What is viral hepatitis?

Viral hepatitis is inflammation of liver caused by a number of viruses. It is a group of infectious diseases.

What are the types of viral hepatitis?

The more commonly seen viral hepatitis in Hong Kong include hepatitis A, B, C and E. There are other rarer types of viral hepatitis such as viral hepatitis D and G.

Hepatitis A and E are transmitted by consumption of contaminated water and food, such as shellfish.

Hepatitis B is transmitted by sexual contact or sharing injection instruments with an infected person, transfusion of infected blood or blood products, or from an infected mother at the time of delivery and infancy period. Other possible routes of transmission include tattooing, ear piercing or acupuncture with contaminated instruments. All these routes of transmission result in contact with body fluid (such as blood and semen) containing the virus. In Hong Kong, about 8-10% of population are chronic carriers of hepatitis B who have increased risk of developing chronic hepatitis, cirrhosis and liver cancer. The Hong Kong Red Cross Blood Transfusion Service screen all donated blood for this virus to prevent transmission by transfusion.

The routes of transmission of hepatitis C include transfusion of blood or blood products containing the virus, sexual contact with an infected person or sharing contaminated injection instruments. In Hong Kong, about 0.5% of population are chronic carriers of hepatitis C.There is also a chronic infection state with an increased risk of development of cirrhosis and liver cancer.

What are the signs and symptoms?

Acute infection with a hepatitis virus may result in a series of symptoms such as tiredness, loss of appetite, nausea, vomiting, yellowing of eye sclera and tea-coloured urine, or the patient may be totally well.

What are the complications?

Viral hepatitis usually lasts for a few weeks. However, a small proportion of patients with severe acute infection may progress to liver failure, which may lead to impaired brain functions and death. Severe inflammation and liver failure may occur in about 1% of cases of acute hepatitis A or B.

After acute infection with hepatitis B and C, a proportion of patients will become chronic carriers of the virus. For hepatitis B infection, this mainly occurs in newborn babies. Infection with hepatitis A and E viruses will not result in chronic carrier state.

How to prevent viral hepatitis?

To prevent yourself from getting infected with hepatitis virus, you should pay attention to avoiding the risk factors. For example, the following ways help to reduce of risk of contracting hepatitis A and E:

• Consume thoroughly-cooked food, especially seafood.
• Avoid eating food from illegal food vendor or hawker.
• Wash your hands thoroughly with soap before handling food or after going to toilet.

The following ways help to reduce the risk of infection of hepatitis B and C:

• Practise safer sex (such as proper use of condom).
• Do not share needles, sharp instruments such as razors, and personal items such as toothbrush.
• Handle sharp objects with great care to avoid needle prick injury.
• Handle open wound properly.
• Make sure non-disposable instruments are thoroughly disinfected before re-use.

There are also effective vaccines for hepatitis A and B available in Hong Kong. Since 1988, Hong Kong has started the universal neonate hepatitis B vaccination programme. You should ask your doctor whether you can benefit from these vaccinations.

There is currently no definitive effective cure for acute hepatitis, and treatment for these diseases is mainly to support the patient during acute illness. There are drug treatment that may be indicated for selected patients with chronic hepatitis B and C infection.

The doctor will carry out a series of investigations such as blood tests to ascertain the diagnosis, and will recommend appropriate treatment regimen depending on the patient's condition.

What can I do if I have viral hepatitis?

If you have been diagnosed to have viral hepatitis, there are several ways to keep your liver healthy:

• Avoid alcohol which is harmful to your liver.
• Eat a balanced diet with plenty of vegetables and fruits, and avoid foods rich in fat.
• Exercise regularly with advice from your doctor.
• Have adequate rest. Do not exert yourself.
  Do not take any non-prescribed drugs. Many drugs have a damaging effect on the liver.
• Quit smoking.

If you are a hepatitis B carrier, your sexual partner may consider relevant blood test and see if hepatitis B vaccine is needed.

If you have any doubt, it is always wise to consult your doctor.

Resource

Viral Hepatitis Control Office, Department of Health

This website contains comprehensive information about the common types of viral hepatitis seen in Hong Kong.