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The ABCDE of Hepatitis

Hepatitis

Some of us, especially kids, may balk at the idea of seeing pig or chicken liver in our dishes. However, do you know the liver plays an important part in ensuring our body’s smooth functioning? Aside from detoxifying our body and metabolising nutrients, it also produces proteins and blood clotting factors to aid energy storage and release, digestion and other important functions.

 

The liver acts as a filter for our body, helping it to detoxify harmful substances and metabolises nutrients. It is also susceptible to various ailments, one of which is hepatitis. A general term for the inflammation of the liver, hepatitis may lead to liver cirrhosis, cancer and liver failure.

Hepatitis virus is a virus that attacks the liver, causing inflammation, which may lead to complications if left untreated. Let’s find out more about the five known hepatitis subtypes – A, B, C, D, and E.

Hepatitis Exposé

Hepatitis as a medical condition is relatively unknown and poorly understood. Many are even unaware that they have hepatitis. Dr Lim Lee Guan, Specialist in Gastroenterology & Consultant, Raffles Internal Medicine Centre, helps decipher the ABCDEs of hepatitis.

Myth 01: You can get hepatitis only from eating contaminated seafood.

Fact: Hepatitis A and E can be spread through consuming contaminated food, water, and even ice. Developing countries are at higher risk for Hepatitis A and E infection. On the other hand, Hepatitis B, C and D are spread through blood and body fluids, such as sexual contact with someone who is infected, contaminated needles or blood transfusions, or as an infant born to Hepatitis B infected mothers. More than 90 per cent of Hepatitis B cases are transmitted from mother to child during birth. Hepatitis D infection only occurs in people who already have chronic Hepatitis B infection.

Myth 02: Viral hepatitis is very rare.

Fact: Hepatitis B and C are the most common infectious diseases in the world, with more than 350 million people infected with it worldwide. In Singapore, about 6 per cent of adults are Hepatitis B carriers. However, many do not know they have the virus as the condition often has no noticeable symptoms. If you feel unwell or uncertain about your heath, it’s best to visit a medical professional to get tested. Hepatitis B and C may lead to chronic diseases and are important causes of liver cirrhosis and cancer. That said, Hepatitis D is rare in developed countries and requires the viral particles of Hepatitis B virus to replicate.

Myth 03: Those infected with hepatitis will get very sick and die from a serious liver disease or cancer.

Fact: For every 1000 older persons (age > 50) who catch Hepatitis A, about 18 will die from it*. Pregnant women who get infected with Hepatitis E face a higher risk of death from that infection, but numbers of such cases are low. 90 per cent of adults infected with Hepatitis B in adulthood have an acute infection which usually lasts for a few weeks or months. These people will recover fully and not have any lasting problems. Hepatitis B transmitted vertically from mother to child is usually chronic. Chronic Hepatitis B and C carriers are at higher risk of liver cancer and should have regular medical check-ups. Their spouses and sexual partners should also practice safe sex and should be vaccinated against Hepatitis B.

*US CDC Health Information for International Travel 2012

Myth 04: There’s no way to prevent hepatitis.

There are vaccinations for Hepatitis A and B. Hepatitis A vaccine requires two doses, given six months apart. Hepatitis B vaccine is a three-dose series, given on a 0, 1, and 6-month schedule. If you need both, you can opt for the combination Hepatitis A+B vaccine, a three dose series administered at a 0, 1, and 6-month schedule, similar to Hepatitis B vaccine. There are currently no vaccines against Hepatitis C.

 

Hepatitis A

Hepatitis B

Hepatitis C

Hepatitis D

Hepatitis E

Global numbers in a year

New infections: 1.4 million

•Chronic infections: 240 million

•Acute cases: 4 million •Deaths: 1 million

•Chronic infections: 130 to 150 million •Deaths: 500,000

Affects 5% of persons with Hepatitis B

New infections: 20 million

• Symptomatic cases: 3 million • Deaths: 56,600

Spread

Ingesting faecal matter from:

•Contaminated food or drinks • Close contact with another person

Contact with infected body fluids via:

• Childbirth from an infected mother

• Sexual intercourse with an infected person

• Sharing contaminated needles or other injection-related materials

Contact with infected body fluid. It only occurs in those who already have Hepatitis B.

Contaminated food or water, and a possibility of transmission from pork, boar and deer.

Symptoms

Diarrhoea, fatigue, loss of appetite, mild fever, nausea, muscle/ joint aches, light abdominal pain, vomiting, weight loss, dark urine, drowsiness, light coloured faeces, jaundice or similar variants.

*Most Hepatitis B carriers may not show any symptoms at all.

Treatment

None needed. Most will recover after two weeks with medications and rest.

While some medications can suppress the virus, they can’t eradicate it.

New treatment available with high rate of success.

While some medications can suppress the virus, they can’t eradicate it.

None. Infection tends to clear on its own.

Vaccination

Yes, Hepatitis A vaccine

Yes, Hepatitis B vaccine

Currently, there is no vaccine available

Yes, Hepatitis B vaccine

Yes, but not widely available.