[Common Diseases] Hepatitis

🥼 What is hepatitis?

Hepatitis is inflammation of the liver and can be caused by viral infection, alcohol, drugs, toxins, autoimmune or metabolic diseases.
In Hong Kong, the most common types of hepatitis include:

  • Hepatitis A (HAV) : Transmitted through food or water, it is acute and self-limiting.
  • Hepatitis B (HBV) : Transmitted through blood, sexual contact, and mother-to-child transmission. Hong Kong is a medium-to-high prevalence area.
  • Hepatitis C (HCV) : Mainly transmitted through blood, and can be infected through blood transfusion or sharing of needles.
  • Drug-induced hepatitis : Liver damage caused by drugs or Chinese herbal medicines.
  • Alcoholic hepatitis : caused by long-term heavy drinking.
  • Autoimmune hepatitis : The immune system attacks the liver's own cells.

🔍 Prevalence of hepatitis in Hong Kong

  • Hepatitis B : According to the Hong Kong Centre for Health Protection, approximately 7%-10% of the Hong Kong population are chronic carriers of the virus.
  • Hepatitis C : The estimated infection rate is about 0.3%-0.5% , which is often related to a history of blood transfusion or intravenous drug injection.
  • Hepatitis A : Local outbreaks have decreased following widespread vaccination, but imported cases still occur occasionally.

⚠️ Symptoms of hepatitis

Most symptoms of acute hepatitis include:

  • Fatigue and weakness
  • Loss of appetite, nausea, and vomiting
  • Discomfort in the upper or right upper abdomen
  • Jaundice (yellowing of the skin and the whites of the eyes)
  • Dark urine and light-colored stools

Chronic hepatitis (such as hepatitis B and hepatitis C) may cause no symptoms for many years but gradually damages the liver, leading to:

  • Liver fibrosis
  • Cirrhosis
  • Liver cancer

🏥 Hong Kong Hepatitis Treatment

Editor's reminder : The treatment strategies for different types of hepatitis vary greatly, and the cause must be confirmed before a plan can be formulated.

1. Hepatitis A (HAV)

  • Acute and self-limited , most patients recover within a few weeks and there is no chronicity.
  • Treatment is supportive :
    • Get rest, eat a balanced diet, and avoid alcohol and medications that damage the liver.
  • Prevention : Get the hepatitis A vaccine (available in Hong Kong, especially recommended for high-risk groups, such as those working in the catering industry and those traveling to high-incidence areas).

2. Hepatitis B (HBV)

  • Acute hepatitis B : Most people can clear the virus on their own, but liver function needs to be closely monitored.
  • Chronic hepatitis B : The viral load, liver function, and degree of liver fibrosis need to be assessed.

Drug treatment (Hong Kong Hospital Authority and international guidelines):

  • Oral antiviral drugs (long-term use):
    • Entecavir
    • Tenofovir (Tenofovir disoproxil fumarate / Tenofovir alafenamide)
  • Interferon therapy (for some patients):
    • Pegylated interferon
  • Goal: Inhibit viral replication, reduce liver inflammation, and prevent cirrhosis and liver cancer.

Follow-up:

  • Blood tests are performed every 3-6 months to check liver function and HBV DNA viral load.
  • Do ultrasound + AFP test every 6 months to monitor liver cancer.

3. Hepatitis C (HCV)

  • Treatment used to be difficult, but now direct-acting antivirals (DAAs) have a cure rate of over 95%.

Commonly used DAAs therapies in Hong Kong:

  • Sofosbuvir + Velpatasvir
  • Glecaprevir + Pibrentasvir
  • The treatment period is usually 8-12 weeks.

Treatment goals:

  • Complete viral clearance (SVR) reduces the risk of cirrhosis and liver cancer.

4. Drug-induced hepatitis

  • Stop taking drugs or herbal remedies that cause liver damage.
  • Supportive treatment is provided, and hospitalization is required in severe cases.
  • Editor’s note: Common cases in Hong Kong include long-term use of health supplements or folk remedies with unknown ingredients.

5. Alcoholic hepatitis

  • Complete abstinence from alcohol is the only effective solution.
  • Severe cases require hospitalization and the use of steroids to control inflammation.
  • Some patients may improve their liver function after stopping alcohol, but if they have cirrhosis, they may need to be evaluated for liver transplantation.

6. Autoimmune hepatitis

  • Treat with immunosuppressants (eg, prednisolone, azathioprine).
  • Long-term follow-up to prevent liver fibrosis and cirrhosis.

🏥 Hong Kong's examination and diagnosis process

  • Blood tests : liver function (ALT, AST, bilirubin), viral markers (HBsAg, HBeAg, Anti-HCV, etc.).
  • Ultrasound : To check liver size, fat deposits, and tumors.
  • FibroScan : Assess the degree of liver fibrosis.
  • Liver biopsy : to confirm the degree of inflammation and fibrosis when necessary.

Public healthcare : General medicine → Internal medicine/liver specialist
Private healthcare : Faster processing of blood tests, imaging tests, and medication plans

🚨 Warning symptoms (seek medical attention immediately)

  • Obvious jaundice
  • Persistent high fever and abdominal pain
  • Heavy vomiting and confusion (possibly hepatic encephalopathy)
  • Decreased urine output and leg edema (suggesting liver failure)

💡 Editor's Tips

  1. Hepatitis B carriers should seek regular follow-up care even if they have no symptoms.
  2. Hepatitis C is now curable , so don't delay seeking medical treatment.
  3. Avoid taking health supplements and Chinese medicine casually , especially those from unknown sources.
  4. Vaccination : There are safe and effective vaccines for both hepatitis A and B.
  5. Quit drinking, control your weight , and protect your liver from extra burden.

💬Editor’s summary :
Hepatitis is quite common in Hong Kong, especially hepatitis B. Many people remain asymptomatic for years, yet progress to cirrhosis or even liver cancer. Treatment options vary significantly for different types of hepatitis, ranging from supportive care to antiviral medications to immunosuppressants, requiring precise treatment tailored to the underlying cause. Both public and private healthcare providers in Hong Kong offer comprehensive screening and long-term management. Early diagnosis, ongoing monitoring, and strict lifestyle control are key.

📌 Disclaimer <br>This article is for reference only and does not constitute any medical advice. It is sourced from major medical articles.

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