KUALA LUMPUR: Hepatitis is an inflammation of the liver, which can be caused by a variety of reasons, including infectious viruses as well as non-infectious agents, and children are not spared from contracting it.
Hepatitis viruses are the most common cause of hepatitis but other infections, drugs, toxins (alcohol), fatty liver disease or autoimmune diseases can be a cause too, said Sunway Medical Centre (SMC) paediatric gastroenterology and hepatology consultant, Dr Ong Sik Yong.
He said there are five main strains of hepatitis viruses, namely hepatitis A, B, C, D, and E.
“These hepatitis viruses can cause hepatitis, but they are different in the way they are transmitted, and hence, the prevention methods,” he shared in a statement today, adding that children are not spared from contracting these viruses.
“Usually, treatments in children will focus on supporting the patient’s general condition, or reversal of existing damage if possible; identified toxins or drugs causing the liver disease have to be stopped immediately,” he added.
He said that most cases of acute hepatitis would resolve over time with treatment, but occasionally, some patients may progress to acute liver failure, which can be fatal in a short period of time.
He also said that Hepatitis A does not cause chronic liver disease, but on the other hand, Hepatitis B and C can cause chronic infection, and infected patient are at risk of death from liver cirrhosis and liver cancer.
“Children with acute or chronic liver disease will require appropriate medical examination to identify the cause, before specific treatment can be offered,” said Dr Ong.
In acute hepatitis, he said that the virus infection would cause acute inflammation of the liver, where the child may experience symptoms, among others, of jaundice (yellowing of the skin and eyes), dark urine, extreme fatigue, nausea vomiting, abdominal pain, fever or loss of appetite.
Meanwhile, he said that in chronic hepatitis, which could arise from viral hepatitis infections such as Hepatitis B or C, fatty liver disease, drugs or autoimmune diseases, patients are often asymptomatic (show no symptoms), thus, the disease is only discovered in advanced stages, and sometimes incidentally, through physical examination or blood tests for other illnesses.
“That is why, patients with chronic infections are at risk of death from liver cirrhosis (scarring fibrosis) of the liver caused by long-term liver damage and liver cancer,” he said.
Dr Ong added that there are many ways viral hepatitis could be transmitted, for example, Hepatitis A and E are typically transmitted by faecal oral route where a child may get infected after consuming contaminated food or water.
“Hepatitis B, C and D, however, are transmitted via parenteral route – a result of parenteral contact with infected body fluids. The virus is most commonly transmitted from mother to child during birth and delivery, in early childhood, as well as through contact with blood or other body fluids during sex with an infected partner, unsafe injections or exposures to sharp instruments,” he added.
However, with advancement of medicine, viral hepatitis is highly preventable with appropriate vaccinations especially against the Hepatitis A and B viruses and Malaysia introduced its Hepatitis B vaccination programme for children in 1989, and has successfully managed to reduce the seroprevalence of infection among Malaysians to 0.01 per cent.
“All newborn babies are recommended to receive the first Hepatitis B vaccination soon after birth, preferably within 24 hours, and they should also receive two subsequent vaccine boosters to be completed at six months old,” he added.
As for pregnant mothers who are Hepatitis B carriers, antenatal antiviral prophylaxis is recommended to prevent mother to child transmission, while Hepatitis A vaccine is usually administered for toddlers aged one and above with the second dose given at least six months after the first dose.
For Hepatitis C, D and E, there are currently no vaccines, and Dr Ong advises against using drugs or supplements with an unknown safety profile, or consuming medication in a way which is not recommended by doctors, as well as inappropriate use of over-the-counter medication, as these can lead to liver injury. – BERNAMA
