The ABCs of Hepatitis B: What Everyone Needs to Know

My family members suffered from complications of undiagnosed chronic hepatitis B in the past; hence I believe it is an important topic for us to discuss today and create an awareness of this illness.

Hepatitis B is a significant public health issue in Malaysia, with a prevalence rate of approximately 3.6% of the population infected with the virus. It can be diagnosed through a simple blood test that detects the presence of viral antigens.

Hepatitis B can be passed from one person to another through blood and other bodily fluids. Common ways of getting the virus include unprotected sex with someone who has it, from an infected mother to her baby during childbirth, and sharing needles with an infected person. Casual contact, such as hugging, holding hands, or sharing utensils, food or drinks is unlikely to transmit the virus. Contrary to popular belief, it is unlikely for this virus to transmit through sharing food.  However, it is theoretically possible for the virus to be transmitted through kissing if there are cuts or open sores in the mouth or gums of the infected person, or if there is exchange of infected bodily fluids.

Once infected, a person may have symptoms of acute hepatitis, which include symptoms such as fatigue, nausea, abdominal pain, dark urine, and jaundice (yellowing of the skin and eyes). Acute hepatitis B usually resolves within days without treatment, but some of these patients will continue to harbour the virus in the liver for an extended period of time, if not lifelong. These people are deemed to have chronic hepatitis B.

Unlike acute hepatitis B, patients with chronic hepatitis B requires ongoing medical care, monitoring and treatment to prevent the development of serious complications such as liver cirrhosis, liver failure and liver cancer. Monitoring a person with chronic hepatitis B involves regular medical check-ups and tests including blood test and ultrasound imaging of the liver, usually at a six-monthly interval, to assess the status of their liver function and to detect early cancer changes.

A large majority of people with chronic hepatitis B do not require treatment. However, once they develop liver inflammation, or liver failure in extreme cases, they would need to be started on antiviral medication and continued for an extended period of time in order to supress the viral activity.

Fortunately, hepatitis B can be prevented. In this day and age, pregnant women are tested for hepatitis B almost as soon as they register with their healthcare provider. Healthcare providers have strict protocol to follow during the childbirth process and these extra steps taken can effectively prevent transmission of the virus from mother to the baby during childbirth. It is important to practice safe sex by using barrier methods such as condoms as well. There is also a hepatitis B vaccination programme implemented nationally. Teenagers and adults who are at risk of contracting the virus are encouraged to get their hepatitis B antibody levels tested as well and receive booster shots. The vaccine is safe and effective.

If you have been tested and diagnosed with hepatitis B, it is important to see a healthcare provider, who can then provide you with further testing, evaluation, and treatment. They can also help you understand your diagnosis and develop a plan to manage the illness. Person living with hepatitis B should take steps to protect their liver, such as avoiding alcohol and certain medications that can be harmful to the liver. You should also practice safe sex in order to prevent transmission to your partner while awaiting further discussion with your healthcare provider. It is also important for your partner to receive hepatitis B vaccination or booster shot. Your family members should be screening for hepatitis B as well.

One of the common questions I get from patients is “which supplement is good for my liver?”. While there are many supplements that are marketed as beneficial for liver health, it is important to remember that supplements are not regulated by the authorities in the same way as medications, and their safety and effectiveness may not be well-established. Certain supplements such as milk thistle, vitamin D and probiotics have been thought to be helpful in liver conditions – though I would caution against taking any supplements without consulting your healthcare provider, as sometimes it could be doing more harm than good.

In summary, hepatitis B is a serious health issue with many dangerous irreversible complications. It is a preventable and treatable disease. It should not be neglected. If you or your loved ones have been recently diagnosed or have been living with hepatitis B for some time, I would encourage to seek consult with a healthcare provider in near future, either with liver specialist (gastroenterologist and hepatologist) or a internal medicine specialist (physician).

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