FAQ About Viral Hepatitis

Hepatitis is an inflammation of the liver. There are 5 main hepatitis viruses, referred to as types A , B, C, D, and E.

Hepatitis A and E are typically caused by ingestion of contaminated food or water.
Hepatitis B, C, and D usually occur as a result of parenteral contact with infected body fluids.
Common modes of transmission for these viruses include receipt of contaminated blood or blood products and invasive medical procedures using contaminated equipment.

Viral hepatitis usually has no any symptom during the early stages of the period of incubation for at least 10 years. Chronic infections over many years can seriously damage the liver and leads to cirrhosis and complications such as liver cancer.
 

Liver Disease Progression

  1. How likely will I be infected when living together with the family members with viral hepatitis? How can I protect myself?
  2. Hepatitis A virus is transmitted primarily by the faecal-oral contact. In families, this may happen through contaminated hands when an infected person prepares food for family members. Infection occurs when a small amount of virus-laden faeces reaches the mouth. Hepatitis A virus can spread through close personal contact or sex with an infected person.

    Hepatitis B and C all found in body fluids such as blood, semen and vaginal fluids of an infected person. Hepatitis B and C transmission can only occur when body fluids from an infected person enter another person’s body.
     

    The most common route of infection are:

    • At birth, from an infected mother to her baby, especially in developing countries.
    • In childhood, from person to person through sores or cuts that are not covered.
    • By having unprotected sex with a person who infected hepatitis B and C.
    • By sharing drug injecting equipment.

     
    Hepatitis B and C can also be passed on:

    • By sharing personal items such as razors, toothbrushes or other items that may carry blood.
    • Through injections, medical and dental procedures in countries where equipment is not sterilised (cleaned) properly, including acupuncture and tattooing equipment.
    • Through blood transfusions or organ transplants.

     
    Hepatitis B and C virus is not passed on during normal social contact, e.g. coughing, hugging, sharing bathroom and toilet facilities, sharing cooking and eating utensils.

    Breastfeeding is safe, especially if the baby has been vaccinated against hepatitis B.
     

  3. Does it mean that I have liver disease when the white of my eye turns yellow?
  4. When the whites of the eyes turn yellow, it generally indicates jaundice.

    Excessively high levels of bilirubin in the blood cause jaundice. Bilirubin is a yellow waste substance found in bile, the liquid the liver makes to help break down fats.

    When there is too much bilirubin in the bloodstream, it may leach into surrounding tissues like skin and eye tissues, causing them to turn yellow. Jaundice has different causes in adults, children, and newborns.
     
    There are three main reasons for jaundice to occur:

    • Liver damage or liver injury: Liver problems cause a type of jaundice known as hepatocellular jaundice. The most common symptoms of liver disease are like: loss of appetite, fatigue, mild fever, muscle or joint aches, nausea and vomiting, pain in the belly.
    • Rapid breakdown of red blood cells: When red blood cells are broken down too quickly, there is an increase in bilirubin production.
    • A blockage in the bile duct system: When the tubes that carry the bile from the liver to the gallbladder and intestines get blocked, bilirubin can’t leave the liver and builds up excessively. This type of jaundice is called obstruction jaundice.

     

  5. Treatment: How to treat viral hepatitis? Will it recur?
  6. Treatment options are determined by which type of hepatitis you have and whether the infection is acute or chronic.

    • Hepatitis A : Hepatitis A do not usually need specific treatment. Bed rest is recommended if symptoms cause a great deal of discomfort. Once you have the hepatitis A antibodies (from vaccination or developed from the previous infection), they will protect you from the infection.
    • Hepatitis B: Chronic hepatitis B can treated with antiviral medications. Treatment for chronic hepatitis B also requires regular medical evaluations and monitoring to determine its efficacy. The treatment can only control the virus but not eradicate it.
    • Hepatitis C: Antiviral medications are used to treat both acute and chronic forms of hepatitis C. People who develop chronic hepatitis C are typically treated with a combination of antiviral drug therapies for 12 weeks. Re-infection with a different genotype post-treatment is possible. There are 6 distinct genotypes for hepatitis C.
    • Hepatitis D: Propagate only in the presence of hepatitis B. Current treatment includes interferon injection.
    • Hepatitis E: There are currently no specific medical therapies to treat hepatitis E. Because the infection is often acute, it typically resolves on its own. People with this type of infection are often advised to get adequate rest, drink plenty of fluids, get enough nutrients, and avoid alcohol.

     

  7. Vaccine: How long the effect of the vaccination will last? Do I need a booster?
  8. Vaccines are available for hepatitis A and hepatitis B. Research into the development of vaccination for other viral hepatitis is under way.

    • Hepatitis A : Vaccination is effective. Most children receive the vaccination between ages 12 and 18 months. Vaccination is also available for adults.
    • Hepatitis B: National Immunisation Registry recommends hepatitis B vaccinations for all newborns to receive their first dose at birth; the second and third doses administered 1 and 6 months, respectively, after the first dose.

    Studies indicate that immunologic memory remains intact for at least 20 years among healthy vaccinated individuals who initiated hepatitis B vaccination >6 months of age.
     

  9. Myth: Will Stay up Late Leads to Liver Disorder? Do liver detox during a specific timing?
  10. There are no scientific studies that indicating staying up late will lead to liver disorders. Detoxification is one of the many of functions of the liver. The liver is working all day long with no specific timing.
     

  11. Myth: How do I take care of my liver?
    1. What to eat?
    2. You should avoid what is bad for your liver.

      Here are some ways to keep your liver healthy:

      • Don’t drink a lot of alcohol. Alcohol can damage liver cells and lead to cirrhosis.
      • Men should drink no more than two drinks* a day and women only one. *A standard drink is defined as 1 can (330ml) of regular beer, half glass (100ml) of wine and 1 nip (30ml) of spirit.

      • Eat a healthy diet and get regular exercise. It is good to keep your weight under control, which helps prevent non-alcoholic fatty liver disease (NAFLD), a condition that can also lead to cirrhosis.

       

    3. Is Chinese medicine harmful?
    4. An “all-natural” herbal product might sound like it is good for your health, but many Chinese herbal medicines consist of additional ingredients which can be toxic to the human body. Drug-induced liver injury is on the rise as self-prescribed herbal and dietary supplements have become more popular over the last decade.
       

    5. Is it healthy to eat internal organs such as liver, kidney, intestines etc.? Does eating pork liver helps to repair our liver?
    6. Internal organs are the most concentrated source of important vitamins, minerals, healthy fats and essential amino acids.

      The liver is a great source of high-quality protein and is one of the most concentrated sources of vitamin A, along with copper, folic acid, and iron. It also contains Coenzyme Q10 (CoQ10), which is important for cardiovascular functions. Pork liver is especially healthy for those who may be at risk for iron deficiency, such as pregnant women, athletes, and adolescents. Iron in pork is in the heme form, which is easier for your body to digest than non-heme iron from plant-based foods.

     

  12. Why mostly Chinese suffered from liver cancer?
  13. Hepatocellular carcinoma (HCC) is commonly associated with hepatitis B. Most hepatitis B carriers are Chinese which is the reason why liver cancer is most common among this ethnic group.

 

Do you know how viral hepatitis can lead to liver cancer? Dr Tan Kai Chah shares his insights into this topic through below video: