Viral Hepatitis (B & C)

How Hepatitis B and C Are Diagnosed

Diagnosing hepatitis B (HBV) and hepatitis C (HCV) begins with understanding symptoms, exposure risk, and liver health. Early diagnosis is critical, as both viruses can silently damage the liver before symptoms appear.

Common Diagnostic Tests for Hepatitis

At SJMC, our specialists use a range of tools to confirm and assess hepatitis infections:

• Blood Tests: Detect the presence of HBV or HCV, determine whether an infection is acute or chronic, and assess your immune status. Additional blood work to identify the viral load, genotype and status of the disease is usually critical for guiding treatment.
  
• Liver Imaging: Tests like transient elastography or magnetic resonance elastography (MRE) measure liver stiffness, which may indicate fibrosis or cirrhosis.
  
• Liver Biopsy: In more complex cases, a liver tissue sample may be collected using a fine needle to evaluate inflammation, scarring, or other complications under a microscope.
  

Who Should Be Screened for Hepatitis?

You should talk to a healthcare provider about hepatitis screening if you:

• Are pregnant
• Were born in or have family from high-prevalence areas (Asia, Africa, Eastern Europe, Pacific Islands)
• Have multiple sexual partners or an STI history
• Share needles or use injectable drugs
• Live with someone who has hepatitis B
• Are on dialysis or immunosuppressive therapy
• Have irregular liver enzyme levels without a known cause
• Are incarcerated or have a history of incarceration
  

Routine screening is especially important because hepatitis often shows no symptoms until advanced liver damage has occurred.

Hepatitis B Treatment Options

Post-Exposure Prevention

If you've been exposed to HBV and are unvaccinated, you may be given hepatitis B immunoglobulin (HBIG) along with the hepatitis B vaccine. This is most effective when administered within 24 hours of exposure.

These are typically given to babies born to Hepatitis B-positive mothers or in cases where a needle stick injury occurred with a known hepatitis B-infected person.

Acute Hepatitis B

Most acute cases resolve without treatment. Supportive care includes:

• Adequate rest
• Hydration
• Nutritional support
• Monitoring of liver function
  

In rare severe cases, antiviral or hospitalisation may be needed.

Chronic Hepatitis B

For chronic infection, treatment focuses on slowing disease progression and reducing the risk of liver damage or liver cancer.

Common treatments include:

• Oral antiviral medicines, such as:
  • Entecavir
  • Tenofovir disoproxil fumarate
  • Tenofovir alafenamide
  • Lamivudine
  • Adefovir
• Interferon therapy may be indicated for some patients
• Liver transplant, in cases of liver failure due to chronic HBV.

Hepatitis C Treatment Options

Direct-Acting Antiviral (DAA) Therapy

The goal of HCV treatment is to completely clear the virus from your bloodstream.

Modern DAA regimens:

• Typically last 8–12 weeks
• Have fewer side effects
• Cure over 95% of chronic cases

Treatment depends on:

• The genotype of the virus
• Presence of liver damage
• Co-existing conditions (e.g., HIV, kidney disease)

• Any previous treatments

  SJMC’s hepatology team personalises your care plan to optimise treatment success and monitor liver function throughout.

Liver Transplant for Hepatitis C

If chronic HCV leads to advanced cirrhosis or liver failure, a liver transplant may be required. Antiviral treatment is usually continued before or after the transplant to prevent reinfection of the new liver.

Vaccinations and Protection

• There is no vaccine for hepatitis C, but you should be vaccinated against hepatitis A and B to prevent co-infections.
• The hepatitis B vaccine is a safe and effective way to prevent HBV infection and is routinely recommended for infants, healthcare workers, and high-risk adults.
  

How to Prepare for Your Appointment

If you suspect you may have hepatitis B or hepatitis C, early medical consultation is essential. You'll usually start with your primary care provider, who may refer you to a specialist based on your symptoms, test results, or risk factors.

Which Specialists Treat Hepatitis?

Depending on your case, you may be referred to:

• Gastroenterologists: Experts in diseases of the digestive system, including the liver.
• Hepatologists: Specialists specifically focused on liver health and liver-related diseases.

At SJMC, our multidisciplinary approach ensures patients have access to the right specialist at the right time, with care tailored to their condition’s complexity.

What to Do Before Your Appointment

To make the most of your consultation:

• List all symptoms, even mild ones like fatigue or nausea.
• Write down your medical history, including prior infections, liver test results, or other chronic conditions.
• Bring a list of medications, supplements, or herbal products you take.
• Note potential exposure events, such as unprotected sex, travel to high-prevalence areas, or sharing needles.
• Ask about dietary restrictions before blood tests or imaging studies.
• Bring a family member or friend for support and to help remember details from your visit.
  

Questions You May Want to Ask

Consider preparing questions like:

• What tests do I need to confirm hepatitis B or C?
• Will I need long-term treatment?
• Is there liver damage already present?
• Should my family members or partner be screened?
• What precautions should I take to protect others?
• Are there lifestyle changes I should begin now?

What to Expect From Your Doctor

Your healthcare provider may ask:

• Have you had symptoms like jaundice, dark urine, or abdominal pain?
• Have you ever had a blood transfusion or organ transplant?
• Do you use injectable drugs or share personal care items?
• Have you been vaccinated for hepatitis B?
• Have you had unprotected sex or multiple partners?
  

Being honest about your history helps guide testing and treatment decisions, ensuring a safer and more effective care plan.

Reference

• Mayo Clinic: Hepatitis B vs. Hepatitis C
• WHO Malaysia: Hepatitis C – From Crisis to Hope
• HealthToday Malaysia: Hepatitis B & C
• The Star: Get Hepatitis Diagnosed and Treated Fast