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Hepatitis B & C
Dr Thng Yongxian
MBBS
MMed
MRCS (IRE)
FRCSED
FAMS
What is Hepatitis B & C?
Hepatitis B and Hepatitis C are liver infections caused by different viruses. Hepatitis B is caused by the Hepatitis B virus (HBV), while Hepatitis C is caused by the Hepatitis C virus (HCV). Both infections can lead to severe liver complications such as cirrhosis, liver cancer, and liver failure.
Hepatitis B and Hepatitis C are serious liver infections caused by different viruses, with distinct modes of transmission, symptoms, and management approaches. Understanding these infections is crucial for effective prevention, early detection, and treatment to prevent severe liver damage and complications.
Transmission of Hepatitis B & C
Hepatitis B (HBV) and Hepatitis C (HCV) viruses have distinct but sometimes overlapping modes of transmission, reflecting their epidemiology and the risk factors associated with infection.
Hepatitis B Virus (HBV) Transmission
- Mother-to-Child: HBV can be transmitted from an infected mother to her baby at birth, known as perinatal transmission.
- Blood and Body Fluids: Exposure to infected blood, semen, and other body fluids can transmit the virus. This includes sharing needles, syringes, or other drug-injection equipment, as well as through unsafe sexual practices.
- Needlestick Injuries: Healthcare workers and others may be exposed through needlestick injuries or other occupational exposures.
Hepatitis C Virus (HCV) Transmission
- Blood-to-Blood Contact: The most common route of HCV transmission is through exposure to infected blood, primarily among people who inject drugs and share needles or other injection equipment.
- Healthcare Exposure: Before widespread screening of the blood supply, HCV was also transmitted through blood transfusions and organ transplants. Modern screening processes have significantly reduced this risk.
- Rare Cases: While less common, HCV can also be transmitted through sexual contact, especially among people with multiple sexual partners or those living with HIV, and from an infected mother to her baby during childbirth.
Signs and Symptoms
The signs and symptoms of Hepatitis B and C can vary widely among people, with some experiencing acute symptoms shortly after infection, while others may remain asymptomatic for years, particularly in chronic cases. Common symptoms for both Hepatitis B and C may include:
- Fatigue
- Mild fever
- Loss of appetite
- Nausea and vomiting
- Abdominal pain, especially around the liver area
- Dark urine
- Pale or clay-coloured stools
- Joint pain
- Jaundice (yellowing of the skin and eyes)
Diagnosis of
Hepatitis B & C
Blood Tests
For Hepatitis B, tests identify markers such as the hepatitis B surface antigen (HBsAg) and hepatitis B core antibody (anti-HBc). For Hepatitis C, the hepatitis C antibody test (anti-HCV) is initially used, followed by an RNA test to confirm active infection.
Liver Function Tests
These tests measure levels of liver enzymes and proteins in the blood, providing information on liver health and indicating potential damage from hepatitis.
Liver Biopsy
While less commonly performed today due to advancements in non-invasive testing, a liver biopsy may still be recommended in certain cases to assess the degree of liver damage and inflammation.
Imaging Tests
Ultrasound, CT scans, or MRIs may be used to visualise the liver and check for signs of liver cirrhosis or liver cancer.
Treatment Options
The treatment of Hepatitis B and C varies based on several factors, including the type of infection (acute or chronic), the severity of liver damage, and the presence of any co-existing conditions.
Medical Treatments
Hepatitis B
- Antiviral Medications: Drugs such as tenofovir and entecavir are used to suppress the virus, slowing liver damage.
- Interferon Injections: Pegylated interferon, used in some chronic Hepatitis B cases, helps the immune system fight the virus.
- Regular Monitoring: To assess virus levels and liver health, guiding ongoing treatment decisions.
Hepatitis C
- Direct-acting Antivirals (DAAs): These medications can cure Hepatitis C in most people within 8 to 12 weeks, with a success rate exceeding 90%.
- Regular Monitoring: This is especially important for assessing treatment response and eliminating the virus.
Lifestyle and Home Remedies
- Healthy Diet: A balanced diet can support liver health and overall well-being.
- Avoid Alcohol and Drugs: These substances can exacerbate liver damage.
- Regular Exercise: Helps maintain a healthy weight and overall health.
Prevention and Vaccination
Preventing Hepatitis B and C is key to reducing the burden of these liver diseases. Effective strategies include:
-
Vaccination
A safe and effective vaccine is available for Hepatitis B and is recommended for all infants at birth, unvaccinated adults at risk of infection, and healthcare workers. No vaccine is currently available for Hepatitis C.
-
Safe Practices
Using sterile needles for tattoos, piercings, and medical procedures. For individuals who inject drugs, accessing clean needle exchange programs can significantly reduce the risk of Hepatitis C.
-
Screening Blood Products
Ensuring all blood products are screened for Hepatitis B and C before transfusion.
-
Safe Sex Practices
Using barrier protection during sexual activity, especially with new or multiple partners, to reduce the risk of Hepatitis B.
