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Everything you should know about Hepatitis B in Singapore

It’s a silent killer that lurks in the bodies of around 6% of the Singapore population. It lives with you for decades before dealing you a fatal blow when your body is at its weakest. It kills even more people than either HIV or tuberculosis. It’s Hepatitis.

With World Hepatitis Day 2018 (marked annually on July 28) just around the corner, in today’s article Pacific Prime Singapore takes a closer look at Hepatitis B specifically, the most common human Hepatitis virus. We’ve divided this blog post into three sections, namely infection, diagnosis and treatment, and prevention and vaccination.

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Ways of transmission

Its main way of transmission is through exposure to blood or bodily fluids (e.g. semen, saliva, vaginal fluids) of an infected person. The virus can live outside the body for at least 7 days and transmit via the following routes;

  • Unprotected sexual intercourse
  • Childbirth (from an infected mother to her child)
  • Sharing of contaminated needles or syringes
  • Blood transfusions if the blood donor is not properly screened for the infection
  • Direct contact with blood or open sores of an infected person

Who’s especially at risk

  • People who frequently require blood or blood products (such as dialysis patients) and are exposed to them (such as healthcare workers)
  • People who share needles for recreational drugs
  • People who have unprotected sexual intercourse
  • Patients who have natural or acquired immune deficiency (e.g. HIV), or cancer patients

Acute vs chronic Hepatitis B

When a person is first infected with the Hepatitis B virus, it is called an acute infection. Most healthy adults can overcome its symptoms in six months and develop immunity to the infection.

However, if your immune system fails to clear the infection within six months, it can lead to chronic Hepatitis B, which can take up to 30 years to develop and subsequently damage the liver.

Once diagnosed, patients should take antiviral medications to suppress the virus, otherwise it may progress to complications such as liver cirrhosis (permanent liver scarring and shrinking), liver failure, and liver cancer in the long run. As a matter of fact, Hepatitis B is the cause for 60 to 70 percent of liver cancers and the virus carriers are 100-200 times more likely to develop liver cancer than non-carriers.

Even though it may take decades for the symptoms to start showing, by that time, the condition may be too advanced to treat, and the patient may require a liver transplant at the most severe stage.


The symptoms of acute Hepatitis B include:

  • Jaundice, yellowing of skin and whites of eyes
  • Fatigue and fever (with aches and chills)
  • Nausea, loss of appetite and vomiting
  • Abdominal pain due to fluid accumulation
  • Dark-coloured urine
  • Clay-coloured bowel movements

The patient is advised bed rest, and to avoid alcohol consumption and traditional Chinese remedies so as not to exacerbate the condition.

However, most people with chronic Hepatitis B have no symptoms and are unaware that they have the virus in their body, and hence pass on the disease to others unknowingly. When symptoms do manifest, unfortunately, it usually means the diseases or cancer caused by Hepatitis are already at their later, more severe stages.

Diagnosis and Treatment

There are a number of blood tests and PCR (polymerase chain reaction) tests that can diagnose and monitor patients with Hepatitis B, as well as distinguish acute and chronic infections. Sadly, there is no viable cure for chronic Hepatitis B at the moment. Patients with chronic Hepatitis should receive regular (at least once a year) monitoring of disease progression for the rest of their life. They should also take medication to suppress the level of virus in their blood and reduce the risk of developing liver cirrhosis and cancer. Most people who start Hepatitis B treatment must continue it for life.

Having said that, a 48-week long clinical trial by the National University Hospital this month may offer a new ray of hope for patients. Combing Interferon, an injection already used to treat Hepatitis B, with Tenofovir, the trial has yielded an 11 percent cure rate, while patients taking just Interferon merely have a 3 percent success rate.

Prevention and Vaccination

Prevention is better than cure. Below are things that we can do to minimize the chances of getting infected with Hepatitis B in our daily life:

  • Avoid unprotected sex and casual sex with multiple sexual partners
  • Do not share needles, razors, toothbrushes, or any sharp objects that may break the skin
  • Make sure only disposable or sterilized instruments are used when going for piercings, tattoos, and acupuncture

Under the National Childhood Immunisation Programme in Singapore, three doses of vaccination are administered to newborns: at birth, at one month and at six months of age. Only those who are not immune to Hepatitis B and not carriers should be vaccinated. Currently, about 90% of children aged 12 years old and below have been immunized against Hepatitis B.

Although newborns in Singapore are now protected against Hepatitis B thanks to the vaccinations, those born before 1982 – the year Hepatitis B vaccinations were included in the program – would not have had the injections.

With this in mind, it is best that you find a quality insurance plan that can cover your vaccination expenses, and protect you against a myriad of illnesses. If you are an expatriate, it is particularly crucial that you secure a comprehensive health insurance policy since you won’t be able to enjoy the same medical benefits as Permanent Residents and Singaporean Citizens.

Pacific Prime Singapore has an extensive network of reputable insurers who offer plans that include coverage for vaccinations. Leveraging our extensive knowledge in the industry, our team of specialists can also help you tailor a plan that meets your specific needs. Contact us today to get a free quote and plan comparison!

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