When you think about hepatitis, what is the first thing that comes to mind? Jaundice? An infection of the liver? Liver failure? Here’s where you can find out what you need to know about this common condition.
Hepatitis is a disease that is often misunderstood or confused with another condition. Consultant Gastroenterologist and Hepatologist from Sunway Medical Centre, Datuk Dr. Chua Tee Joo says that many people are not clear about what this disease is all about. Datuk Dr. Chua demystifies this medical condition with expert insight on what it is, how it occurs and the treatment options available.
Not necessarily an infection
“Hepatitis is not necessarily an infection of the liver,” Datuk Dr. Chua clarifies. “Some people get confused with this term and it is important to know that hepatitis is the inflammation of the liver.”
There are several types of hepatitis but it is generally divided into three:
- Infectious hepatitis
- Drug-induced hepatitis
- Autoimmune hepatitis
Datuk Dr. Chua clarifies that the symptoms of each type of hepatitis are generally the same. These symptoms include jaundice, fever and lethargy.
There are 5 types of hepatitis that fall under this category. They are, hepatitis A, B, C, D and E. The last two types — D and E — are rare. Datuk Dr. Chua also explains that because they are so rare, there is not enough information and insufficient research papers that provide in depth knowledge on this condition. “Hepatitis A, B and C on the other hand, are the more common types which are affecting Malaysians. They are caused by hepatotropic viruses which can affect your liver.”
Datuk Dr. Chua explains that, “Hepatitis is a food bourne infection. A person could get infected when consuming contaminated water, contaminated shellfish and even consuming food which has been handled with poor hygiene techniques.” For hepatitis A, the route of transmission is oral-fecal.
Hepatitis A is generally not a life-threatening condition. “It is an acute illness whereby you can experience the symptoms of hepatitis such as jaundice. Treatment is available. Once you have recovered from hepatitis A, you will have lifelong immunity against this condition,” says Datuk Dr. Chua.
A vaccine is available to prevent hepatitis A. Although it is not part of the National Immunisation Program (NIP), Datuk Dr. Chua says that the vaccine can be found at most clinics.
Hepatitis B is another form of infectious hepatitis which can be transmitted through bodily fluids such as via sexual transmission, blood transfusion and fetal-maternal transmission. Besides that, using shared needles, being an intravenous (IV) drug user and getting a tattoo from a tattoo parlour that does not follow good sterilization and hygiene practices, can increase chances of being infected by hepatitis B.
“This condition is divided into two — chronic and acute,” says Datuk Dr. Chua. According to the World Health Organization, acute hepatitis B is characterised by an infection of the hepatitis B virus which may or may not cause any symptoms or complications. In other words, the person could have been infected by the virus but the body was able to get rid of it. Chronic hepatitis B, on the other hand, is a condition which is described as having the virus in the blood for more than six months.
Patients with chronic hepatitis B could be an active or inactive carrier. “An active carrier has an increased risk of the disease progressing to end stage liver disease which is known as liver cirrhosis. It can also increase your risk of liver cancer,” explains Datuk Dr. Chua. “An inactive carrier on the other hand, has a lower risk of contracting these diseases but there is a possibility that a switch could occur and he or she can become an active carrier.”
The treatment options for hepatitis B include injections and medication. “The medical practitioner will need to take into account the patient’s age, health status, hepatitis status – active or inactive — in order to prescribe a suitable treatment plan.”
Injections are generally recommended for patients who are living with a more serious form of hepatitis B. This treatment option is more expensive compared to medication but there is a 20 percent chance for a complete cure. “However, there are possible side effects that the patient may experience including lethargy, depression and hair loss. It could also affect your blood count,” explains Datuk Dr. Chua. This treatment is usually prescribed to younger patients. Older patients are generally prescribed oral medication. However, Datuk Dr. Chua points out that there is no clear cut end point to the treatment because every patient is different.
Immunisation against the hepatitis B virus is recommended and this falls under the NIP. The vaccine is administered to newborn babies. However, Datuk Dr. Chua’s encourages parents to have their child undergo a blood test during their teens. “This step is to ensure that your child has sufficient antibodies to protect him or her from the virus.” The good news is, if your child does not have sufficient antibodies and has not received the hepatitis A vaccine, the vaccine for hepatitis A and B can be administered in a single shot.
According to Datuk Dr. Chua, hepatitis C is a relatively new type of infectious hepatitis which was discovered in the 1980s. One of the most common ways to get infected by hepatitis C is through blood. Sexual transmission is possible but rare. “The symptoms of hepatitis C is just like any other form of hepatitis. As a matter of fact, they are not very prominent and this condition is not fatal, unlike hepatitis B,” explains Datuk Dr. Chua.
Treatment options for hepatitis C depend on the genotype of the infection. “The treatment options are different and prescribed according to each individual. There are treatments available which can cure certain types of hepatitis C genotype,” he assures. “There are new types of medication being made available but for some genotypes and the chances of a cure are as high as 98 to 99 percent.”
This form of hepatitis is relatively common in Malaysia, especially with the consumption of certain types of traditional or herbal supplements. Drug induced hepatitis is commonly caused by medication which have been adulterated. “Many people have an impression that herbal treatments and supplements are safe because it is ‘natural’. However, they may not be aware of the exact content of the product,” warns Datuk Dr. Chua adding that it is not that all forms of traditional or herbal supplements are bad. It is just that patients should be aware of the ingredients in the products they are consuming as these can be detrimental. Before consuming any traditional or herbal remedies, it is important that you consult your doctor to ensure that the products are safe for consumption.
Autoimmune hepatitis on the other hand, is a form of hepatitis which is linked to the antibodies in the liver. Autoimmune hepatitis is generally more common among females although the cause is unknown.“ Many patients with autoimmune hepatitis tend to experience other symptoms such as joint pain, rash and hair loss. It is only during the diagnosis and investigation period that the patient is diagnosed with hepatitis,” says Datuk Dr. Chua. There is no cure for autoimmune hepatitis but there are treatment options available which include steroids and immunosuppressant medications.
The best way to identify if you have been infected by a hepatitis virus is to go for a blood test. There are health screening packages that screenings for certain types of hepatitis. Be sure to get yourself tested, especially if you think you are at risk.