Hepatitis B in Singapore
Up to 6 per cent of the population in Singapore are hepatitis B carriers, with many being unaware of their condition.
Hepatitis B (HBV) 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.
In fact, hepatitis B carriers are 200 times more likely to develop liver cancer than non-carriers.
In Singapore, liver cancer is the fifth most common cancer in men and third most common cancer in women, according to the Singapore Cancer Registry Annual Report 2022.
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 Clinical Assistant Professor Rajneesh Kumar, Senior Consultant, Department of Gastroenterology and Hepatology, Singapore General Hospital (SGH), a member of the SingHealth group.
How is HBV 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:
How to prevent Hepatitis B
Hepatitis B is best prevented by vaccination. The following groups who are at highest risk for contracting hepatitis B should be vaccinated:
Side-effects of vaccines are rare and include local soreness at the injection site, mild fever, malaise but extremely infrequently may cause swelling of the lymph nodes (glands in the neck, groin, armpits), and abnormalities of the nervous system.
The vaccine is administered at time 0,1 and 6 months. However, before one gets vaccinated, one should check oneself for the immune status.
Only those who are non-immune to hepatitis B and not carriers should be vaccinated.
Symptoms of Hepatitis B
The symptoms of acute hepatitis B include:
Treatment in the acute period of the illness is essentially symptomatic relief of symptoms like itch, nausea and vomiting.
It is generally advisable for patients with severe symptoms or deep jaundice to be admitted to hospital for observation because of the potentially severe consequences (fulminant hepatitis ) which may prove to be fatal, albeit rarely.
This enables rapid intervention, which may be lifesaving, to be instituted if required. The patient is advised bedrest, and avoidance of alcohol and traditional Chinese remedies which could exacerbate his condition.
3 Phases for chronic hepatitis b carriers
A chronic hepatitis B carrier goes through 3 phases, especially if the infection is acquired at birth. This is the usual scenario amongst carriers in Singapore:
Hepatitis B treatment
Although the number of hepatitis B carriers is expected to decrease over time, largely due to widespread screening and immunisation efforts, there still exists a significant proportion of our population who are carriers.
The treatment of these carriers include:
For more on the symptoms and treatment for hepatitis B, visit here.
Ref: G25 (ed)
Related articles:
The ABCs of Hepatitis
Hepatitis A: Causes, Symptoms and Prevention Tips
Know Your Vaccines: Hepatitis B, MMR, Varicella, Pneumococcal and Flu