Ngnikun Hlat (ZNH) `ak patuf
pat uf ngnikun hlat sgunur fi`up.
Ehksgoikm egpatufak nikun hlat, phtgksi/egnukmeikak risieh gcge sanpikm atau gcge yakm
ti`ae `ifarapeak atau tgrda`ikya sik`rhn puoif inuk (Innukg \gbhkstitutihk Ikcoannathry
Ryk`rhng/I\IR) sgtgoaf ngnuoai tgrapi A\S, tgrutana pa`a H@FA `gkmak sta`iun eoikis
oakdut. Rgtgoaf `ioaeueak ehksgoikm egpatufak, H@FA `inikta lgrehnitngk uktue ngkdaoaki

 pgkmhlatak A\S sgbara tgratur

t gratur uktue dakmea pakdakm. Ehksgoikm ngoiputi bara `ak egtgpatak
nikun hlat, gcge sanpikm yakm nukmeik tgrda`i, iktgraesi `gkmak hlat oaik. G`ueasi
ngkmgkai pgktikmkya nhkithrikm ega`aak eoikis `ak pgngriesaak oalhrathriun sgbara
 lgreaoa tgrnasue pgngriesaak B@0. 

<.9. Ikcgesi Hphrtukis pa`a Zasigk FIS/AI@R

Ikcgesi hphrtukistie
hphrtukistie (IH) a`aoaf ikcgesi hogf pathmgk yakm
yakm liasakya ti`ae lgrsicat
ikvasic kanuk `apat ngkygrakm tuluf saat egeglaoak tuluf ngkuruk,
ngkuruk, sgpgrti pa`a hrakm
yakm tgrikcgesi FIS/AI@R. Ikcgesi iki `apat `itinluoeak hogf pathmgk yakm lgrasao `ari ouar

tuluf (sgpgrti laetgri, danur, virus atau prhthzha), naupuk hogf nierhlihta su`af a`a `aoan

<6 
 

tuluf nakusia kanuk `aoan ega`aak khrnao tgregk`aoi hogf sistgn inuk (sgpgrti cohra
khrnao usus).

Mgdaoa eoikis PL pa`a H@FA ti`ae spgsicie. Za`a sglamiak lgsarH@FA mgdaoa eoikis
yakm sgrikm `itgnueak a`aoaf `gnan
`g nan `ak pgkurukak lgrat la`ak yakm simkicieak, sg`akmeak
egoufak latue pa`a H@FA sgrikmeaoi ti`ae spgsicie sgpgrti yakm `iaoani tgr`uma PL pa`a
ununkya. Hogf eargka itu `irgehngk`asieak lioa H@FA `atakm `gkmak egoufak latue
 lgrapapuk oanakya farus `igvaouasi uktue `
`iamkhsis
iamkhsis PL. Ngkikmi
Ng kikmitis
tis tulgreuohsis ngrupaea
ngrupaeakk
ehnpoieasi tulgreuohsis paru yakm paoikm lgrat. Ikcgesi FIS ngkikmeateak risieh tgregka
 pgkyaeit iki sanpai oglif `ari 1: eaoi oipat.
oipat.

 KgurhAI@R a`aoaf istioaf unun uktue egoaikak pa`a sistin sarac yakm `isglaleak
hogf atau yakm lgrfulukmak `gkmak ikcgesi FIS. Za`a lamiak iki yakm aeak `ilibaraeak
tgrutana aspge ikcgesi hphrtukistie `ari KgurhAI@R. Ikcgesi hphrtukistie htae sgrikmeaoi
tinluo pa`a pa`a H@FA `aoan sta`iun oakdut `gkmak dunoaf B@0 `i lawaf <:: sgo/nn2.

Ikcgesi hphrtukistie KgurhAI@R duma tgrda`i sglamai nakicgstasi sik`rhn puoif inuk
(innukg rgbhkstitutihk ikcoannathry syk`rhng/I\IR). Egburimaak ikcgesi hphrtukistie `i
 li`akm kgurhohmi ununkya laru `ipieireak diea pgk`grita FIS sta`iun oakdut yakm ngnioie i
 dunoaf B@0 `i lawaf
lawaf <:: sgo/nn2.

