TERAPI ANTIVIRAL PADA SIROSIS HATI DEKOMPENSATA TERKAIT INFEKSI VIRUS HEPATITIS B

Fadrian Fadrian✉
DOI: https://doi.org/10.22338/mka.v39.i1.p35-41.2016

Abstract

Hepatitis B masih merupakan masalah kesehatan global. Diperkirakan sekitar 2 miliar penduduk dunia pernah terpapar virus hepatitis B (VHB) dan lebih dari 350 juta diantaranya menjadi kronik. Sirosis hati, gagal hati, dan karsinoma hati dapat terjadi pada 15-40% penderita dengan infeksi virus hepatitis B kronik. Pada saat ini sekitar 1 juta kematian per tahun akibat penyakit hati berhubungan dengan VHB. Terapi antiviral pada sirosis hati dekompensata terkait VHB merupakan suatu tantangan dalam pengobatan. Tujuan terapi pada pasien sirosis hati dekompensata terkait VHB diantaranya penekanan replikasi virus, serokonversi HBeAg, pembalikan dekompensasi hati, dan pengurangan risiko kanker hati. Terapi antiviral diindikasikan pada semua pasien sirosis hati dekompensata jika DNA VHB terdeteksi, terlepas dari kadar ALT atau status HBeAg. Terapi antiviral pilihan adalah nucleosida/tida analog, seperti lamivudine, telbivudine, adefovir dipifoxil, tenofovir, entecavir. Lama pengobatan biasanya seumur hidup, dan penghentian terapi dipertimbangkan apabila terdapat risiko reaktivasi virus, perburukan dekompensasi hati, dan regresi histologis.

Keywords

antiviral; sirosis hati dekompensata; hepatitis B

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