Complications Associated with Hepatitis B & C
Chronic infection with Hepatitis B or C can lead to serious complications over time, impacting liver function and overall health.
Liver Cirrhosis
Scar tissue replaces healthy liver tissue, impeding liver function. This condition can lead to liver failure.
Liver Cancer
Both Hepatitis B and C are leading causes of liver cancer, specifically hepatocellular carcinoma.
Liver Failure
Advanced liver disease can progress to liver failure, a life-threatening condition where the liver can no longer perform its critical functions.
Kidney Disease
Hepatitis C, in particular, can be associated with conditions affecting the kidneys.
Vascular Disorders
Hepatitis C can also lead to problems with blood vessels, such as vasculitis.
Dr Thng Yongxian
MBBS (SG)
MMed (Surg)
MRCS (Ire)
FRCSEd (Gen)
FAMS (Surg)
Dr Thng Yongxian is a dual fellowship-trained Hepatopancreatobiliary & General Surgeon who has performed over 6000 surgical procedures.
- Bachelor of Medicine & Bachelor of Surgery,
National University of Singapore - Membership of the Royal College of Surgeons, Ireland
- Master of Medicine, General Surgery, Singapore
- Fellow of the Royal College of Surgeons, Edinburgh
- Fellow of the Academy of Medicine, Singapore
He pursued his subspecialty training in Hepatopancreatobiliary surgery first in the Department of Hepatopancreatobiliary Surgery, Singapore General Hospital. Following this, he completed a clinical fellowship in Minimally Invasive Hepatopancreatobiliary Surgery at Seoul National University Hospital in Bundang, South Korea.
Dr Thng set up and pioneered the Minimally invasive surgery program for his hospital in complex liver and pancreas cases. His surgeries were featured on live national television. His surgical videos have also been presented at international surgical conferences. He also pioneered the use of capsule colonoscopy for colorectal screening.
Dr Thng has served on various committees at hospital, cluster and ministry level. Dr Thng served as a member of the Ministry of Health (MOH) Laparoscopic cholecystectomy Clinician workgroup for value-driven care (VDC).
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Our Clinic Locations
Nexus Surgical @ Mt. Alvernia
820 Thomson Road, #06-05 ,Singapore 574623
Monday-Friday: 9.00am-5.00pm
(Lunch: 1.00-2.00pm)
Saturday: 9.00am-1.00pm
Sunday & PH: Closed
Nexus Surgical @ Mt. Elizabeth Orchard
3 Mount Elizabeth, #08-06, Singapore 228510
Monday-Friday: 9.00am-5.00pm
(Lunch: 1.00-2.00pm)
Saturday: 9.00am-1.00pm
Sunday & PH: Closed
Nexus Surgical @ Mt. Elizabeth Novena
38 Irrawaddy Road, #08-43, Singapore 329563
Monday-Friday: 9.00am-5.00pm
(Lunch: 1.00-2.00pm)
Saturday: 9.00am-1.00pm
Sunday & PH: Closed
Nexus Surgical @ Parkway East
319 Joo Chiat Place, #05-01, Singapore 427989
Monday-Friday: 9.00am-5.00pm
(Lunch: 1.00-2.00pm)
Saturday, Sunday & PH: Closed
Nexus Surgical @ Gleneagles Medical Centre
6 Napier Road, #05-10, Singapore 258499
Monday-Friday: 9.00am-5.00pm
(Lunch: 1.00-2.00pm)
Saturday: 9.00am-1.00pm
Sunday & PH: Closed
Nexus Surgical @ Mt. Alvernia
820 Thomson Road, #06-05 ,Singapore 574623
Monday-Friday: 9.00am-5.00pm
(Lunch: 1.00-2.00pm)
Saturday: 9.00am-1.00pm
Sunday & PH: Closed
Frequently Asked Questions (FAQ)
Can Hepatitis B or C be transmitted through casual contact?
Hepatitis B and C cannot be transmitted through casual contact like hugging, sharing eating utensils, or kissing. These viruses are primarily spread through blood-to-blood contact, unsafe sexual practices, and from mother to child during childbirth.
How often should people with Hepatitis B or C undergo liver function testing?
The frequency of liver function tests for people with Hepatitis B or C varies based on their disease stage, treatment regimen, and doctor’s recommendations. Generally, monitoring may occur every 3 to 6 months, but doctors should determine specific intervals.
Can Hepatitis B and C co-infection occur, and how is it managed?
Yes, co-infection with Hepatitis B and C can occur and presents a more complex treatment challenge. Management typically involves antiviral medications that can target both viruses, but doctors must tailor treatment plans individually.
Can Hepatitis B or C be completely cured, or will I need medication for life?
Hepatitis C can often be cured with a course of direct-acting antiviral medication, leading to a sustained virological response (SVR), meaning no detectable virus remains in the blood 12 weeks after treatment completion. Hepatitis B, however, is not currently curable, but its effects can be managed with ongoing antiviral therapy to control the virus and minimise liver damage. Therefore, people with Hepatitis B may require medication for life to control the virus and prevent complications.