Understanding Hepatitis B

Hepatitis B is a virus. It is a virus that enters our body and targets our liver, resulting in infection and inflammation. Do you know that we can effectively prevent Hepatitis B infection through vaccination and avoiding high risk behaviours. In the event when we contract the virus, there are ways to follow up the condition and prevent long term complications like cancer and death. We will explain more in this article.

Statistics

There is an estimated 300 million carriers of Hepatitis B virus in the world today, with over 500,000 dying annually from Hepatitis B related liver disease. The incidence of hepatitis b is higher in Asia, Africa and eastern-Europe.

In Singapore, about 4-6% of the population has chronic hepatitis B infection. That’s 1 in 25!

When someone is first infected, it is called an acute infection. If that same person has had hepatitis B for more than 6 months, then that will become chronic hepatitis B.

How Hepatitis B is contracted

The only way to get the hepatitis B virus is by coming into contact with infected blood or bodily fluid.

Birth Process

One common way is during the birth process. If the mother is infected with hepatitis B at the point of delivery, then the child may become infected in the process of delivery.

Sexual contact

Sexual contact is another major mode of transmission of the virus where there is exchange of bodily fluids.

Contact with contaminated blood

Coming into contact with contaminated blood such as through an injury, scratch, sharing of unsterilized needles during tattoo or drug injections are also common modes of transmissions.

Where Hepatitis B will not be contracted

You will not get hepatitis B through touching, kissing, hugging, sharing of food and water, sharing of cups and utensils.

High Risk Groups and Screening

There are people who are at a higher risk of contracting hepatitis b and they are

• infants born to infected mothers
• sexually active individuals with multiple sex partners
• gay and bisexual men
• household contacts with individuals who has hepatitis b
• intravenous drug user
• individuals undergoing hemodialysis
• healthcare workers and public-safety workers at risk for occupational exposure to blood

If you fall under these at risk groups, then it’s highly recommended that you go for regular screening for hepatitis B.

Screening

Screening is as simple as taking 1 tube of blood at your nearest GP or family clinic with results available in a matter of days. Typically checks for Hepatitis B include surface antibodies and Hepatitis B surface antigens.

Symptoms for Hepatitis B infection

Not all patients infected with hepatitis B may show symptoms.  When present, symptoms and signs includes :

• fever, fatigue and joint pain.
• loss of appetite, nausea and vomiting
• abdominal pain
• tea coloured urine, pale or clay coloured stool
• jaundice or yellowing of eyes and skin

In a small proportion of patients, acute Hepatitis B infection may result in liver failure.

It is important to understand that acute Hepatitis B infection may progress to chronic hepatitis infection.

The risk is high amongst children. Approximately 90% of infants and 25-50% of children aged 1-5 will get chronic Hepatitis B infection. In contrast, about 90% of adults recover completely from Hepatitis B and do not become chronically infected. It is important to identify and treat patients with chronic Hepatitis B infection as it may lead to liver scarring, liver failure and even liver cancer, all of which are fatal.

Hepatitis B Vaccinations

Hepatitis B vaccines given in a series of 3 doses are more than 98% effective in helping us prevent hepatitis b infection.

The world health organisation recommends that all infants receive the hepatitis B vaccine at birth followed by 2-3 doses of the vaccine weeks to months later. In Singapore, Hepatitis B vaccine is given as a 3 dose series as part of our childhood immunisation program at birth, 1-2 months old and at 6 months old. This is a program which was started way back in 1987.

Now, if you were born before that, please go for a hepatitis b screening to determine if you need the vaccination.

Conclusion

Recognise that hepatitis b is pretty common in Singapore. Long term complications can develop if left unchecked and untreated. Screening tests are easily and widely available and vaccinations are very effective and not expensive to do.