Preventing Hepatitis: A Comprehensive Guide for Health-Conscious Singaporeans

Hepatitis is a condition characterised by liver inflammation and can be caused by various factors, including viral infections, bacteria, and toxins. Acute Hepatitis is primarily driven by Hepatitis A, B, C, and E viruses, although other non-liver-specific viruses can also trigger it. As for chronic Hepatitis, the most common culprits are the Hepatitis B and Hepatitis C viruses. According to SingHealth, Hepatitis B is the leading cause of chronic viral Hepatitis in Singapore.

Hepatitis Symptoms

Hepatitis A symptoms usually develop within 15 to 50 days after exposure to the virus. They can include:

• Fatigue
• Fever
• Loss of appetite
• Nausea
• Vomiting
• Diarrhoea
• Dark urine
• Light-coloured stools
• Joint pain
• Abdominal pain
• Jaundice (yellowing of the skin and eyes)

Hepatitis B symptoms can develop anywhere from a few weeks to several months after exposure to the virus. They can be similar to the symptoms of hepatitis A, but they can also be more severe. Some people with hepatitis B may not have any symptoms at all.

Hepatitis C symptoms can develop for weeks, months, or even years. Many people with hepatitis C never develop any symptoms. When symptoms occur, they can be similar to the symptoms of hepatitis A or B.

Hepatitis D symptoms are the same as the symptoms of hepatitis B. However, hepatitis D can only occur in people infected with hepatitis B.

Hepatitis E symptoms are fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, pale stools, and jaundice.

Hepatitis Transmission

Hepatitis A is spread through the faecal-oral route which can be transmitted through stool contact with an infected person. This often happens from contaminated food or water or close personal contact, such as sexual contact or sharing needles.

Hepatitis B is spread by getting contact with infected blood or body fluids. This can happen through sharing needles, through sexual contact, from mother to child during childbirth, or through medical procedures involving using contaminated needles or equipment.

Hepatitis C is often spread through contact with infected blood. However, it is less easily transmitted than hepatitis B. At times, it is spread through sexual contact but is less common.

Hepatitis D can only occur in people already infected with hepatitis B. It is spread through the same routes as hepatitis B, including sharing needles, sexual contact, and from mother to child during childbirth.

Preventing Hepatitis

Hepatitis A Prevention

• Get vaccinated against hepatitis A.
• Practice good hygiene, including regular handwashing with soap and water.
• Avoid consuming contaminated food or water.
• Practice safe and protected sex and avoid sharing personal items like toothbrushes and razors.

Hepatitis B Prevention

• Get vaccinated against hepatitis B.
• Use barrier methods (condoms) during sexual activity.
• Avoid sharing needles or personal items that may come into contact with blood or body fluids.
• If pregnant, ensure prenatal screening and take appropriate measures to prevent transmission to the baby.

Hepatitis C Prevention

There is no vaccine for hepatitis C, so focus on prevention measures for hepatitis B and safe sex practices to reduce transmission risks.

Hepatitis D Prevention

As hepatitis D can only occur in individuals already infected with hepatitis B, preventing hepatitis B transmission is the primary preventive measure.

Hepatitis E Prevention

Avoid consuming contaminated water and practice good hygiene when handling food.

Diagnosing Hepatitis

Some diagnostic tests can detect Hepatitis. The type of test used will depend on the type of Hepatitis that is suspected:

Hepatitis A

The most common test for hepatitis A is an antibody test. This test measures the antibodies to the Hepatitis A virus in your blood. Antibodies are proteins your body produces as a response to an infection. If you have antibodies to hepatitis A, you have been infected with the virus at some point.

