Hepatitis B, a serious liver infection, is often only diagnosed in the later stages, when patients start seeking medical help for advanced liver problems.

About 3.6 per cent of the population aged 18-79 in Singapore, or about 150,000 people, are hepatitis B carriers, but many are unaware of their condition. Hepatitis B infection often goes undiagnosed until patients seek medical help for advanced liver problems.

Hepatitis B is a serious infection of the liver caused by the hepatitis B or hep B virus (HBV).

If your immune system is unable to clear a hepatitis B infection within six months, it can lead to chronic hepatitis B (permanent liver inflammation). Over time, serious complications can include liver cirrhosis (permanent liver scarring and shrinking), liver failure and liver cancer.

Hepatitis B is the cause for 60 to 70 per cent of liver cancers. In fact, hepatitis B carriers are 100 times more likely to develop liver cancer than non-carriers.

Liver cancer was the fourth most common cancer in men in Singapore from 2008 to 2012, according to the Singapore's National Registry of Diseases Office. Unfortunately, a large number of cases are diagnosed at a late stage, when the patient has only a few months left to live.

“Early detection is critical to prevent progression to irreversible liver damage or liver cancer,” says Dr Rajneesh Kumar, Consultant, Department of Gastroenterology and Hepatology, Singapore General Hospital (SGH), a member of the SingHealth group.

How is hepatitis B virus transmitted?

You cannot catch the hep B virus through hugs or casual contact with an infected person. Neither can the virus spread through coughing, sneezing or sharing eating utensils. However, hepatitis B infection can spread through:

  • Unprotected sex with an infected person (direct contact with bodily fluids such as blood, semen or vaginal secretions)
  • Sharing of contaminated needles and syringes or improperly sterilised​ sharp implements
  • Childbirth, from an infected mother to her child

Symptoms of hepatitis B infection

Common symptoms of adult-acquired hepatitis B infection include:

  • Yellowing of skin and whites of eyes
  • Fatigue and fever (with aches and chills)
  • Loss of appetite
  • Nausea
  • Abdominal pain
  • Dark-coloured urine
  • Clay-coloured bowel movements

It’s important to know that you may be a carrier and not show symptoms. You can still pass on the virus to others.

Hepatitis B is usually asymptomatic in infected infants and children. But an infected child has a 90 per cent chance of becoming a hep B carrier as an adult.

Hepatitis B treatment

Adults who acquire acute hepatitis B will usually be able to clear the short-term infection within six months without any treatment.

If the viral infection persists beyond six months, your doctor may prescribe antiviral medications to help you fight the infection before it progresses to liver cirrhosis. Disease progression will be monitored through regular blood tests.

Liver transplant is the only option in advanced liver cirrhosis when the liver is so severely damaged that it stops functioning and liver failure results.

How to prevent a hepatitis B infection

  • Get vaccinated (requires three doses)
  • Singaporeans born before 1985 would not have been inoculated with the hepatitis B vaccine under the National Childhood Immunisation Programme. If you are born before 1985, ask your GP for a hep B screening (simple blood test). Vaccination is recommended if you are hep B-negative, which means you are not protected against the virus.
  • Avoid unprotected sex and casual sex with multiple sexual partners due to the higher risk of hep B infection.
  • Do not share needles, razors, toothbrushes or any sharp objects that may break the skin.
  • If you go for body and ear piercing, tattooing and acupuncture, make sure only disposable or sterilised instruments are used.

Ref: N18​