Fatty liver disease on the rise in Malaysia

KUALA LUMPUR - Early detection of liver diseases is among the challenges faced by doctors in diagnosing and treating liver diseases in Malaysia.

Consultant gastroenterologist and hepatologist at Sunway Medical Centre, Sunway City Dr Chung Yun Chien said this was because many patients have few symptoms until the disease has progressed, when intervention may be ineffective.

"In the early stages, fatty liver disease usually has no symptoms and is often first detected by blood tests for liver function. However, these tests cannot distinguish between mild fatty build-up and more severe damage.

"Some people with fatty liver disease can have normal blood tests,” he said in a statement in conjunction with World Liver Day, observed on April 19.

Dr Chung said metabolic-associated fatty liver disease (MAFLD) is now becoming the most common liver disease in Malaysia, with a higher prevalence of 37.4 per cent in 2018 compared to 22.7 per cent in 2013.

Besides MAFLD, viral Hepatitis B and C (HBV, HCV) are also common causes of liver disease among Malaysians, and all three are the leading cause of liver-related deaths in the country.

Besides exposure to the hepatitis B virus at birth (born to a mother with infection), other risks of contracting liver diseases among Malaysians also include specific activities such as tattooing, unprotected sexual activities, intravenous drug use (IVDU) and excessive alcohol consumption.

Dr Chung added that genetic factors also pose a primary risk if a person has a family history of liver diseases such as hemochromatosis, Wilson disease, or alpha-1 antitrypsin deficiency.

As for the cause of viral hepatitis, Dr Chung said there are five main viruses that cause viral hepatitis, referred to as A, B, C, D, and E. Each type possesses different characteristics and transmissions, but their symptoms tend to be similar.

Hepatitis A and E viruses, for example, are transmitted through contaminated food or water. At the same time, Hepatitis B, C and D often pass through a specific type of break in the skin barrier, either through injections or close contact with blood or other body fluids.

In terms of treatment, Dr Chung said mass vaccination for Hepatitis B has been introduced in many countries, including Malaysia. Under the National Immunisation Programme, all newborns in the country has been vaccinated since 1989.

"This has markedly shrunken the reservoir of infection. Although hepatitis B-related chronic diseases will persist beyond the years, the numbers of new infections will see a decline due to the mass vaccination among newborns,” he said.

Dr Chung said antiviral treatments are also available and effectively reduce the viral load.

"Antiviral treatment has decreased the number of patients with liver cirrhosis and cancer of the liver related to chronic Hepatitis B infection,” he said, adding that much research is also being conducted to look for agents that can eradicate the virus.

Dr Chung said the introduction of direct antiviral agents (DAAs) in 2011 has resulted in a sharp decline in chronic Hepatitis C cases in Malaysia, as the highly effective eradication treatment for this hepatitis type has become available in the country.

Dr Chung also advised the public to adopt an active lifestyle by maintaining a healthy weight, limiting alcohol consumption, avoiding toxins and illicit drugs, overconsumption of unregulated supplements and herbal products, as well as avoiding risky behaviours to maintain a healthy liver.

"Don’t forget to get vaccinated. There are vaccines for Hepatitis A and Hepatitis B. Although there is no vaccine against Hepatitis C, the treatment for this infection has been successful since DAAs are available in Malaysia," he said. - BERNAMA