Viral Hepatitis

What is Viral Hepatitis?

Cancer is the leading cause of death in Singapore1. It can happen anywhere in the body, but stomach cancer is cancer that develops in the stomach. Stomach cancer, also known as gastric cancer, is the 4th most common cancer and the 2nd most common cancer death worldwide2. It can occur anywhere in the stomach, but it mostly occurs in the main stomach body.

The stomach has 4 layers, and the stage of stomach cancer depends on which layers are affected.

The 4 layers are:

Hepatitis A: caused by the hepatitis A virus (HAV) and it usually only causes an acute or short-term infection. It does not result in chronic liver damage and will not lead to liver cancer and liver cirrhosis3.
Hepatitis B: caused by the hepatitis B virus (HBV) and it is the most common type of viral hepatitis worldwide (approximately 257 million people)4. It can cause either acute or chronic infections and may even lead to liver damage, liver cancer, and liver cirrhosis.
Hepatitis C: caused by the hepatitis C virus (HCV) and it usually causes both acute and chronic infections. Like hepatitis B, it can also lead to liver damage, liver cancer, and liver cirrhosis.
Hepatitis D: caused by the hepatitis D virus (HDV) and it can cause both acute and chronic infections. It is considered rare as you can only be infected with hepatitis D if you have been infected with hepatitis B.
Hepatitis E: caused by the hepatitis E virus (HEV) and it usually causes acute infections. It is particularly dangerous for pregnant women.

What causes Viral Hepatitis?

The causes of viral hepatitis depends on the type of hepatitis virus. Their causes based on type of hepatitis virus are:

Hepatitis A: mainly transmitted via the orofaecal route, for example, consumption of contaminated food and water, sexual intercourse, and close person-to-person contact5,6. Can be prevented with the hepatitis A vaccine6.
Hepatitis B: mainly transmitted by bodily fluids, for example, mother to baby during the birthing process, contact with contaminated needles or razors, sexual intercourse7. Can be prevented with the hepatitis B vaccine8.

Hepatitis C: caused by contact with contaminated bodily fluids such as mother to baby during the birthing process, sharing needles or razors with an infected person9.
Hepatitis D: caused by contact with the blood or bodily fluids of individuals infected with hepatitis D4.
Hepatitis E: mainly transmitted via the orofaecal route via the consumption of contaminated food and water10. Some cases may be transmitted via contaminated blood of individuals infected with hepatitis E10

What are the common symptoms of Viral Hepatitis in Singapore?

Some common symptoms of viral hepatitis include1,11:

Tiredness, fatigue, or lethargy
Abdominal discomfort
Yellow eyes or skin (jaundice)
Dark urine
Light/pale stools
Nausea
Vomiting
Unexplained weight loss
Loss of appetite

Symptoms of chronic hepatitis may not appear until liver damage or cirrhosis occurs; however, symptoms of acute hepatitis may appear shortly after infection.

Is Viral Hepatitis painful?

It can be depending on how much liver damage there is if you have chronic hepatitis, while acute hepatitis may cause abdominal discomfort in some individuals.

Who is at risk of Viral Hepatitis in Singapore?

Certain individuals and activities can increase your risk of viral hepatitis, these are12:

Intravenous drug users
Lived with or have had sex with infected individuals
Poor sanitation
Traveling or living in countries where hepatitis is endemic
Individuals without the vaccines for hepatitis.

How is Viral Hepatitis diagnosed?

There are a variety of tests that are used to diagnose viral hepatitis, these are2,11:

Medical history: this is to identify if you have any risk factors such as recent blood transfusion, tattoos, or intravenous drug use.
Liver function tests: this is to test how well your liver is working. You may not show any symptoms of a viral hepatitis infection, so a liver function test will help identify if your liver is functioning properly. If your liver enzyme levels are high, it may indicate that your liver is injured, stressed, or not functioning properly.
Physical examination: this allows your gastroenterologist to identify if there are any physical changes in your appearance such as yellow skin or eyes, or abdominal swelling.
Blood tests: to check for the presence of the hepatitis virus or antibodies produced in response to the hepatitis virus.
Ultrasound/CT Liver: used to check for fluid retention in your abdomen, enlarged or damaged liver, liver tumours, or abnormalities of the gallbladder.
Liver biopsy: a tissue sample is taken from your liver to check if any liver damage or scarring has occurred. This is not common and is usually done when all other test have not shown the cause and prognosis.

