How to prevent the silent time bomb - Hepatitis B

How to prevent the silent time bomb - Hepatitis B

How to prevent the silent time bomb - Hepatitis B

HEALTH

2019-08-30

5  Mins Read

In the past, 10% of the population in South China were carriers of hepatitis B¹, a common type of hepatitis. Although it’s now a disease that can be effectively prevented, the scary part is that it shows no sign of illness and causes irreversible damages to most patients’ liver by the time obvious symptoms appear.

Spreading through blood, sexual activities and childbirth

Hepatitis B is transmitted only through contact with blood, and sexual activities. In Hong Kong, the virus is most commonly transmitted from mother to her newborn during delivery. If the mother is a hepatitis carrier, the baby would have a 90% chance of acquiring the virus. But thanks to the advancement in medical science, the mother who is found to be a carrier at pregnancy checks will now receive immunoglobulin vaccines to greatly lower the risk of mother-to-child transmission.

8 in 10 liver cancer cases are related to hepatitis B virus

Since hepatitis B often has no symptoms and many carriers don’t even know they are infected, blood test is the only way to diagnose the virus. Nevertheless, there are 2 situations where symptoms show themselves:

  1. Acute hepatitis attack
    Symptoms include loss of appetite, tiredness and brownish urine. In most cases, patients can recover from acute hepatitis and the lifespan of the liver will not be shortened.
  2. Serious liver injury
    Patients with serious liver injury is a sign where they have developed an irreversible condition such as cirrhosis or liver cancer. Upon diagnosing cirrhosis, the liver function of most patients has evidently deteriorated to a point where no medication could improve the condition and a liver transplant is the only radical cure. Furthermore, hepatitis B is the main cause of liver cancer as about 80% of liver cancer cases are related to hepatitis B1². Likewise, symptoms of liver cancer do not usually appear in the early stages and the majority of diagnosed patients are already at the late stage. This also explains why live cancer ranks 3rd in Hong Kong’s top fatal illnesses³.

High-risk individuals should receive vaccination

There are vaccines to prevent hepatitis B with a 90%+ prevention rate. High-risk individuals such as healthcare workers who frequently come into contact with blood, hemodialysis patients and those who have unsafe sex are advised to receive vaccination. The level of antibody indeed goes down over time but research shows that the body’s immunological memory cells could produce antibody to fight against the virus even at a low level. To have peace of mind, high-risk individuals can also consider taking a second shot.

The treatment

There hasn’t been any radical cure for chronic hepatitis B yet and the purpose of treatment is to prevent the virus from causing problems in the body. But not all hepatitis B carriers require treatment unless the virus is active and starts damaging the liver. To date, there are 2 treatments proven to be effective:

Interferon injection: A 48-week treatment that stimulates the body’s immune system to suppress the virus. In general, the reaction rate reaches 50% to 70% though it’s not permanently effective and may lead to fever, muscle pain and symptoms of cold and flu.

Oral drug: A long-term treatment to suppress the virus. The first generation of oral drugs had side effects including drug resistance and damaged liver function which was vastly improved in the second generation. Since oral drug is more effective and exerts fewer side effects than injection, it has become the mainstream treatment in fighting hepatitis B.

Given that hepatitis B patients have a high chance of developing liver cancer, high-risk individuals such as the elderly, those who have a family history of liver cancer and cirrhosis patients are advised to go for liver cancer screening regularly. Through taking blood tests to check the level of alpha-foetal protein and ultrasound, it is hoped to detect cancer cell mutation at an earlier stage so as to increase the chances of recovery.

Dr. Ng Chi Ho, Specialist in Gastroenterology & Hepatology

¹Information of Viral Hepatitis Control Office:https://www.info.gov.hk/hepatitis/english/leaflet2010a.htm

²Information of the University of Hong Kong:https://hku.hk/press/press-releases/detail/16803.html

3 Liver Cancer in 2016:http://www3.ha.org.hk/cancereg/pdf/factsheet/2016/liver_2016.pdf