Dr C.K. Leow
Liver, Pancreas, Colon and General Surgery

Hepatitis and You

Inflammation of the liver is called hepatitis. Hepatitis can be due to alcohol ingestion, a reaction to a drug or chemicals, fat accumulation in the liver and viral infection of the liver. Inflammation of the liver due to viral infection is called viral hepatitis. The viruses which can cause hepatitis are hepatitis A virus (HAV), hepatitis B virus (HBV) and hepatitis C virus (HCV).

Normally you get HAV infection from eating contaminated food. Once you have recovered from it, you become immune to further attacks. HBV and HCV are transmitted through contact with blood, blood products and bodily fluids. Most infected individuals after recovering from an attack of hepatitis will develop immunity. However, a small proportion of these individuals, while having recovered from an attack, become chronic carriers of HBV or HCV.

Chronic HBV and HCV carriers are at risk of developing health problems such as liver cirrhosis (hardening of the liver), easy bruising, haemetemesis (vomiting blood) secondary to oesophageal varices (swollen veins) and liver cancer to name a few.

It is estimated that there are over 500 million HBV carriers worldwide. Most of them are concentrated in the Asian and African continents. In Singapore, 4-6% of the population are HBV carriers. In Taiwan, Hong Kong and China, the carrier rate is much higher. Due to the potential long term health problems of being a carrier, these individuals will require long term medical monitoring.

Symptoms of an HBV / HCV carrier

In most cases, carriers do not have symptoms or have very non-specific symptoms. Only when they develop the complications of being a chronic carrier would their symptoms become more specific.

The common symptoms for most carriers include tiredness, occasional vague discomfort in the right upper part of the abdomen and skin itchiness or rash. Examples of late symptoms include easy bruising, swelling of the stomach or ankles, passing black motion or jaundice.


The only way to find out if you are an HBV or HCV carrier is to perform a blood test. The blood test is to find out 3 potential scenarios:

  1. Not previously infected and not immune.
  2. Previously infected but immune.
  3. Previously infected and carrier of the virus.


A. Not Infected and Not Immune

You are strongly advice to get immunized for HBV. This involves a course of 3 injections. There is no immunization for HCV.

B. Infected but Immune

If you are immune to HBV, you are protected against future HBV attacks.

C. HBV / HCV Carriers

As you are at risk of developing health complications, you are strongly advised to have regular checks on a 6 monthly basis for the rest of your life. If you are married and have children, your spouse and children need to have their hepatitis status checked. Your brothers and sisters should be advised to have their hepatitis status checked as well.


Hepatitis B and C infections are major health problems worldwide. By avoiding certain ‘at risk’ lifestyle habits, such as intravenous drug usage, casual sex with multiple partners, you can reduce the risk of being infected. If you are not immune and not a carrier, protect yourself. Get immunised, at least, against HBV!