WHEN it comes to one's health and prevention of disease, few people think of protecting their liver.
Many people do not even know what this essential organ does.
The liver is both an organ and a gland, performing a wide range of functions to keep the body healthy.
For example, it cleans toxins from blood and stores glycogen for energy. It also produces bile, which helps to break down proteins, carbohydrates and fats.
However, these important functions can be threatened by the hepatitis virus, of which there are five – hepatitis A, B, C, D, and E. Any of these can cause the liver to become inflamed.
Hepatitis A and E are usually spread when people consume infected food and/or water, often due to conditions where personal hygiene or sanitation is poor. This is known as the faecal-oral route, explains IMU University general physician and rheumatologist Dr Chua Siew Houy.
"The hepatitis A virus (HAV) can remain infectious on hands for several hours, on foods for several days, and on frozen foods, surfaces, and in faeces for several months," adds Dr Chua.
Meanwhile, consuming undercooked animal liver is the most common cause of hepatitis E, while hepatitis B, C and D are transmitted through infected blood and other bodily fluids, while hepatitis B (HBV) is commonly passed from an infected mother to her child during pregnancy or childbirth.
Other forms of transmission of hepatitis B, C and D viruses include unprotected sex with an infected partner, sharing of needles and exposure to contaminated blood.
MALAYSIANS AND HEPATITIS
Hepatitis A, B and C are common in Malaysia and most cases are self-limiting, says Dr Chua but that does not mean we should take it lightly.
"Approximately one million individuals are chronically infected with HBV, which accounts for more than 80 per cent of liver cancer in Malaysia."
As viral hepatitis infections can be asymptomatic, many remain unaware that they are infected. More worrisome is the fact that even without symptoms, these individuals are still contagious and could unknowingly infect others, explains Dr Chua.
The only way to confirm viral hepatitis is to get a blood test. As many are asymptomatic, viral hepatitis is often discovered incidentally through routine screening tests.
PROTECTION
Vaccination is an effective method to protect against both HAV and HBV, with the hepatitis B vaccine given to infants within 24 hours of birth. Thereafter, the follow-up doses are given in a combination vaccine at 2, 3 and 5 months of age.
Those who are unsure of their vaccination status or at higher risk of HBV should be screened for their immune status and consider booster doses if needed, advises Dr Chua.
Treatment is available for viral hepatitis to eradicate the virus and prevent progression of liver disease.
Expectant mothers who test positive for hepatitis B, especially those with a high viral load, can be given antiviral medications, alongside hepatitis B vaccination and immunoglobulin injections for the child immediately after birth, to reduce the risk of perinatal HBV transmission.
While there is no vaccine available for hepatitis C, effective treatment is available in the form of direct-acting antivirals, an effective therapy with a success rate of more than 95 per cent, says Dr Chua.
To further reduce the risk of infection to yourself and avoid passing it to others, it is important to practise good personal hygiene and a safe and healthy lifestyle.
Avoid contact with infected blood and bodily fluid, clean blood spills with bleach, cover wounds or cuts and discard blood-stained items (including feminine hygiene products) in separate plastic bags to avoid contamination.
Ensure good sanitation and wash hands thoroughly with soap and water before eating and after using the toilet.
In addition, it's also important to avoid high-risk activities such as unprotected sex and injecting drugs, and ensuring that any needles used for acupuncture, body piercing and tattoos are new and sterile.
Dr Chua says where food is concerned, always make careful choices.
"Hepatitis A and E are often transmitted through contaminated food and water, especially in foods like raw shellfish and always wash fruits and vegetables before eating."
All these precautions – screening, vaccination and lifestyle – are important to help reduce the risk of infection and prevent hepatitis from spreading further among our population.
Vaccination not only protects you, but others too, especially the ones closest to you.
Those who do experience symptoms from a hepatitis infection will exhibit:
*Fever
*Fatigue
*Loss of appetite
*Nausea and/or vomiting
*Abdominal pain
*Dark urine
*Jaundice (yellowing of the skin/eyes)
*Pale-coloured stool