Meet The Rest of The Hepatitis Family

    Meet The Rest of The Hepatitis Family

    At the moment, there is no existing vaccine that can prevent the infection of the rest of the hepatitis types (C, D and E). Hepatitis C in particular has no cure and deadly. What you can do is learn who is at risk of the remaining 3 hepatitis types and how you can prevent them.


    Hepatitis C

    What Is It?

    Hepatitis C is generally considered to be the most serious of the hepatitis viruses.

    According to the World Health Organisation, every year approximately 3–4 million people are infected with the hepatitis C virus. About 150 million people are chronically infected and at risk of developing liver cirrhosis and/or liver cancer. More than 350,000 people die from hepatitis C-related liver diseases every year.

    In Malaysia, hepatitis C affects about 2% of the population. The hepatitis C virus can exist in an individual for a long time and not exhibit any signs or symptoms. The infected individual will not be aware of the disease until it has reached a critical stage which usually pronounces complications with the liver.

    Hepatitis screening for blood donations was introduced in Malaysia from 1991 by the National Blood Bank to ensure that viral hepatitis was not spread through blood transfusions. If you received a blood transfusion before this time, you could be at risk of hepatitis C infection.

    A person infected with hepatitis C may develop scarring of the liver tissue (cirrhosis), liver cancer and suffer liver failure. Hepatitis C is spread primarily through contact with infected blood. It can also spread through sexual contact and during pregnancy from mother to child.

    Signs And Symptoms

    Hepatitis C is both deadly and silent – it does not typically cause any signs or symptoms.

    Approximately 80% of infected individuals will not exhibit any signs or symptoms but the hepatitis C virus can continue to linger for numerous years.

    Some infected individuals may exhibit:

    • Fever
    • Fatigue
    • Decreased appetite
    • Nausea
    • Vomiting
    • Abdominal pain
    • Dark urine
    • Grey-coloured faeces
    • Joint pain
    • Jaundice

    Who Is At Risk?

    The following individuals are at risk of being exposed to the hepatitis C virus:

    • Injection drug users
    • People who have sex with an infected person
    • People who have multiple sex partners
    • Health care workers
    • Infants born to infected women
    • Haemodialysis patients


    There is currently no vaccine for hepatitis C.  Therefore, the only way to prevent the disease is to reduce the risk of exposure to the virus.

    This means avoiding behaviours like:

    • Unnecessary and unsafe injections
    • Unsafe blood products
    • Unsafe sharps waste collection and disposal
    • Use of illicit drugs and sharing of injection equipment
    • Unprotected sex with hepatitis C-infected people
    • Sharing of sharp personal items that may be contaminated with infected blood
    • Tattoos, piercings and acupuncture performed with contaminated equipment
    Hepatitis D

    What Is It?

    Hepatitis D or ‘delta hepatitis’ is a serious liver disease. It is generally uncommon but can cause acute and chronic infections.

    Hepatitis D infection can lead to potentially life-threatening consequences such as fulminant acute hepatitis or severe chronic active hepatitis, which may progress to cirrhosis. It may also lead to the development of liver cancer.

    Hepatitis D is caused by a structurally incomplete virus. It requires the helper function of the hepatitis B virus to replicate. Hence, hepatitis D infection only occurs among people who are already infected with the Hepatitis B virus.

    Hepatitis D is transmitted through exchange of infected blood or bodily fluid exchange during sexual intercourse. It can be acquired as a co-infection with the hepatitis B virus or as a super-infection in people with hepatitis B infection.

    Signs And Symptoms

    Symptoms of hepatitis D infection are similar to those experienced with hepatitis B infection.

    Typical signs and symptoms include:

    • Jaundice
    • Nausea,
    • Vomiting
    • Tiredness
    • Abdominal pain
    • Loss of appetite
    • Dark-coloured urine
    • Joint pain

    Who Is At Risk?

    Anyone infected with hepatitis B is at risk for hepatitis D. Injection drug users have the highest risk. Others at risk include individuals who live with or have sex with a person infected with hepatitis D


    The hepatitis B vaccination can help to protect against hepatitis D infection as well. This is because hepatitis D infection cannot occur without hepatitis B infection.

    In Malaysia, the hepatitis b vaccine is available for free in 3 doses under the NIP: first at birth, second dose at 1 month and the third dose at 6 months. Other preventive measures include avoiding exposure to infected blood, contaminated needles, and an infected person’s personal items such as toothbrushes, razors, and nail clippers.

    Hepatitis E

    What Is It?

    Hepatitis E is a serious liver that usually results in an acute infection.

    According to the World Health Organisation, every year there are 20 million hepatitis E infections, over three million acute cases of hepatitis E, and 57 000 hepatitis E-related deaths. Hepatitis E is primarily transmitted mainly through the faecal-oral route via contaminated water and food. But infection can also occur through infected blood products and from mother to child during pregnancy.

    Signs and symptoms

    Individuals infected with hepatitis E may display signs and symptoms three to eight weeks after initial exposure.

    Signs and symptoms typically include:

    • Jaundice
    • Anorexia (loss of appetite)
    • An enlarged, tender liver
    • Abdominal pain and tenderness
    • Nausea and vomiting
    • Fever

    Who Is At Risk?

    People most likely to be exposed to the hepatitis E virus are:

    • International travellers, particularly those traveling to developing countries
    • People living in areas where hepatitis E outbreaks are common
    • People who live with or have sex with an infected person


    There is no vaccine for hepatitis E.

    The only way to prevent the disease is to reduce the risk of exposure to the virus is to avoid consumption of tap water when traveling internationally and practicing good hygiene and sanitation.