Hepatitis is a condition where the liver is inflamed. The liver is a vital organ that processes nutrients, filters the blood, and fights infections. When the liver is inflamed or damaged, its function can be affected.

The cause of hepatitis is usually a viral infection, although there are other possible causes of hepatitis as well. These include autoimmune hepatitis and hepatitis that occurs as a secondary result of some medications, drugs, toxins, and heavy alcohol consumption. Autoimmune hepatitis is a disease that occurs when your body makes antibodies against your liver tissue.

There are 5 types of viral hepatitis, and they are categorised into Hepatitis A, B, C, D and E. These categories of hepatitis are each transmitted by different viruses. However, in Malaysia, Hepatitis A, B, and C are the most common.

Hepatitis A is always an acute, short-term disease, while hepatitis B, C, and D are most likely to become on-going and chronic. Hepatitis E is usually acute but can be particularly dangerous in pregnant women.

Hepatitis signs and symptoms do not normally show until you have had the virus for a few weeks. While not everyone with hepatitis develops symptoms, one may experience fatigue, sudden nausea and vomiting, low-grade fever, abdominal pain on the upper right side of the stomach (by the liver), joint pain, bowels that are clay-coloured, dark-coloured urine, loss of appetite, yellowing of the skin and the whites of your eyes (jaundice) and sometimes intense itching.

Any symptoms of hepatitis need urgent medical attention.

Commonly, hepatitis infections are diagnosed through blood tests, abdominal ultrasound, and liver biopsy if necessary.

What is it?
An acute, and short-term disease caused by an infection with the hepatitis A virus (HAV).

What causes it?
The hepatitis A virus (HAV).

How long does it last?
Symptoms may be relatively mild and go away in a few weeks, but an infection may result in a severe illness that lasts several months.

How is it transmitted?
Hepatitis A is spread when one ingests faecal matter (may be in microscopic amounts) from contact with food or drinks contaminated by faeces (at any point of growing, harvesting, processing, handling, and even after cooking) or stool from an infected person.

Who should be vaccinated?
All children aged 12–23 months and all children and adolescents 2–18 years of age who have not previously received hepatitis A vaccine (known as “catch up” vaccination).

Who is at risk?
Tourists and travellers, men who have sexual relations with men, those who inject illegal drugs, occupational hazards (exposure), people who are homeless with no access to proper sanitation.

How serious it it?
People who get hepatitis A usually recover completely and do not have lasting liver damage. In rare cases, and more common in older people and those with serious health issues, such as chronic liver disease, hepatitis A may cause liver failure and even death.

How is it treated?
Usually rest, adequate nutrition, and lots of fluids is recommended. Some people with severe symptoms will need medical care in a hospital.

What is it?
Hepatitis B can be acute or chronic, and caused by an infection with the hepatitis B virus (HBV).

What causes it?
The hepatitis B virus (HBV).

How long does it last?
Hepatitis B can start as a mild illness, lasting a few weeks to six months, leading to a serious, chronic condition if one is not immunised, lasting 6 months or longer, or even a lifetime, possibly leading to serious illnesses such as cirrhosis and liver cancer.

How is it transmitted?
Hepatitis B is spread through exchange of blood or other body fluids- even in microscopic amounts, from an infected person with the hepatitis B virus to someone who is not infected. The hepatitis B virus can also be transmitted from mother to a child, sexual intercourse, sharing of equipment (needles, syringes etc), sharing of personal items (razors, toothbrush) and can spread easily due to poor infection control (accidental needle pricks) in healthcare facilities.

Who should be vaccinated?
Infants and children to adolescents who are younger than 19 years of age who have not been vaccinated, those who are sexually active and exposed to multiple partners and partners who have hepatitis B.

Who is at risk?
Men who have sexual relations with men, healthcare workers who are at risk for exposure to blood or blood-contaminated body fluids on the job, haemodialysis patients and predialysis, peritoneal dialysis, and home dialysis patients, tourists and travellers to countries where hepatitis B is common, people with hepatitis C, people with chronic liver disease and people with HIV.

How serious it it?
A person’s risk of hepatitis B infection increases if he/she is exposed to multiple sex partners or with someone who is infected with HBV, or men having sexual relations with men as Hepatitis B spreads through contact with blood, semen or other body fluids from an infected person. Sharing of needles during IV drug use may also put a person at risk. Living with someone who has a chronic HBV infection is also risky while a diseased mother can also infect a new-born child. Healthcare workers are also at risk for exposure to blood or blood-contaminated body fluids on the job also pose as a risk to infection, and travellers and tourists, especially to regions with high infection rates of HBV, such as Asia, the Pacific Islands, Africa and Eastern Europe.

How is it treated?
An acute condition probably won’t need medical treatment. Instead, you will need plenty of rest, adequate nutrition, and lots of fluids and a healthy diet to support your body as it fights off the infection.

However, chronic hepatitis B, may need drug therapy. Usually, drug therapy is used only if you have active liver disease. You will need to take these medications every day that basically helps by slowing the virus’s ability to multiply in your system. This also helps reduce swelling and liver damage. You will be regularly monitored for early signs of liver damage and liver cancer. Your healthcare provider will need to see you at least twice a year.

What is it?
Hepatitis C can be acute or chronic, and caused by an infection with the hepatitis C virus (HCV).

What causes it?
The hepatitis C virus (HCV).

How long does it last?
Hepatitis C can range from a mild illness, lasting a few weeks, to a serious chronic infection. Most people who get infected with the hepatitis C virus develop chronic hepatitis C.

How is it transmitted?
Hepatitis C is spread through exchange of blood or other body fluids- even in microscopic amounts, from an infected person with the hepatitis C virus to someone who is not infected. The hepatitis C virus can also be transmitted from mother to a child, sexual intercourse, sharing of equipment (needles, syringes etc), and due to poor infection control (accidental needle pricks) in healthcare facilities.

Who should be vaccinated?
There is currently no vaccine available for hepatitis C.

How serious it it?
More than 50% of people who get infected with the hepatitis C virus develop a chronic infection, while 5%-25% of people with chronic hepatitis C develop cirrhosis over 10–20 years.

How is it treated?
At present, there is not a recommended treatment for acute hepatitis C. Instead, people should be considered for treatment if their infection becomes chronic where there are several medications available to treat chronic hepatitis C. Treatments usually involve 8-12 weeks of oral therapy (pills) and cure over 90% of people with few side effects.

Vaccine for Hepatitis B is available at Island Hospital, Penang.
The price for Hepatitis B vaccine at Island Hospital is as follows:

RM30 per dose for 0-19 years age group – 3 doses required (Total RM 90)
RM60 per dose for 20 years old & above – 3 doses required (Total RM 180)