Hepatitis, an inflammation of the liver caused by a variety of infectious viruses and non-infectious agents, leads to a range of health problems including chronic disease and severe liver complications, even failure.
According to the World Health Organization (WHO), an estimated 354 million people worldwide live with hepatitis B or C. In Malaysia, approximately one million are infected with the hepatitis B virus (HBV), and an estimated 2.5% of adults have been infected by hepatitis C.
The most common types of hepatitis in Malaysia are B and C, which can cause chronic disease, liver cirrhosis, and liver cancer. Hepatitis A and E are transmitted through contaminated food or water, whereas B, C, and D spread through blood and bodily fluids.
“The prevalence of hepatitis B in Malaysia stands at about 1%, while hepatitis C affects approximately 2.5% of the population,” said Dr Sheikh Anwar Abdullah, consultant gastroenterologist at a medical centre in Sunway City. “Understanding these transmission modes is crucial for effective prevention.”
A significant challenge in managing hepatitis C is its asymptomatic nature, often leading to late diagnosis when the disease has progressed to a severe stage. “The majority of patients are asymptomatic, and if you don’t check, you might not know you have it until it’s already chronic,” Anwar explained.
Treatment for chronic hepatitis B is aimed at suppressing the virus and preventing disease progression, while treatment for hepatitis C involves the advancement of antiviral drugs and treatment plan.
“The treatment for hepatitis B is not a cure, it is just to suppress the virus and slow it down, which is a lifelong battle for patients. For hepatitis C, antiviral drugs can now cure the infection in about 98% of cases in as short as three months,” he added.
Early screening and diagnosis are critical to preventing complications of hepatitis C, while regular follow-ups are essential for hepatitis B patients to monitor liver function and detect early signs of cancer.
The importance of screening
Anwar stressed the importance of routine screening, especially for groups such as healthcare workers, individuals with high-risk behaviours, and those with a family history of hepatitis. “Screening is crucial to detect the disease early and start treatment to prevent complications,” he said.
He also highlighted the importance of antenatal screening for pregnant women to prevent vertical transmission from mother to child. “We now give antiviral treatment to pregnant women with hepatitis B to reduce the risk of transmission to the baby.”
One of the barriers to effective hepatitis management is the stigma associated with the disease, which makes people reluctant to get screened. As such, increased public awareness campaigns could be held to educate people about the disease, its transmission, and the importance of early detection and treatment.
For individuals living with hepatitis, lifestyle modifications play a crucial role in managing the disease. “Avoid alcohol and traditional medicines that can harm the liver,” Anwar advised. Maintaining a healthy diet and avoiding infections are also essential.
The impact of vaccination
One significant success in combating hepatitis B has been vaccination programmes. “Since 1989, we have vaccinated newborns, dramatically reducing the transmission rate,” Anwar noted.
Among schoolchildren, the prevalence of the hepatitis B virus in Malaysia has steadily declined from 2.5% in 1985 to 0.4% in 1996, with 92.7% of those vaccinated being protected under the expanded immunisation programme by the government and WHO.
Anwar highlighted, however, that follow-up and booster shots are sometimes needed. “Many believe that the initial vaccination provides lifelong protection, but some may need booster shots if their antibody levels drop,” he said.
Overall, while Malaysia has made strides in reducing hepatitis B prevalence through vaccination, challenges remain in screening, early diagnosis and public awareness.
The above insights underscore the importance of continued efforts in vaccination, routine screening and education to combat hepatitis and improve public health outcomes in Malaysia.