What is Hepatitis A?

Hepatitis A is a liver disease caused by the Hepatitis A virus (HAV). HAV infects and affects the liver, causing inflammation of the liver.

How is Hepatitis A transmitted?

  • Hepatitis A is transmitted by close body contact with an infected person.

  • HAV is transmitted by the faecal-oral route where contaminated faeces (or faecal remnants) end up in the mouth of another person who therefore gets infected.

  • Contaminated water and food, and raw or inadequately cooked seafood (such as clams, oysters and mussels) have been implicated in many epidemics.

What are some signs and symptoms of Hepatitis A?

Many people with hepatitis do not have symptoms. However, some people with Hepatitis A may experience flu-like symptoms such as:

  • Tiredness and generally feeling unwell

  • Fever

  • Loss of appetite

  • Stomach discomfort or pain

  • Diarrhoea

  • Dark yellow urine

  • Light-coloured stools

  • Yellowish eyes and skin

Symptoms often improve after 1-2 weeks but some patients may feel lethargic for a few months after jaundice resolves.

What are the risk factors for Hepatitis A?

ANYONE can get Hepatitis A. But some people are more likely to get infected than others.
Those at higher risk of getting Hepatitis A include:

  • Those who live with someone with Hepatitis A

  • Homosexual men

  • Travellers to countries where Hepatitis A is endemic

Can Hepatitis A be treated?

There is no definite treatment for Hepatitis A but most people who have Hepatitis A, recover. Here are some things to note for recovery from Hepatitis A:

  • You may need to rest in bed for several days or weeks

  • You have to abstain from alcohol until you are well

  • Your doctor may prescribe you medicine for your symptoms

How serious is Hepatitis A?

Risk of death from Hepatitis A is low (less than 1%). However, two major studies in the United States and China suggest that when a carrier of hepatitis B is infected with HAV, the risk of death may go up to five times.

How can I protect myself against Hepatitis A?

There are several protection methods such as:

  • Hepatitis A vaccine

    • The Hepatitis A vaccine is given through an injection.

    • Children can get the vaccine after they turn two years old. Children aged between 2 to 18 years old will need three injections (which are spaced out over one year).

    • Adults get two injections, 6 months apart.

For the vaccine to be effective, all injections must be taken. This is especially important for Hepatitis B carriers and travelers to Hepatitis A endemic areas. Efficacy is more than 95% after vaccination. You can get the Hepatitis A vaccine in most clinics, polyclinics and NUH's University Digestive Centre.

  • You can also protect yourself and others from Hepatitis A by:

    • Always washing your hands after using the toilet and before preparing food or eating.

    • Wear gloves if you have to touch others' stool and wash your hands thoroughly afterwards.

    • When in foreign countries, drink bottled water, don't take ice cubes or wash fruits/vegetables with tap water.

What is Hepatitis C?

Hepatitis C is a liver disease caused by the Hepatitis C virus (HCV). HCV infects and affects the liver, causing inflammation of the liver.

How is Hepatitis C transmitted?

  • Hepatitis C is transmitted by exposure to blood from an infected person.

  • The prevalence of Hepatitis C is estimated at between 0.5% - 1.0% (or one infected person in every 100 - 200 persons).

What are some signs and symptoms of Hepatitis C?

Many people with hepatitis do not have symptoms. However, some people with Hepatitis C may have flu-like symptoms such as:

  • Tiredness and generally feeling unwell

  • Fever

  • Loss of appetite

  • Stomach discomfort or pain

  • Diarrhoea

  • Dark yellow urine

  • Light-coloured stools

Symptoms often improve after 1-2 weeks but some patients may feel lethargic for a few months after jaundice resolves.

Clinical Presentation Of Hepatitis C

  • ·Infection of HCV first causes an acute infection which results in the inflammation of the liver. During this stage (which can last up to six months), 60% - 70% of patients do not have symptoms.

  • During acute infection, patients often feel tired, lose their appetite and have jaundice (yellowing of the eyes).

  • Approximately 80% of sufferers of acute HCV infection become chronic (long-term) carriers.

  • Chronic Hepatitis C usually progresses at a slow rate (often over 10-30 years). If the disease stays untreated, it may lead to long-term complications.
Can Hepatitis C be treated?

  • Currently, there is no vaccine for Hepatitis C. Treatment consists of weekly injections (pegylated interferon) and an oral daily medication (ribavarin). The treatment period ranges between 6 - 12 months.

  • Both interferon and ribavarin treatment are associated with side-effects. Thus, your doctor should inform and discuss with you before initiating treatment.

  • Depending on the type of HCV a patient has, the chance of cure is about 50%.

How serious is Hepatitis C?

  • 85% of people exposed to the HCV will develop the disease.

  • One in five patients with HCV will develop liver scarring and hardening within 20 years.

  • The risk of developing liver cancer goes up to 5% after 20 years. It also increases to 4% per year if the liver has been scarred or has hardened.

What are some common risk factors for Hepatitis C?

Common risk factors include:

  • Blood-to-blood contact

  • Drug injections

  • Tattoos, ear and body piercing

  • Sharing personal items (such as toothbrushes, razors or anything that can get contaminated with blood) with a person known to have HCV

  • Sexual behaviors that are considered high-risk (such as anal sex, multiple sexual partners, and/or ever having a sexually-transmitted disease).

  • Patients who are on long-term kidney dialysis

  • Blood transfusions and products (before 1994)

How can I protect myself against Hepatitis C?

You can protect yourself and others from Hepatitis C by:

  • Wearing gloves if you are in contact with blood

  • Not sharing drug needles

  • Ensuring that the tools used are sterilised and hygienic

  • Not using an infected person's personal items (such as toothbrushes, razors etc.)

  • Refraining from high-risk sexual behaviours. Have only one sexual partner (if you have several partners, use a condom during sex).

If you have Hepatitis C, please DO NOT donate blood or plasma. The person who receives it could become infected with the virus.