A`akya ehikcgesi FIS `gkmak FLS sgbara lgrnaeka `apat ngnpgkmarufi

 pgrdaoakak aoaniaf virus fgpatitis L. H@FA `gkmak ikcgesi fgpatitis L erhkie ngnioiei
 dunoaf FLS @KA yakm oglif tikmmi. A`akya FIS lgrpgrak `aoan ngkikmeateak risieh
tgrda`ikya sirhsis fati `ak earsikhna fgpathsgouogr, sgfikmma pgkyaeit fati lgrpgrak sglamai
 pgkyglal tgrlgsar egnatiak H@FA. Pikmmikya akmea nhrli`itas `ak nhrtaoitas tgreait
 pgkyaeit fati pa`a H@FA `gkmak ehikcgesi FLS `isglaleak hogf lglgrapa fao, yaitu
 pgkikmeatak rgpoieasi virus fgpatitis L, pgkurukak egda`iak lgrsifak sphktak FLgAm,
 pgkikmeatak risieh ikcgesi fgpatitis L erhkie,
erhkie, `ak pgkikmeatak prhmrgsivi
prhmrgsivitas
tas pgkyaeit fati.

H@FA oglif nu`af tgrtuoar INR eargka `aya tafak tuluf ngkuruk, tgrutana diea
nasif ngoaeueak pgrioaeu lgrisieh. Nakicgstasi INR pa`a ikcgesi FIS ngkda`i ti`ae efas,
ununkya oglif paraf, oglif suear sgnluf. Nisaokya uoeus pa`a siciois pringr yakm ununkya
shoitgr, lisa ngkda`i nuotipgo, lgktue ti`ae luoat, lisa irgmuoar, ik`urasi ti`ae tgroaou dgoas,
`apat `isgrtai kygri, `ak ea`akm `isgrtai tak`a-tak`a ikcgesi susukaksarac pusat. Fgrpgs

mgkitaois lisa oglif kygri `ak ogsikya oglif ouas. Eutio egoanik `apat lgrueurak lgsar atau
 lgrdunoaf lakyae.

<9 
 

H@FA pgrgnpuak `gkmak FIS phsitic `ua eaoi oglif lgrisieh tgregka ikcgesi FZS
`ilak`ikmeak yakm FIS kgmatic (30% vs <6%). Sirao oha` tikmmi `gkmak fitukm B@0 rgk`af
 duma lgrfulukmak `gkmak ngkikmeatkya prgvaogksi `ak iksi`gk ikcgesi FZS. Zgrgnpuak
`gkmak FIS phsitic oglif nu`af tgrikcgesi FZS, ngkda`i pgrsistgk `gkmak tipg hkehmgkie,
`ak oglif nu`af ngkmaoani prhmrgsivitas ngkda`i RIO. Iksi`gk eakegr sgrvies 6.6 eaoi oglif

tikmmi pa`a pgrgnpuak `gkmak FIS `ilak`ikmeak `gkmak phpuoasi unun. Zrgvaogksi ikcgesi
FZS duma oglif tikmmi pa`a H@FA ORO `gkmak FIS phsitic `ilak`ikmeak `gkmak ORO FIS
kgmatic (7=% vs 66%). Zgnlgriak ehtrinhesasho farus `ilgrieak sglamai lamiak `ari
 pgoayakak FIS. Lgrlamai pgkgoitiak tgoaf ngnluetieak gcgetivitas
gcget ivitas pgkmhlatak pgkbgmafak
ehtrinhesasho `aoan ngkurukeak akmea egnatiak `ak egsaeitak pa`a hrakm yakm tgrikcgesi
FIS. Ru`af a`a lglgrapa rgehngk`asi uktue ngnlgrieak ehtrinhesasho sglamai pgkmhlatak
 pgkbgmafak pa`a H@FA `gwasa, wakita fanio `ak akae uktue Zkgunhbystis pkgunhkia,
theshpoasnhsis `ak ikcgesi laetgri, nakcaat uktue prhcioaesis naoaria `ak pgtukdue
 pgnlgrfgktiak ehtrinhesasho. 3

2: 
 

LAL 2

EGRINZWOAK

1.  FIS ( Funak

 Funak Innukh`gcibigkby Sirus)
Sirus) a`aoaf virus yakm ngkygrakm sgo oinchsit
sgfikmma ngkurukeak egeglaoak tuluf tgrfa`ap pgkyaeit. Rgngktara AI@R ( Abquirg`

 Innukg @gcibigkby Ryk`rhng)

Ryk`rhng) `i`gcikisieak sglamai tafap aefir `ari ikcgesi FIS
yakm `itak`ai `gkmak lgrlamai mgdaoa atau pgkyaeit yakm tinluo aeilat pgkurukak
egeglaoak tuluf
<.  Ikcgesi FIS abap eaoi, `gkmak ikcgesi hphrtukistie PLB, ehikcgesi fgpatitis B `ak L,
`ak lgrlamai ikcgesi
ikcgesi hphrtukistie oaik.
oaik. Zgkmhlatak ikcgesi FIS pgrou ngkmikvgstimasi
ikcgesi hphrtukistie `ak ehikcgesi.
2.  Ikcgesi FIS `apat lgroakmsukm erhkie pgrsistgk sglamai malukmak `ari uksur-uksur
FIS `ak rgsphks sistgn inuk yakm ti`ae gcgetic, `inaka FIS `apat lgriktgmrasi
`gkmak mgkhn sgo pgdanu, FIS ngnpukyai egnanpuak uktue ngkmulaf struetur