What are the treatment options for Viral Hepatitis in Singapore?

The treatment options for viral hepatitis depend on the type of hepatitis virus you have been infected with.

Treatment options include:

Hepatitis A: since hepatitis A is a short-term illness, it usually goes away by itself. However, if you experience mild symptoms, over-the-counter medication may help alleviate them.
Hepatitis B: anti-viral medications.
Hepatitis C: anti-viral medications.
Hepatitis D: Usually occurs in conjunction with Hep B and is managed as such.
Hepatitis E: no medical treatments are available. Since hepatitis E is a short-term illness, it usually goes away by itself.

Frequently asked questions

How do I reduce the viral load of hepatitis B and C?

Antiviral drugs can help to reduce your viral load.

Are all causes of hepatitis viral in origin?

Hepatitis is an inflammation of the liver, while hepatitis can be caused by a number of factors, viral hepatitis is caused by viruses. However, there are many other causes of hepatitis.

Is hepatitis contagious?

Viral hepatitis is contagious and can pass between individuals via bodily fluids through sex or sharing infected needles.

References:

Cleveland Clinic Medical Professional. (2020, January 6). Viral Hepatitis. Retrieved from Cleveland Clinic: https://my.clevelandclinic.org/health/diseases/4245-hepatitis-viral-hepatitis-a-b--c
NIDDKD. (2019, May). What Is Viral Hepatitis? Retrieved from National Institute of Diabetes and Digestive and Kidney Diseases: https://www.niddk.nih.gov/health-information/liver-disease/viral-hepatitis/what-is-viral-hepatitis
World Health Organisation. (2022, June 24). Hepatitis A. Retrieved from World Health Organisation: https://www.who.int/news-room/fact-sheets/detail/hepatitis-a
Centers for Disease Control and Prevention. (2022, March 30). Hepatitis B Questions and Answers for the Public. Retrieved from CDC: Centers for Disease Control and Prevention: https://www.cdc.gov/hepatitis/hbv/bfaq.htm
Kuan-Yin Lin, G.-J. C.-L.-C.-Y.-Y.-E.-C. (2017). Hepatitis A virus infection and hepatitis A vaccination in human immunodeficiency virus-positive patients: A review. World Journal of Gastroenterology, 3589-3606.
Christian Herzog, K. V. (2021). Hepatitis A vaccination and its immunological and epidemiological long-term. Human Vaccines and Immunotherapeutics, 1496-1519.
Thomas Tu, J. M. (2020). The Lived Experience of Chronic Hepatitis B: A Broader View of Its Impacts and Why We Need a Cure. Viruses.
Hong Zhao, X. Z.-H. (2020). Hepatitis B vaccine development and implementation. Human Vaccines and Immunotheapeutics, 1533-1544.
Mayo Clinic Staff. (2021, August 31). Hepatitis C. Retrieved from Mayo Clinic: https://www.mayoclinic.org/diseases-conditions/hepatitis-c/symptoms-causes/syc-20354278
Thomas Horvatits, J. S. (2019). The Clinical Perspective on Hepatitis E. Viruses.
Khan, A. (2021, April 22). Hepatitis. Retrieved from healthline: https://www.healthline.com/health/hepatitis
National Centre for Infectious Diseases (NCID). (2022, October 17). Hepatitis. Retrieved from National Centre for Infectious Diseases (NCID): https://www.ncid.sg/Health-Professionals/Diseases-and-Conditions/Pages/Hepatitis.aspx

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General

Liver

Oesophagus

Biliary/Pancreas

Stomach/Duodenum

Intestinal