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Hepatitis

Hepatitis is an infectious disease caused by viruses. The whole body is affected by the viral infection which leads to systematic illness, and the liver is particularly susceptible to damage. Hepatitis is classified according to its cause. In Hong Kong, viral hepatitis is more common. To date, at least six hepatitis viruses have been identified. They are hepatitis A, B, C, D, E, and G viruses.

Hepatitis A: a type of viral hepatitis that usually leads to acute hepatitis and jaundice. While most patients have a complete recovery, it can progress to liver failure or even death in a very small number of cases.

Hepatitis B: a type of viral hepatitis that leads to acute and chronic hepatitis. It can be followed by chronic liver damage, including cirrhosis and liver cancer.

Hepatitis C: an RNA virus that causes liver damage. Like hepatitis B, some hepatitis C carriers develop liver scarring or even liver cancer due to chronic hepatitis.

Hepatitis D: a virus that cannot propagate on its own and needs hepatitis B virus for replication in human cells. Therefore, hepatitis D is limited to people with hepatitis B. Hepatitis D is transmitted in the same way as hepatitis B. The infection can occur either simultaneously or after the patient has become a hepatitis B carrier. People with both hepatitis B and D are at higher risk of chronic hepatitis and cirrhosis.

Hepatitis E: a form of viral hepatitis caused by hepatitis E virus, affecting adults mostly. Pregnant women, however, are more vulnerable to serious complications from the disease.

Hepatitis G: a newly discovered virus. We are not yet able to assess how severe hepatitis G is in Hong Kong.

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Causes of Hepatitis

Transmission

Hepatitis A	Hepatitis B	Hepatitis C
Incubation period lasts for 2-6 weeks. Early symptoms are nonspecific and resemble those of a bad flu. These include mild fever, general fatigue, muscle pain, headache, loss of appetite, nausea, vomiting, upper abdominal discomfort and distension, constipation or diarrhoea, etc. After the condition persists for about 26 weeks, the skin and the 'white' of the eyes will become yellow in colour, and the urine will get darker like tea.	Incubation period lasts for 6 weeks to 6 months. Early symptoms are nonspecific and resemble those of a bad flu. These include mild fever, general fatigue, muscle pain, headache, loss of appetite, nausea, vomiting, upper abdominal discomfort and distension, constipation or diarrhoea, etc. After the condition persists for about 26 weeks, the skin and the 'white' of the eyes will become yellow in colour, and the urine will get darker like tea.	Incubation period ranges from 15 to 60 days with an average of 40 days. Symptoms include jaundice (yellowing of the skin and the ‘white’ of the eyes), fatigue, abdominal discomfort and dark (tea-coloured) urine.

Hepatitis D	Hepatitis E	Hepatitis G
Loss of appetite, nausea, upper right abdominal pain, jaundice, swelling of the liver, etc.	Incubation period ranges from 15 to 60 days with an average of 40 days. Symptoms include jaundice (yellowing of the skin and the ‘white’ of the eyes), fatigue, abdominal discomfort and dark (tea-coloured) urine.	General symptoms of viral hepatitis, such as loss of appetite, nausea, upper right abdominal discomfort, pain, jaundice, swelling and tenderness of the liver, etc.

Diagnosis of Hepatitis

Hepatitis A	Hepatitis B	Hepatitis C
Can be detected by a blood test. A blood sample will be taken by your doctor and sent to a laboratory for testing to find out if you are infected with hepatitis A/B virus.	Can be detected by a blood test. A blood sample will be taken by your doctor and sent to a laboratory for testing to find out if you are infected with hepatitis A/B virus.	Can be detected by a blood test for HCVAb and HCVRNA.

