5 days ago
Hepatitis B: A Silent illness that needs attention
Dr Lu Chee Men
What Is Hepatitis B?
Hepatitis B is a virus that attacks the liver and can cause both acute (short-term) and chronic (long-term) illness. A person with a chronic infection is referred to as a Hepatitis B carrier. The virus is spread through contact with infected blood or bodily fluids — such as during unprotected sex, sharing needles, or from mother to baby during childbirth.
The younger a person is when they contract hepatitis B, the more likely they are to develop a chronic carrier state.
In Malaysia, hepatitis B is considered an intermediate burden, meaning it's a significant health concern, and many people carry the virus without even knowing it.
What Does It Mean to Be a Chronic Hepatitis B Carrier?
If the virus remains in your body for more than six months, you are considered a chronic hepatitis B carrier. You may feel healthy and show no symptoms, but the virus could silently be causing long-term liver damage.
Without regular medical follow-up, chronic hepatitis B can lead to liver cirrhosis (scarring of the liver), liver failure and liver cancer (hepatocellular carcinoma).
These complications can be life-threatening but they are preventable with proper care and monitoring.
Why Is Regular Follow-up So Important?
Even if you feel fine, regular follow-up is crucial to monitor liver function and viral activity, detect early signs of liver damage or cancer, determine when to start treatment and protect your loved ones from infection.
By seeing your doctor every six to 12 months, you can stay ahead of the disease and reduce the risk of serious complications.
What Does Follow-up Usually Involve?
Blood tests – to check liver enzymes, HBV DNA levels, and overall liver function Ultrasound scan or FibroScan – to assess liver damage/scarring and to detect for early sign of liver cancer Tumour marker test (AFP) – to detect early signs of liver cancer Antiviral treatment, if necessary Routine follow-up will help doctor to decide when to start treatment and catch liver problems early — before symptoms appear.
When Does Hepatitis B Need to Be Treated?
Treatment for hepatitis B is not always necessary. Patient may need antiviral therapy if there is evidence of active liver damage, such as elevated liver enzymes (ALT/AST), high levels of HBV DNA (viral load), inflammation or fibrosis shown on liver biopsy or elastography and signs of cirrhosis or scarring of the liver.
In addition, treatment is required if the patient is immunocompromised or undergoing chemotherapy, to prevent reactivation.
A pregnant woman has a high viral load — antiviral medication (usually tenofovir) is given during the third trimester to reduce the risk of mother-to-child transmission
Prevention Is Better Than Cure
The Hepatitis B vaccine is safe, effective and provides long-term protection. In Malaysia, the vaccine is part of the National Immunization Programme (NIP) and given to all infants since 1989. However, many adults borne before that remain unvaccinated.
To prevent hepatitis B, here are things that can be done: Get vaccinated if you haven't already, practice safe sex (use condoms), avoid sharing needles, razors, or toothbrushes, ensure medical and dental procedures use sterilized equipment.
All pregnant women should be screened for hepatitis B
Last but not least, here are some of the common myths and facts about Hepatitis B You can get hepatitis B from casual contact like hugging or sharing food.
Hepatitis B is not spread through casual contact. It is spread through blood and bodily fluids.
If I feel fine, I don't need to see a doctor.
Hepatitis B can be silent for years. Regular monitoring is essential to detect liver damage early.
There is no hope if I have chronic hepatitis B.
Many people live long, healthy lives with proper medical care and follow-up.
Your Health Is in Your Hands
Living with chronic hepatitis B is not a death sentence.
Dr Lu Chee Men, Resident Consultant Gastroenterologist & Hepatologist, Internal Medicine Physician of KPJ Sabah Specialist Hospital advised the public that 'With regular check-ups and monitoring, many carriers live full, healthy lives. However, ignoring the condition increases the risk of serious liver disease.'
Don't wait for symptoms. Don't assume you're fine just because you feel fine.
Take control — get checked, follow up, and protect your liver.
