1. { HEPATITIS VIRAL DISEASE

2. Alcoholic Hepatitis The inflammation of the liver caused by the long-term heavy intake of alcohol. Symptoms include enlargement of the liver, development of fluids in the abdomen, and elevation of liver enzymes. Alcoholic hepatitis can progress to cirrhosis if heavy alcohol use continues.

3. Non-alcoholic Fatty Liver Disease Non-alcoholic fatty liver disease in people with fatty liver no history of alcohol use. Symptoms fatigue, pain in the upper right abdomen, and weight loss. In the most severe cases, non-alocholic fatty liver disease can progress to liver failure.

4. Autoimmune Hepatitis the inflammation of the liver resulting from the body's own immune system attacking the liver. This disease is chronic and has very minor symptoms. When symptoms do occur, fatigue, abdominal discomfort, itching, jaundice, enlarged liver, and nausea. If left untreated, automimmune hepatitis can lead to cirrhosis and liver failure.

5. INFECTIOUS HEPATITIS (A-E VIRAL)

6. PENYEBARAN HEPATITIS A-E (virus)

8. Hepatitis A Virus (Hepeviridae family) Hepatitis B Virus (Hepadnaviridae family) Hepatitis C Virus (Flaviviridae family) Hepatitis E Virus (Hepeviridae family) VIRUS HEPATITIS HAV HBV HCV HEV

9. HEPATITIS A

11. Hepatitis A, is transmitted by a fecal to mouth route. The most common ways to become infected is consuming contaminated food or water, or sexually. Due to those facts, its found much more in third world countries.

12. Hepatitis A INCUBATION :15-45 days Within a week, jaundice causing a yellowing of the skin and eyes. Symptoms are as follows: Fatigue Fever Abdominal pain Nausea Diarrhea Appetite loss Depression Jaundice Weight loss Sharp pains in upper right side of abdomen

13. This strain of the virus does not have a chronic stage, vaccination permanently prevent the illness

16. HEPATITIS B

17. PENYEBARAN

18. PENULARAN HEPATITIS B Hepatitis B transmitted via : blood transfusions, tattoos, sharing drug needles, and breastfeeding a child. sexually transmitted disease ? Many people refer to it as an STI or sexually transmitted infection.

19. hepatitis B acute or chronic. Over 85% of adults who get the virus will build up anti-bodies and fight it off. Acute symptoms include: Ill health Loss of appetite Nausea Vomiting General pains Mild fever Dark Urine Jaundice GEJALA HEPATITIS B

23. DIAGNOSIS HBsAg (hepatitis B surface antigen): positive means infected with HBV Anti-HBs (antibody to hepatitis B surface antigen): positive, it means immune to HBV infection, either from vaccination or from past infection and cannot pass the disease to others.

24. DIAGNOSA Anti-HBc (antibody to hepatitis B core antigen): positive or reactive, it means HBV infection or HBV in the past. IgM anti-HBc: positive or reactive, HBV recent infection.

25. Hepatitis Be-Ag Hepatitis Be-Ag The e- ag marker is also absent in patients with (core or precore mutants). HbsAg carriers do not have detectable HBV DNA in serum. Hepatitis B e antigen (HBeAg) correlated with active viral replication, clinical infection In chronic hepatitis B Conversion to (e ag–negative, e Ab–positive) Means decreased inflammation, with normal transaminase and decreased levels of HBV DNA in serum—the inactive carrier state.

26. PREVENTION Hepatitis B vaccine is the best protection. (VACCINE safe & effective) o A combined vaccine hepatitis A and B is for over 18 years age o Routine vacc. recommend for young people aged 0 to 18 years. o Vaccination recommend for risk groups of all ages. o The usual dosage is 3 x injections given over a 6 months period.

27. PREVENTION sex use latex condoms correctly and every time Infants born to HBV-infected mothers give hepatitis B immune globulin and vaccine within 12 hours after birth. Do not shoot drugs, never share drugs, needles, syringes, water, or "works," and get vaccinated against hepatitis A and hepatitis B (if not already infected). Do not share personal-care that might have blood on them (e.g., razors, toothbrushes). Assess the risk getting a tattoo or body piercing. hepatitis B, do not donate blood, organs, or tissue. injecting drugs, the tools are sterile and don’t share with others. Health care or public safety worker, get vaccinated against hepatitis B,

29. TREATMENT Most people recover on six months of the initial infection. remain infected after that period,should be evaluated Adefovir dipivoxil, alpha interferon, lamivudine 3 drugs licensed for the treatment of persons with chronic hepatitis B. These drugs should not be used by pregnant women. Drinking alcohol can make your liver disease worse

30. HEPATITIS C HEPATITIS C

31. Hepatitis C Acute hepatitis C is often mistaken for the flu, are very similar. 60% acute hepatitis C never knew symptoms : Decreased apatite Fatigue Abdominal pain Itchiness Jaundice Mild fever Dark Urine, Jaundice if left untreated, leads to: liver cancer, cirrhosis, and fatal scarring of the liver.

32. DIAGNOSIS HCV HCV determined by a specific blood test detects antibody (the antibody is insufficient immunity). The test does not distinguish acute and chronic infection or past versus present infection. If test is positive, a supplemental test should be done to confirm HCV infection status and exclude laboratory error. This test is not a part of a routine physical exam.

33. PREVENTION HCV There is NO vaccine to prevent HCV infection Don’t touch anything have the blood of an infected person Don’t share anything that might have blood on it. Use latex condoms correctly and every time Notify physician and dentist that you are infected with HCV. Get vaccinated against hepatitis A and B. HCV, limit or do not drink alcohol.

34. TREATMENT the treatment of choice Combination therapy with pegylated interferon and ribavirin Interferon side effects, flu-like symptoms Ribavirin, given by mouth, can cause birth defects. (early destruction of red blood cells and severe anemia. a pregnancy should not take ribavirin. (should not be attempted until 6 months after treatment has ended). Treatment of children with HCV is under investigation. all liver transplants are performed for end-stage hepatitis C. no specific evidence proving that herbal relieves hepatitis symptoms or fights the virus. many herbs are toxic to the liver.

37.  also known as the delta antigen  called delta antigen – after the 3 known HBV antigens  single-stranded RNA virus  spherical in shape with a diameter of 35-37 nm  considered to be a subviral satellite  HBV-infected humans are the only established host Hepatitis Delta Virus (HDV)

38. it only infects people with active HBV infection it only infects people with active HBV infection  blood contact  parenteral route  sexual  transfusion of contaminated blood or blood products  accidental needle sticks, tattoos  ear piercing  sharing of infected razors  intravenous drug abuse, male homosexuals  mentally retarded patients  those who receive frequent IV procedures

41. HEPATITIS E

46. ANIMAL RESERVOIR HEPATITIS E

57. DIAGNOSTICUM

63. RESUME