If left untreated, hepatitis can progress from chronic liver disease to cirrhosis, and possibly cancer. — Filepic
Hepatitis is an inflammation of the liver caused by a variety of infectious viruses and non-infectious agents.
It can lead to a range of health problems, including chronic liver disease and severe complications like liver failure.
There are five types of viral hepatitis: hepatitis A, B, C, D and E.
According to consultant gastroenterologist and hepatologist Dr Sheikh Anwar Abdullah, the most common types of hepatitis in Malaysia are B and C.
Approximately one million people in Malaysia are infected with the hepatitis B virus (HBV) and an estimated 2.5% of adults here have been infected by the hepatitis C virus (HCV).
Worldwide, the World Health Organization (WHO) estimates 354 million people live with hepatitis B or C.
Hepatitis A and E are transmitted through contaminated food or water, whereas hepatitis B, C and D spread through blood and bodily fluids.
“Understanding these transmission modes is crucial for effective prevention,” says Dr Sheikh Anwar.
He adds that hepatitis B and C can cause chronic liver disease such as liver cirrhosis and liver cancer.
Catching it early
A significant challenge in managing hepatitis C is its lack of symptoms, often leading to late diagnosis when the disease has already progressed to a severe stage, potentially causing liver cirrhosis or cancer.
“The majority are asymptomatic, and if you don’t check, you don’t know you have it until it’s already chronic,” says Dr Sheikh Anwar.
Similarly, chronic hepatitis B can also be asymptomatic until a late stage.
However, acute hepatitis B will usually present with symptoms such as abdominal pain, jaundice, dark urine, fatigue, nausea and vomiting, among others.
While hepatitis B has no cure, hepatitis C fortunately does.
Says Dr Sheikh Anwar: “The treatment for hepatitis B is not a cure, it is just to suppress the virus and slow it down, which is a lifelong battle for patients.
“For hepatitis C, antiviral drugs can now cure the infection in about 98% of cases in as short as three months.”
Early screening and diagnosis are critical to prevent the complications of hepatitis C, while regular follow-ups are essential for hepatitis B patients to monitor their liver function and detect any early signs of liver cancer.
Of equal importance is routine screening, especially for high-risk groups such as healthcare workers, individuals with high-risk behaviours, and those with a family history of hepatitis.
“Screening is crucial to detect the disease early and start treatment to prevent complications,” says Dr Sheikh Anwar.
He also highlights the importance of antenatal screening for pregnant women to prevent vertical transmission from mother to child.
“We now give antiviral treatment to pregnant women with hepatitis B to reduce the risk of transmission to the baby,” he explains.
One of the barriers to effective hepatitis management is the stigma associated with the disease.
“There is a significant stigma, which makes people reluctant to get screened,” Dr Sheikh Anwar says.
He calls for increased public awareness campaigns to educate people about the disease, its transmission, and the importance of early detection and treatment.
Lifestyle modifications can play a crucial role in managing hepatitis.
“Avoid alcohol and traditional medicines that can harm the liver,” he says.
Maintaining a healthy diet and avoiding infections are also essential to prevent liver complications.
Reducing HBV
One significant success in combating hepatitis B has been the inclusion of its vaccine in the National Immunisation Programme (NIP).
“Since 1989, we have vaccinated newborns, dramatically reducing the transmission rate,” notes Dr Sheikh Anwar.
Among Malaysian schoolchildren, the prevalence of HBV has steadily declined from 2.5% in 1985 to 0.4% in 1996, with 92.7% receiving the vaccination.
However, the consultant pointed out that follow-up and booster shots are sometimes needed.
“Many believe that the initial vaccination provides lifelong protection, but some may need booster shots if their antibody levels drop,” he says.
The hepatitis B vaccine confers protection for at least 20 years, and for many, their immunity is indeed likely to be lifelong, according to the WHO.
