For viral hepatitis, vaccination is key to preventing liver damage

Vaccination remains the key in protecting the population against viral hepatitis. — Positive Parenting

OUR LIVER is a vital internal organ that's responsible for many of our bodily processes. This includes filtration, digestion, metabolism of fat, detoxification of drugs and alcohol, protein synthesis and the storage of vitamins and minerals. Without our liver, our daily lives would be heavily affected. Acute liver failure often causes complications such as cerebral oedema (or excessive fluid in the brain), bleeding disorders, infections and kidney failure.

Hepatitis is one of the many diseases which affect the liver. It can be caused by both infectious virus and non-infectious agents, leading to inflammation in the liver. Hepatitis has many different strains and it can be fatal if the disease is severe.

Symptoms and types

There are many different types or strains of the hepatitis virus, ranging from hepatitis A to hepatitis E. All variants of the disease primarily target the liver and its functions, ultimately leading to other liver diseases and potentially liver failure or cancer.

Strains of hepatitis vary in mode of transmission, severity of illness, geographical distribution and prevention or treatment methods. As such, some people are more susceptible to specific forms of the virus compared to others. For example, hepatitis A can be caused by poor hygiene when handling food and is much more prevalent in developing countries where access to proper sanitisation is limited.

As all variants of hepatitis primarily affect the liver, the major symptoms of the diseases are usually the same. They include jaundice, abdominal pain and swelling, swelling in the legs and ankles, itchy skin, urine that's dark, stool that's pale, chronic fatigue, nausea or vomiting, loss of appetite and being easily bruised.

Types of Hepatitis

Hepatitis A (hepA) is very contagious and common in developing countries with poor sanitisation and limited access to clean water. It is spread by ingestion of the virus (in contaminated food and water) and faecal transmission. One of the methods to prevent hepA infection is vaccination. Besides vaccines, practising good hygiene, especially before eating and drinking is also important to prevent its spread

.Hepatitis B (hepB) is a progenitor for other chronic diseases and is the major cause of liver cancer. Like hepA, it is also caused by person-to-person transmission, but via exchange of bodily fluids (through sex or blood-to-blood contact) instead. Most people tend to acquire this disease at birth. HepB vaccination is included in the National Immunisation Policy (NIP). Treatments for the disease include antiviral which prevents liver damage and cancer.

Hepatitis C (hepC) is a precursor for chronic diseases and the major cause of liver cancer and transplants. Today, most people become infected with hepC by sharing needles or other equipment used to prepare and inject drugs. There is no hepC vaccine, so the best way to prevent hepC is by avoiding behaviours that can spread the disease, especially injecting drugs. Screening for hepC is key because treatments can cure most people with hepC in 12 to 24 weeks.

Hepatitis D is a satellite disease which can only affect people who have contracted hepatitis B. There is no available vaccine, but there are medications available for it.

Hepatitis E is similar to hepA, whereby the disease is spread by ingestion of virus via contaminated food and water. There is currently no vaccine available.

Get your jab

Vaccination is one of the main methods of prevention of hepA and hepB diseases and has been proven to be effective in preventing them. Vaccinations are highly recommended for young children and those travelling to developing countries.

HepA vaccine consists of two shots given at a six-month interval. Children are recommended to receive the first dose between 12 and 23 months of age. If you’re travelling, get the vaccine at least one month before your trip.

In Malaysia, the first dose of hepB vaccine is given at birth, followed by another three primary doses and one booster dose given as the hexavalent vaccine at two months, three months, five months and 18 months.

Adults can also get their hepB vaccination, which consists of three doses. The first dose can be taken at any preferred time, while the second dose is given one month afterwards and the third dose, six months after the first dose.

It is highly recommended that individuals, especially young children, are properly vaccinated against the viruses to ensure protection against these diseases and potential liver damage.

Dr Nazrul Neezam Nordin is a consultant paediatrician and paediatric gastroenterologist and hepatologist. This story also appears on Positive Parenting, an education initiative by the Malaysian Paediatric Association (MPA). For more articles and expert advice, check out

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