Pencegahan Transmisi Vertikal Hepatitis B: Fokus pada Penggunaan Antivirus Antenatal

Abstract

Hepatitis B merupakan penyebab utama penyakit hati kronik dan dapat menyebabkan sirosis, gagal hati dan karsinoma hepatoselular pada 15-40% populasi. Terhitung sebanyak dua miliar penduduk dunia terinfeksi hepatitis B. Sebanyak 240 juta diantaranya mengidap hepatitis B kronik dan 780.000 jiwa meninggal karena komplikasi akut dan kronik hepatitis B. Transmisi hepatitis B berbeda di berbagai belahan dunia. Pada negara maju, transmisi hepatitis B sebagian besar melalui transmisi horizontal, sedangkan pada negara berkembang transmisi heptitis B 90% melalui transmisi vertikal. Upaya pencegahan transmisi vertikal berupa pemberian imunoglobulin mencapai tingkat keberhasilan hingga 95%, namun menyisakan sebagian kecil populasi yang mengalami kegagalan imunoprofilaksis yang berisiko untuk berkembang menjadi hepatitis B kronik. Pemberian antivirus pada saat antenatal berperan dalam mencegah transmisi vertikal pada populasi yang berisiko mengalami kegagalan imunoprofilaksis.Kata Kunci: analog nukleos(t)ida, hepatitis B, kegagalan imunoprofilaksis, transmisi vertikal  Prevention of Hepatitis B Vertical Transmission: Focus on Antenatal Antiviral AdministrationHepatitis B is one of the main cause of chronic liver disease, and potentially cause cirrhosis, liver failure and hepatocellular carcinoma in 15-40% population. Globally, 2 billion people are infected by Hepatitis B. Two hundred and forty million people are suffering from chronic hepatitis B, and more than 780 000 people are dying from both acute and chronic complication of hepatitis B. In developed countries, horizontal transmission is the main mode of virus transmission, while in developing countries vertical transmission occured in 90% population with hepatitis B. Immunoglobulin administration as a prevention strategy for vertical transmission has 95% success rate, but it left 5-10% of those who has immunoprophylaxis failure to be at risk to develop chronic hepatitis B. Antiviral administration during pregnancy is considered to prevent hepatitis B vertical transmission in population at risk on developing immunoprophylaxis failure. Keywords: hepatitis B, immunoprophylaxis failure, nucleos(t)ide analog, vertical transmission