1 / 21

jurding

jurnal reading

chaerunisautami
Download Presentation

jurding

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. JOURNAL READING “Lamivudine Treatment during pregnancy to prevent perinatal transmission of hepatitis B virus infection” Nama : ChaerunisaUtami NRP :

  2. PENDAHULUAN • Infeksi hepatitis B kronikmengenai 400 juta orang di seluruhdunia • Penyebabterseringsirosishati & cahepatoselular

  3. Penularansecaravertikal HBV adalahpenyebabutamainfeksi HBV kronikdanmerupakanmasalah di daerahendemis.

  4. Penularandapatdicegahdenganvaksinasipadabayi yang beresiko. • Meskipunsebagaiprofilaksis, tetapipenularan perinatal terjadipadasebagiankecilbayi yang menerimaimunisasipasifaktiflengkap

  5. Viremia maternal yang tinggidihubungandenganterobosanvaksinasi

  6. Pada HIV dalamkehamilan , digunakanterapizidovudinesebagaiterapi standard • Tetapidalamsebuahpercobaan, terapikombinasizidovudinedan lamivudine lebihberhasilmenurunkanangkapenularansecara perinatal HIV dariibukebayi

  7. Dengandasar yang sama, yaitu lamivudine menginhibisireplikasi HBV • Maka, kemungkinan lamivudine jugabergunauntukmencegahpenularan HBV dariibukebayi

  8. Kami mencobamemberikanterapi lamivudine padaibuhamildenganangka HBV yang tinggiselamabulanterakhirkehamilannya

  9. METODE • Sampel : wanitahamildengan hepatitis B kronik • DenganHBV-DNA levels ≥ 1.2 X 109geq/mL

  10. Kriteriaeksklusi : • Mempunyaiinfeksipenyerta lain (hepatitis C, HIV)

  11. Pasiendiberi 150 mg lamivudine 1 hari 1 kali sejakusiakehamilan 34 mingguhinggasaatkelahiran.

  12. HBV-DNA level dinilaipadasaatawalterapi, tiapseminggusetelahkelahiran, danpadasaatkelahiran

  13. Semuapemeriksaan di kalibrasidengan EUROHEP (standarisasi)

  14. Bayibarulahir di vaksindengan 300 IU Hbigpadasaatkelahiran. • Laludiberiimunisasiaktifdengan 20 ugvaksin hepatitis B rekombinanpadasaatusia 2 bulan ,3 bulan ,4 bulan, dan 11 bulanberturut-turut

  15. Anaktersebut di follow up padasaatusia 9-12 bulan

  16. HBV-DNA levels (polymerase chain reaction), hepatitis, B surface antigen (HBsAg), anti-HBs, dan anti-HBc di test padasaatkelahiran, sebelumdiberiHBIg(kapileratauumbilikal) • Dan padasaatusia 3, 6, dan 12 bulan

  17. HASIL

  18. DISKUSI • Penularan hepatitis B dapatdicegahdenganvaksinasi • Angkakeberhasilanvaksinasi 10 ug DNA rekombinanditambahdengan immunoglobulin padasaatlahir ± 95-100 %

  19. We conclude that lamivudine treatment in highly viraemic • HBsAg-positive pregnant women appears effective in • preventing vaccination breakthrough in their offspring. This • approach should be evaluated further in larger controlled • trials. In countries where a vaccination program is not • possible due to logistic or economic constraints, short-term • treatment in late pregnancy of HBsAg positive pregnant • women with lamivudine alone might be a possible alternative, • but this needs to be investigated further.

  20. Pemberian lamivudine padaibuhamilpadapenelitianinimenunjukkanefektifsebagaiupayapencegahanterbarupenularan HBV dariibukeanak • Perludilakukanpenelitianlebihlanjut

More Related