Hepatitis B

Many different tests can be used to diagnose hepatitis B. These tests include:

• Hepatitis B surface antigen (HBsAg): This test measures the levels of HBsAg in the blood. HBsAg is a protein that is produced by the hepatitis B virus. If you have HBsAg in your blood, you are currently infected with the virus.
• Hepatitis B core antibody (HBcAb): This test measures the levels of HBcAb in the blood. HBcAb is an antibody that the body produces in response to the hepatitis B core protein. If you have HBcAb in your blood, you have been infected with the virus at some point.
• Hepatitis B e antigen (HBeAg): This test measures the levels of HBeAg in the blood. HBeAg is a protein that is produced by the hepatitis B virus. If you have HBeAg in your blood, it means that you are currently infected with the virus and that the virus is actively replicating.
• Hepatitis B DNA: This test measures the levels of hepatitis B DNA in the blood. Hepatitis B DNA is the genetic material of the hepatitis B virus. If you have hepatitis B DNA in your blood, you are currently infected with the virus.

Hepatitis C

The most common test for hepatitis C is an antibody test. This test measures the antibodies to the hepatitis C virus. Antibodies are proteins your body produces as a response to an infection. If you have antibodies to hepatitis C, you have been infected with the virus at some point.

Hepatitis D

The only way to diagnose hepatitis D is to test for both hepatitis B and hepatitis D. If you have hepatitis B, you can be tested for hepatitis D by measuring the levels of hepatitis D antigen (HDAg) in the blood. HDAg is a protein that is produced by the hepatitis D virus. If you have HDAg in your blood, it means that you are currently infected with both hepatitis B and hepatitis D.

Hepatitis E

The most common test for hepatitis E is an antibody test. This test measures the antibodies to the hepatitis E virus in the blood. Antibodies are proteins your body produces as a response to an infection. If you have antibodies to hepatitis E, you have been infected with the virus at some point.

Medical Tests for Hepatitis

Liver Function Tests

• These tests measure liver enzymes and proteins in the blood to assess liver health and function.

Hepatitis Serology Tests

• Serology tests detect antibodies specific to each hepatitis virus and help diagnose the type of hepatitis infection.

Liver Biopsy

• A liver biopsy involves removing a small tissue sample from the liver for examination under a microscope to assess liver damage and inflammation.

Vaccinations for Hepatitis

Hepatitis A vaccine

Hepatitis A is a two-dose vaccine- the first dose is given as an injection, and the second dose is given 6-12 months later. The vaccine is about 95% effective in preventing hepatitis A.

Hepatitis B vaccine

The hepatitis B vaccine is a three-dose vaccine. The first dose is given as an injection, and the second and third doses are delivered 1-2 months and six months later. The vaccine is about 95% effective in preventing hepatitis B.

It is recommended to get vaccinated for all children at the following ages:

• 12 months of age
• 18 months of age
• 4-6 years of age

The hepatitis A and B vaccines are also recommendable for adults who are at increased risk of infection, such as:

• People who travel to countries where hepatitis A or B is common
• People who work in healthcare or other settings where they may be exposed to blood or body fluids
• People who have sex with multiple partners
• People who use illegal drugs

If you are concerned about your risk of hepatitis A or B, talk to your doctor. They can recommend the appropriate vaccines for you.

Hepatitis C, D, and E

There is no vaccine available for hepatitis C, D, or E. However, there are treatments available for hepatitis C. If you are concerned about your risk of hepatitis C, our General Practitioners are available for consult. We can recommend appropriate testing and treatment options for you.

Where to Get Tested for Hepatitis in Singapore

MHC offers vaccinations for Hepatitis A and B in our clinics. You may book an appointment at Amara Medical Centre or Novena clinic. Alternatively, you may also contact our clinics for the latest update on the available vaccinations. Hepatitis is preventable through vaccination, safe practices, and good hygiene. Early detection through medical testing is crucial for effective treatment and preventing severe complications. Singaporeans should take proactive measures to safeguard their health by vaccinating, practising safe behaviours, and seeking medical attention promptly. By doing so, they can significantly reduce the risk of Hepatitis and maintain a healthy and fulfilling life.

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