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Eliminasi
Target
2020 90% ibu hamil dapat diperiksa, dideteksi dan diobati
Program Triple Eliminasi
Permasalahan
6/30/2019 3jk
Human Immunodeficiency Virus
Retrovirus RNA
1) Serologic test
- Rapid test
- Enzyme
Immunoassay (EIA)
test
- Wastern Blot test
2) Virologi test
- HIV DNA
kualitative (EID)
- HIV RNA
kuantitative
Vertical transmission important to child infection
• Ascending infection from plasenta
• Maternal vaginal/cervical
Without prevention 20-50% infected
5-10% during pregnancy
10-20% delivery
5-20% breastfeeding
WHO (2013)
- Viral load < 1000 copies/ml and Vaginal delivery can be considered
- ARV > 6 month
After delivery
1) Baby profilaksis Zidovudine until 6 weeks evaluation VL 4-6
weeks
2) Non breastfeeding
Criteria Theory
ARV (+)
< 14 weeks
Viral load (+)
< 1000 copies/ml
Delivery SC (+) or
Vaginal (+)
Neonatal Governance
Criteria Theory
ARV prophylaxis (+)
< 12 hours after
delivery
Evaluation Viral load 4-6 weeks
4-6 month
With appropriate effort, the risk of transmission can be reduced to less than 2%.
Even less than 1% if ARV already given long time before pregnancy
Hepatitis B
• Hepadnaviridae
• DNA virus
• Tidak sitopatik
• Lebih dari 240 juta pengidap hepatitis B kronik, dengan kematian
mencapai 800.000/tahun
• 78% kanker hati dan 57% sirosis hati disebabkan infeksi kronik
virus hepatitis
Hep B
Faktor Resiko
• Teoritis flare
• Secara klinis tidak signifikan
Transmisi vertikal
intrauterine perinatal postnatal
Failure of
immuno-
prophylaxis
Telbivudine &Tenovofir
• Serelogical screening
Clinical manifestations
• Primary syphilis
- papule, ulcerated, indurated margin and regional lymphadenopathy
- 3-6 weeks
• Secondary syphilis
- generalized maculopopular rash, genital lesion, general lympohadenopathy,
fever, pharyngitis
- 6 weeks – 6 month
• Latent syphilis
- usually subclinical
• Tertiary syphilis
- gumma formation, CV disease, neurosyphilis
- 5-20 years
Serelogical screening
Treponema pallidum
• Menembus barier plasenta stadium
berapapun dan usia hamil kapanpun
• Infeksi natal IUGR, preterm, stillbirth, hydrops
fetalis, BBLR, neonatal death, congenital
anomalies
70-100% untreated
vs
1-2 % adequately treated in pregnancy
Strategi
Nasional