Hepatitis is the inflammation (swelling) of the liver. There are various causes of liver inflammation (such as alcohol abuse and drug use) but the most common cause of hepatitis is when viruses attack the liver. The liver is the largest gland in our body and is an organ that we cannot live without because it detoxifies the blood to keep the body free of toxins and other harmful substances. Blood from the digestive tract flows into the liver where it is ‘cleaned’; the liver will detoxify chemicals and metabolise drugs that have entered the blood stream before it is circulated back to the rest of the body. When the hepatitis virus infects the liver, its tissues may become hardened over time (cirrhosis) and will not be able to carry out their proper function.

Types of viral hepatitis

The most common types of viral hepatitis are hepatitis A, B and C and these are caused by three different hepatitis viruses.

Hepatitis A

Hepatitis A is caused by the hepatitis A virus and is transmitted through food or water that has been contaminated by the faeces of an infected person. If you often consume raw shellfish, do take note that one way hepatitis A can spread is when a person consumes seafood that have been contaminated by sewage in the water. Hepatitis A is the mildest form of the infection as it causes acute hepatitis, which means that the body will be able to clear the infection within a short period of time (although some infections may cause further complications). Most symptoms develop 15 to 50 days after exposure to the virus and can last from a few weeks to several months.

Hepatitis B

Hepatitis B, derived from an infection with the hepatitis B virus, is the most common strain in Singapore and can lead to liver cancer. Hepatitis B is transmitted when a person comes into contact with infected blood or body fluids. For example, hepatitis B infections can be acquired through blood transfusion from an infected donor, through acupuncture, tattooing, ear piercing, manicures and even dental treatment if non-sterile instruments are used. Mothers who are hepatitis B carriers can also pass on the virus to their child at birth. Individuals who have unprotected sex are also at a higher risk of hepatitis B infection. When symptoms occur, they can show up 2 to 5 months after infection although those who have been infected by the hepatitis B virus may not show any symptoms of the disease until liver damage has already progressed to a late stage.

Hepatitis C

Hepatitis C, caused by the hepatitis C virus, is mostly transmitted through contact with the blood or body fluids of an infected person and can lead to liver cirrhosis. Tattooing and sharing of needles among drug abusers are routes through which the virus can be transmitted. Currently, there is no vaccination for hepatitis C. Like hepatitis B, most people do not show any signs or symptoms until many years later, when liver damage has already occurred. Where symptoms do appear, they can start to show up 1 to 3 months after infection.

Symptoms of viral hepatitis

Not all persons infected with the hepatitis virus will show signs of the disease but those that do may show these symptoms:

  • Jaundice (skin and whites of the eyes turn yellow)
  • Fever and fatigue
  • Headache
  • Nausea
  • Loss of appetite
  • Abdominal pain
  • Dark-coloured urine and clay-coloured stools

Treatment of viral hepatitis

There are no specific treatments for acute hepatitis infections and the disease is mostly left to run its course. Treatment for hepatitis A infection is usually aimed at relieving the symptoms, especially if the infected person experiences vomiting or diarrhoea. Treatment will include developing a proper nutritional balance to prevent malnutrition and dehydration. For hepatitis B and C infections, antiviral medications can be used to eradicate the virus. Regular medical monitoring will also be carried out to track the progression of the infection and determine the best form of treatment.