hepatitis a laporan

7/28/2019 Hepatitis A laporan

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Hepatitis A, B, and C

HEPATITIS implies a (usually infectious) inflammatory process

damaging the liver. The onset is usually insidious with anorexia,vague abdominal discomfort, nausea and vomiting, sometimes joint

pains and rash, often progressing to jaundice. Fever may be absent

or mild. Severity ranges from asymptomatic cases acute liver

damage. Chronic active hepatitis is usually (but not always) caused

by hepatitis B virus, and prolonged Hepatitis B carrier states with

obvious signs of disease are very common in some parts of the

orld. Up to 20 percent of the population are affected in certain

areas of Asia. Because of this Hepatitis B virus is the cause of up to

80 percent of all cases of hepatic (liver) cancer worldwide. The

virus is second only to tobacco among known human cancer-

promoting agents.

Hepatitis B virus has been found in virtually all body secretions

and excretions, however only blood (and serum derived fluids),

saliva, semen and vaginal fluids have been shown to be infectious.

For transmission to occur the virus infected body fluid must be

introduced through the skin. This can be done by contaminated

needles and syringes and other IV equipment. Infection can also be

spread through contamination of wounds or lacerations. Even a

tiny drop of infected fluid can result in infection if it makes contact

ith the mucous membranes of the mouth, nose or vagina. This is

probably the major route of transmission in areas of the worldhere Hepatitis B is endemic, and in residential institutions.Transmission by close personal contact can occur, especially

between sexual partners and most frequently between male

homosexuals. Communally used razors or toothbrushes have also

been occasionally implicated. Note however fecal-oral transmission

has NOT BEEN demonstrated.Incubation period is usually 40 to 180 days, but cases are infective

many weeks before the first onset of symptoms so quarantine

measures are not really useful. Chronic carrier-states in which the

patient is otherwise well but carries the virus can last for many

years; equally, chronic states in which the liver is being insidiously

damaged by active disease can occur.Other forms of hepatitis can be produce symptoms similar to the

other (A and B) forms of hepatitis. C is the most significant as it is

most often transmitted by blood transfusions, and increasingly it is
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recognized that blood should be tested for this virus. It can have

long-term effects similar to although usually not as severe as

Hepatitis B.Like hepatitis B, Hepatitis C causes inflammation of the liver,

caused by viral damage to the main liver cells. Hepatitis C is spreadby blood. Blood transfusion has therefore been an important route

by which it is passed on. About one potential blood donor in 300

has the virus in Western countries. (Of course this route of

infection could be ended by nationwide testing of donated blood). Other ways of transmitting the disease involve the sharing of

needles by drug abusers, and the use of unsterilised tattooing

instruments. Sexual intercourse with an infected partner carries a

small risk, very much less than the risk of catching AIDS, or even

Hepatitis B. It seems improbable that family contacts of other

kinds can spread the disease. However, in practice it is not possibleto discover how a particular patient has been infected in half the

cases of the disease, so that all patients with Hepatitis C should

observe normal hygienic practices scrupulously, and be especially

careful in disposing of material contaminated with their blood.Only a small proportion of Hepatitis C infected patients will

develop the symptoms of an acute hepatitis, with loss of appetite,

mild fever, and jaundice. Whether or not such symptoms develop,

between half and three quarters of patients will clear the virus and

develop immunity to it, exactly as happens with Hepatitis A and

ith most viral illnesses such as influenza or measles, for example.But between a quarter and a half of those initially infected will

continue to be infected over many years. Some of these people have

little or no liver damage, and their only long-term risk is that they

may develop primary liver cancer. But half or more of those who

are chronically infected will show progressive damage to the liver

due to chronic Hepatitis C infection.The risk is similar to that with chronic infection with Hepatitis B -

a relatively low risk in most Western countries - and a risk that can

be minimized by taking care of the liver by avoiding alcohol,

adopting a balanced diet, and ensuring that one is protected against

Hepatitis B by accepting vaccination for it.The symptoms suffered by those with Chronic Hepatitis C vary

from person to person. Some people have no symptoms until the

liver has been quite severely damaged. Others suffer tiredness,

fatigue, nausea, and perhaps mild abdominal discomfort. The

major threat of this condition is that it slowly damages the liver,


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ith the inflammation leading to scars forming, and eventually,

hen scarring of the liver starts to impair its ability to perform its

normal functions, cirrhosis of the liver results, and in time, this

cirrhosis will prove fatal. Fortunately, Hepatitis C advances to

cirrhosis very slowly - usually over decades rather than years.If there is a suspicion of chronic active hepatitis from any cause,

blood tests are required to show whether hepatitis virus infection is

present, and liver function tests can identify those in whom some

liver damage is occurring. To establish the severity of liver damage,

a liver biopsy may be required. A liver biopsy involves taking a

sample of the liver with a specially designed needle. Under local

anesthetic, this is passed between the lower right ribs into the

center of the liver. The sample taken is about the size of a pin. It

takes only a minute or so to get the sample, but the overall

procedure involves a full day, because a period of observation is

required afterwards to make sure there is no bleeding from thepuncture site in the liver itself. In a normal, or even a moderately

damaged liver, the risk of any complication of the biopsy is very

slight. Very rarely, complications of the biopsy may require

surgery to repair the puncture site.Treatment is available if the benefits outweigh the risks. If blood

tests (liver function tests) are abnormal, indicating that some

damage to the liver is occurring, but the liver biopsy shows only

minor degrees of damage, what is sometimes referred to as

"treatment for persisting hepatitis" is not usually undertaken, as

the risk and inconvenience of treatment outweigh the potentialbenefits.If a biopsy shows progressive liver damage, treatment for

"aggressive hepatitis", or the beginning of cirrhosis, can be

considered. The only useful treatment so far is with alpha

interferon - a natural substance produced in the body as part of the

inflammatory response to bacteria and viruses. Given by injection

three times a week over several months, this expensive treatment

ill stimulate a cure in up to a quarter of patients, and will usefully

slow the progress of the infection in another quarter or more.Interferon is not without side effects, but overall, more than half of

all patients do benefit to varying degrees.Hepatitis B

It is imperative that the families be vaccinated against Hep B prior

to relocating to Indonesia. Should time not permit then they should


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at least start the program and they can continue it at a reputable

clinic on their arrival in Indonesia .The vaccination is very effective if given correctly and offers good

immunity to Hepatitis B. It is now also becoming compulsory from

birth in certain developing countries, to prevent the spread ofHepatitis B.How is HBV spread?

HBV is found in blood and certain body fluids of people who are

infected with the Hepatitis B Virus (HBV), fluids such as serum,

semen, vaginal secretions, and saliva. HBV is not found in sweat,

tears, urine, orrespiratory secretions. Contact with even small amounts of infected

blood can cause infection.Hepatitis B virus can be spread by:

unprotected sex injecting drug use during birth from mother to child contact with blood or open sores of an infected person human bites sharing a household with an infected person sharing items such as razors, toothbrushes, or washcloths pre-chewing food for babies or sharing chewing gum

using unsterilized needles in ear or body piercing, tattooing,or

acupuncture - so check needles are always taken out ofsterile packages in front of you

using the same immunisation needle on more than oneperson - insist on a clean needle every time

Hepatitis B virus IS NOT spread by: casual contact like holding hands eating food prepared by a carrier

kissing on the cheek or dry lip kissing

sharing silverware, plates, or cups visiting an infected person's home playing with a child who is a carrier sneezing or coughing

sumber:http://www.expat.or.id/medical/hepatitis.html.
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hepatitis a laporan

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