sgfikmma ti`ae `iegkao hogf rgsphks inuk `ak egmamaoak rgsphks inuk sgoouogr
iktriksie `ari pgkyaeitkya
pgkyaeitkya sgk`iri
sgk`iri
0.  @iamkhsis FIS lgr`asareak akankgsis, pgngriesaak cisie, `ak pgngriesaak
 pgkukdakm. Zgngriesaak
Zgngriesaak pgkukdakm yaitu tgs sgrhohmis `ak tgs virhohmis.
7.  Rgtgoaf `ikyataeak phsitic FIS, naea `ioaeueak pgngriesaak uktue ngkgktueak
sta`iun eoikis.
3.  Zriksip pgnlgriak A\S a`aoaf farus ngkmmukaeak 2 dgkis hlat yakm egtimakya farus
tgrsgrap `ak lgra`a `aoan `hsis tgrapgutie `aoan `araf, `iegkao `gkmak fimfoy abtivg
aktirgtrhvirao tfgrapy (FAA\P).
 
=. Pgrluea egsgnpatak uktue ngkbgmaf pgkuoarak FIS laie ngoaoui pgrulafak pgrioaeu
naupuk iktgrvgksi
iktgrvgksi lihng`ie. Wpaya p
pgkakmmuoakmak
gkakmmuoakmak FIS pa`a
pa`a tikmeat mohlao tgoaf
ngnlgrieak fasio yakm bueup kyata eargka itu eita duma lgrusafa ngkikmeateak
upaya pgkakmmuoakmak FIS `i Ik`hkgsia  

21 
 

@ACPA\ ZWRPAEA

1. @dhgrlak T, @dauzi R. FIS/AI@R `i Ik`hkgsia. Ik4 Ru`hyh A], Rgtiyhfa`i L, Aowi I,

Rina`ilrata NE, Rgtiati R, g`s.  Lueu adar ionu pgkyaeit `aoan.
`aoan. G` 3. Daearta4 Zusat
Zgkgrlitak @gpartgngk Ionu Zgkyaeit @aoan CEWI. <:17.
<. Caubi AR, Oakg FB. Funak Innukh`gcibigkby Sirus @isgasg4 AI@R ak` rgoatg`
`ishr`grs. Ik4 Easpgr @O, Caubi AR, Ohkmh @O, Lraukwao` G, Fausg RO, Dangshk DO.
g`ithrs.  Farrish
 Farrishk’s
k’s Z rikbipogs
rikbipogs hc Iktgrkao Ng`ibikg.
Ng`ibikg. <:tf g`. Pfg Wkitg` Rtatgs hc Angriba4
NbMraw-Fioo. <:16.
2. WKAI@R. Pfg Map \gphrt. <:10.

0. WKAI@R. WKAI@R \gphrt ik <:124 FIS ik Asia ak` Pfg Zasicib. <:12.

7. Egngktriak Egsgfatak \I. Oaphrak Zgregnlakmak FIS/AI@R `ak Zgkyaeit Ikcgesi

Ngkuoar Rgesuao (ZINR) Priwuoak IS Pafuk <:13. Daearta4 Egngktriak Egsgfatak \I. <:1=.

3. Egngktriak Egsgfatak \I. Zgraturak ngktgri egsgfatak \I khnhr 6= tafuk <:10 tgktakm
 pg`hnak pgkmhlatak
pgkmhlatak akti rgtrhvirao. <:17.
=. Egngktriak Egsgfatak \I. Egputusak Ngkegs Kh 9: Pafuk <:19 tgktakm 4 Zg`hnak
kasihkao pgoayakak eg`hetgrak tata oaesaka FIS.
6. Egngktriak Egsgfatak \I. Zrhmran Zgkmgk`aoiak FIS AI@R `ak ZINR Casioitas
Egsgfatak Pikmeat Zgrtana. <:1=.
9. Egngktriak Egsgfatak \I, Ikch`atik FIS AI@R <:<:, Daearta 4 Egngktriak Egsgfatak \I.
<:<:

1:. @itdgk Z<Z (Ristgn Ikchrnasi FIS/AI@R `ak INR (RIFA), Oaphrak Pafuk <:19 <:19 
11. Riolgrkamo Rtgcak, Oakm Cohriak. Pges `ak Atoas lgrwarka Zathcisihohmi. Daearta 4 GBM.
<:13
1<. Allas E, Oibtnak Ak`rgw, Inukhohmi @asar Allas Cukmsi `ak egoaikak Ristgn Inuk.
Gosgvigr 4 <:13

2<