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Hepatitis A, B, C

Hepatitis is a liver disease. It is due to inflammation of the liver. It can be caused by viruses, medications (including complementary herbal medications), alcohol, a person own immunity and others.

What is Hepatitis?

Hepatitis is a liver disease caused by inflammation of the liver. There are many causes such as viral infection, alcohol consumption and chemicals.  There are several types of Hepatitis diseases caused by Hepatitis viruses, including:

– Hepatitis A is caused by Hepatitis A virus infection.

– Hepatitis B is caused by Hepatitis B virus infection.

– Hepatitis C is caused by Hepatitis C virus infection.

Infections with Hepatitis B and C viruses are the most common and can lead to chronic disease, which is a major cause of liver cirrhosis and liver cancer.

 

What are the warning signs of Hepatitis?

Many people have no symptoms. If symptoms are present they are the same for the different causes of hepatitis

The symptoms are:

  • tiredness
  • loss of appetite
  • nausea
  • vomiting
  • abdominal pain
  • yellow discolouration of the white of the eyes, skin
  • Tea-coloured urine
  • pale or clay-coloured stool

 

What are the complications of chronic Hepatitis?

Hepatitis B and C can become chronic (i.e. infection persisting for more than 6 months). Chronic Hepatitis can cause inflammation leading to significant damage to the liver. If the damaged liver is replaced by fibrous tissue, this may lead to severe scarring, called liver cirrhosis.

Additional symptoms and complications with liver cirrhosis ascites :

  • abdominal swelling (ascites)
  • easy bruising
  • altered behaviour or alertness (encephalopathy)
  • vomiting of blood
  • passing of black tarry stool
  • liver cancer (hepatocellular carcinoma)
  • death

When liver cirrhosis occurs, the liver becomes severely scarred and cannot perform its normal functions effectively. This can later lead to the development of liver cancer. In severe cases, some patients will need a new liver (liver transplantation).

 

Hepatitis A

What is hepatitis A?

Hepatitis A is contracted by eating food or drinking water that has been contaminated by the hepatitis A virus. Hepatitis A virus is found in the stool of persons with hepatitis A infection.

The symptoms of hepatitis usually appear at 15 to 45 days following exposure. Apart from the symptoms of hepatitis above, some may have diarrhea and fever. However some cases the symptoms are mild or absent. Older persons tend to have more severe symptoms than children. Those with severe symptoms and liver inflammations may require hospital admission. Acute hepatitis A usually resolves within 6 months and does not develop into chronic liver disease apart from a small percentage who may have a more prolonged relapsing illness.

 

Who is at risk of getting hepatitis A?

  • consuming food or drinks prepared by infected food handlers with poor hygeine.
  • household or sex contacts of infected persons
  • men having sex with men

 

What should I do if I have viral hepatitis A?

If you suspect that you may have been infected by hepatitis A virus :

 

Consult your doctor

Your doctor will assess and examine you.

The doctor will also do blood tests including specific tests for hepatitis A.

You may need hospital admission if your liver is not functioning well.

Most people only need symptomatic treatment and a period of monitoring.

There is a small chance of very severe hepatitis A infection whereby your life may be at risk.

Usually, you do not need long-term follow-up.

 

Protect your family or loved ones

Good personal hygiene with proper hand washing and sanitation can help prevent hepatitis A. Wash your hands with soap and water after using the toilet and before preparing food or eating.

Vaccines are available for long-term protection.

 

Hepatitis B

What is Hepatitis B?

Hepatitis B spreads through contact with infected blood or body fluids, much like Human Immunodeficiency Virus (HIV). However, Hepatitis B is 50 to 100 times more infectious than HIV.

Hepatitis B does not spread through sharing utensils, breastfeeding, hugging, kissing, holding hands, coughing, sneezing, or using public swimming pools or similar facilities.

Symptoms of hepatitis typically appear between 25 to 180 days after infection. Symptoms can include joint pain and muscle aches. However, about half of infected individuals do not experience symptoms.

Unlike Hepatitis A, Hepatitis B can lead to chronic liver disease and subsequently to liver cirrhosis and liver cancer.

 

Who is at risk of getting hepatitis B?

Individuals at high risk of getting hepatitis B infection include:

  1. Individuals who have sexual contact with someone infected with hepatitis B virus;
  2. Babies born to mothers infected with Hepatitis B;
  3. Individuals who share contaminated equipment with hepatitis B virus such as needles, tattooing equipment, razors, and the like;
  4. Individuals who received blood products contaminated with the Hepatitis B virus before 1995.

