KUALA LUMPUR, July 23 – 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 including liver failure.
According to the World Health Organization (WHO), an estimated 354 million people worldwide live with Hepatitis B or C1.
In Malaysia, approximately a million people are infected with the Hepatitis B virus (HBV), and an estimated 2.5 per cent of adults have been infected by the Hepatitis C virus.
Dr Sheikh Anwar Abdullah, consultant gastroenterologist and hepatologist at Sunway Medical Centre delves deeper into the nuances of hepatitis in Malaysia, its prevalence, transmission, and the importance of vaccination and screening.
The Landscape Of Hepatitis In Malaysia
Dr Sheikh Anwar explained that 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 per cent, while Hepatitis C affects approximately 2.5 per cent of the population. Understanding these transmission modes is crucial for effective prevention,” he said.
Challenges In Diagnosis And Treatment
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, potentially causing cirrhosis or cancer.
“The majority are asymptomatic, and if you don’t check, you don’t know you have it until it’s already chronic,” explained Dr Sheikh Anwar.
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,” noted Dr Sheikh Anwar.
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 liver cancer.
The Importance Of Screening
Dr Sheikh Anwar stressed the importance of routine screening, especially for high-risk groups such as health care 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,” he added.
Addressing Stigma And Misconceptions
One of the barriers to effective hepatitis management is the stigma associated with the disease.
“There is a significant stigma, which makes people reluctant to get screened,” Dr Sheikh Anwar acknowledged.
He called for increased public awareness campaigns to educate people about the disease, its transmission, and the importance of early detection and treatment.
Lifestyle Modifications And Management
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,” Dr Sheikh Anwar advised.
“Maintaining a healthy diet and avoiding infections are also essential to prevent liver complications.”
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,” noted Dr Sheikh Anwar.
Among school children, the prevalence of hepatitis B virus in Malaysia has steadily declined from 2.5 per cent in 1985 to 0.4 per cent in 1996, with 92.7 per cent vaccinated being protected under the Expanded Programme of Immunisation by the WHO and the Malaysian government.
However, Dr Sheikh Anwar highlighted 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.
While Malaysia has made strides in reducing Hepatitis B prevalence through vaccination, challenges remain in screening, early diagnosis, and public awareness.
Dr. Sheikh Anwar ‘s insights underscore the importance of continued efforts in vaccination, routine screening, and public education to combat hepatitis and improve public health outcomes in Malaysia.