Hepatitis D	Hepatitis E	Hepatitis G
Can be detected by a blood test. A blood sample will be taken by your doctor and sent to a laboratory for testing to find out if you are infected with hepatitis D/E/G virus.	Can be detected by a blood test. A blood sample will be taken by your doctor and sent to a laboratory for testing to find out if you are infected with hepatitis D/E/G virus.	Can be detected by a blood test. A blood sample will be taken by your doctor and sent to a laboratory for testing to find out if you are infected with hepatitis D/E/G virus.

Treatment of Hepatitis

Hepatitis A

Hepatitis B

Hepatitis C

Most patients have a complete recovery.

Persons who recover from the infection usually develop lifelong immunity. There is no chronic carrier state.

Currently, there is no effective medication to cure acute/chronic hepatitis B. Treatment is limited to rest and following the doctor's advice to build up the patient's own body resistance.

Some patients will become lifelong hepatitis B carriers, which may cause chronic hepatitis, cirrhosis and liver cancer.

Drugs can be used to treat hepatitis C. The treatment should take into consideration the severity of disease, contraindications, and likelihood of successful response, etc.

Hepatitis D	Hepatitis E	Hepatitis G
Currently, there is no effective treatment.	Most patients recover in 3-6 weeks with supportive treatment and rest.	Currently, there is no effective treatment.

Prevention of Hepatitis

Hepatitis A

Hepatitis B

Hepatitis C

Vaccination:

Hepatitis A vaccination (2 injections)

Aged >1 with no previous vaccination against hepatitis A

People who travel frequently or stay in areas of high and intermediate risk (vaccination should start 4 weeks before departure)

Other preventive measures:

Personal hygiene - wash your hands before preparing or eating food, flush and wash your hands with soap after going to the toilet.

Food hygiene - drink only boiled water. All food, especially bivalve shellfish such as oysters, clams and scallops, should be carefully cleaned and thoroughly cooked.

Environmental hygiene - treat sewage and excrements properly, treat and store drinking water properly and keep the kitchen and eating utensils clean.

Vaccination:

Hepatitis B vaccination (3 injections)

Persons with no previous vaccination against hepatitis B

Other preventive measures:

Handle an open wound carefully and make sure it is properly bandaged.

Wear plastic gloves when handling contamination with blood or body fluids. Sterilise contaminated items with 1 part of bleach diluted with 4 parts of water.

Do not share razors, toothbrushes, nail clippers and other items that can rupture the skin. Do not share syringes or needles.

Avoid procedures like body/eyebrow tattooing, acupuncture and mole removal. Make sure the instruments are disposable or thoroughly sterilised if you have to undergo such procedures.

Limit the number of sex partners. Practice safer sex and use the condom properly. If your sex partner is known to be a carrier, receive vaccination as soon as possible.

Currently, there is no vaccine for prevention.

Other preventive measures include:

Do not share needles, syringes or other items that may contain blood;

Avoid sharing personal care items (e.g. razors, toothbrushes) that are potentially contaminated with blood; Persons with hepatitis C should not donate blood or organs.

Use condoms properly every time when you have sex.

Hepatitis D

Hepatitis E

Hepatitis G

Vaccination against hepatitis B provides automatic protection from hepatitis D.

Currently, there is no vaccine for prevention. Adopt good hygiene practice at all stages of food preparation. Specifically:

Personal hygiene - keep your hands clean, wash hands with soap before preparing or eating food and after going to the toilet.

Food hygiene -drink only boiled water. All food, especially seafood (e.g. shellfish), pork and pig offal should be carefully cleaned and thoroughly cooked. Avoid raw or undercooked food. Handle and store raw and cooked food separately to prevent cross-contamination.

Environmental hygiene - always keep the environment clean, especially in the kitchen and toilet.

Currently, there is no vaccine for prevention.

Avoid unnecessary exposure to body fluids.

Last Updated: Aug 2017

Please note that all medical health articles featured on our website have been reviewed by Quality Healthcare doctors. The articles are for general information only and are not medical opinions nor should the contents be used to replace the need for personal consultation with a qualified health professional on the reader’s medical condition.