Individuals at high risk of Hepatitis B infection are advised to undergo hepatitis screening so that appropriate treatment and care can be provided as needed.

 

What should I do if I have viral hepatitis B?

If you suspect that you may have been infected by hepatitis B virus :

 

Consult a doctor

If you suspect you have been infected with Hepatitis B virus, please do hepatitis screening.

Consult with healthcare personnel. The doctor will assess and examine you including conducting blood specific blood tests for Hepatitis B. Some cases require ultrasound or liver biopsy. If necessary, the doctor will provide treatment to prevent complications of Hepatitis B infection. If your liver function has deteriorated, hospitalization may be required.

However, half of individuals may not need treatment but require regular monitoring as the infection situation may worsen, necessitating treatment to prevent liver cancer complications.

If you are infected, protect your family and loved ones from Hepatitis B virus infection by taking the following steps:

– Inform family members, sexual partners, and housemates to undergo Hepatitis B screening to determine infection status. If negative, they can receive Hepatitis B vaccination to prevent infection.

– Practice safe sex.

– Do not share personal items that may have blood (such as toothbrushes, razors, nail clippers, scissors, syringes, etc.).

– If injured at home, ensure spilled blood is cleaned using a bleach solution (one part bleach mixed with 10 parts water). It’s best if cleaning is done by yourself to reduce the risk of infection to other family members. If done by someone else, that individual should wear gloves. Used tissues or cloth to wipe blood should be placed in a plastic bag and discarded. The wound should also be covered with a plaster.

– For positive pregnant women, your baby will receive two types of treatment: Hepatitis B vaccine and immunoglobulin injection at birth.

– In Malaysia, Hepatitis B is given to all children under the National Immunisation Programme.  Hepatitis B immunization is given shortly after birth. Subsequent doses are administered in a  6 in 1 combination vaccine (Diphtheria – Tetanus-Pertussis-Polio-Haemophilus influenza type b – Hepatitis B) at 2, 3, 5, and 18 months of age.

 

Looking after yourself :

  • You need to adopt a healthy lifestyle.
  • You must avoid alcohol.
  • You should not take pills and medications without approval from your treating doctor.

 

Hepatitis C

What is Hepatitis C?

Hepatitis C can be transmitted through body fluids like blood and semen. The majority of persons infected with hepatitis C do not have any symptoms. Compared to Hepatitis B this is less common in Malaysia. However, infection with hepatitis C leads to chronic liver disease and can cause liver cirrhosis with its complications.

 

Who is at risk of getting hepatitis C?

  • injection drugs users
  • people who had blood transfusions before 1994
  • Hemodialysis patients
  • any person with a sexual partner infected with hepatitis C.
  • Healthcare workers or anyone whose work involves contact with human blood
  • people with multiple sex partners
  • baby born to an infected mother but the risk is very low (about 4%)

 

What should I do if I have viral hepatitis C?

If you suspect that you may have been infected by hepatitis C virus :

 

Consult a doctor

Your doctor will assess and examine you.

The doctor may do blood tests including specific tests for hepatitis C and an ultrasound of your liver.

In some cases, you may need a liver biopsy, a procedure whereby a small liver tissue is taken for further tests.

You may need hospital admission if your liver is not functioning well. Otherwise, you may be seen and followed up in the clinics.

It is important to consult a doctor because Hepatitis C can be treated. Treatment can prevent complications. The treatments consist of injections and tablets.

You may need to be screened regularly for complications, especially liver cancer.

 

Protect your family or loved ones :

There is no vaccine for Hepatitis C.

  • You should inform your family members (parents, siblings, spouse and children) and any other household members to get themselves tested. If they are tested positive they need to consult a doctor.
  • The risk of spreading Hepatitis C by sex is less. However, if you are having sex with more than one sex partner you are recommended to use a condom.
  • You should never share objects that may have blood on them (for example: needles, razors, toothbrushes, nail clippers).
  • You should wipe any blood spilled yourself. Use household bleach (1 part into 10 parts of water) for disinfection and throw the tissue paper or cloth contaminated with blood into a plastic bag. Tie the plastic bag and discard it into the dustbin. Cover your cut with a plaster.

Looking after yourself :

  • Adopt a healthy lifestyle.
  • Avoid alcohol.
  • Do not take any tablets without informing your doctor that you have viral hepatitis.
  • Follow your doctor’s advice.

 

Support group

Malaysian Liver Foundation.

 

Last Reviewed

:

17 July 2024

Writer

:

 Dr. Diana binti Mahat

Reviewer

:

Dr. Jamiatul Aida binti Md Sani

 

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