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Things To Know About Hepatitis B And C
Things to know about hepatitis B and C
Dr. Pham Hoang Trung

Currently, in the Vietnamese community in particular and in the Asian community in general, there are many concerns about young people who are very young, in their early 30s, who have died from liver cancer caused by hepatitis B infection. And the white Americans natives here, if they had liver cancer, would have to be 50-60 years old. In comparison, we found that Vietnamese people have liver cancer due to the hepatitis B virus infection twenty to thirty years earlier than whites. More sadly, Vietnamese men have 13 times higher incidence of liver cancer than white Americans. This rate is also considered to be the highest when compared to other Asians, meaning that Korean people have an 8 times higher incidence of liver cancer than white Americans and Chinese people with 6 times more liver cancer than White Americans.
Calculation based on the blood tests of oversea Vietnamese with hepatitis B and C is also very high, the rate of hepatitis B is 16% and the rate of hepatitis C is 10%. The chance of getting hepatitis can be even higher because many people have never tested it. Among the types of hepatitis that lead to liver cancer, hepatitis B is the main cause of liver cancer in Asian in general and in Vietnamese in particular. The danger of hepatitis B is that there are cases where the patient immediately get liver cancer without going through the stage of cirrhosis and the blood test results of these patients still do not show strong activity of the B virus, that is, the number of hepatitis B viruses counted through DNA is still low. That is the danger of hepatitis B.

And hepatitis C must get cirrhosis before getting liver cancer although hepatitis C is more at risk of cirrhosis than hepatitis B. About 25% of patients with acute hepatitis C will recover completely. No treatment is needed. But about 75% of the remaining patients will develop chronic hepatitis C with the detection of hepatitis C viruses in the blood. And about 20% of these patients with chronic hepatitis C are at risk for developing cirrhosis within 10 to 20 years after being infected with the hepatitis C virus.

Studies show that people with chronic hepatitis B are 100 times more likely to get liver cancer than those who do not have hepatitis B. The reason people with hepatitis B are more susceptible to liver cancer without passing through cirrhosis stage is due to the fact that the DNA of hepatitis B virus is able to penetrate into the DNA of the patient's nucleus. This invasion changes the metabolism of liver cells, at the same time upsets the program of reproduction of new liver cells, driving the liver cells in the direction of abnormalities which gradually become cancer.

A pregnant mother with hepatitis B can transmit the hepatitis B virus to the fetus. If uninfected at birth and not vaccinated, babies born to mothers with hepatitis B have a 60% risk of getting hepatitis B before they are 5 years old. And those babies who are infected with hepatitis B, then get older will have a very high risk of liver cancer, i.e. the risk of liver cancer up to 40% and can get into at a very young age, about 30 something already getting liver cancer. As a result, babies born without hepatitis B infection should be vaccinated right away to avoid getting infected with hepatitis B and thereby avoid the risk of liver cancer. Even adults who have a blood test do not find themselves infected with hepatitis B should be vaccinated to be immune, so they are not afraid of becoming infected later.

If you have never had a blood test for hepatitis, you should have a blood test to see if you have hepatitis A, B, or C. If after a blood test you find you have had hepatitis B or C and have not already had hepatitis A, you should get vaccinated against hepatitis A because if you already have hepatitis B or C, and then later you will be infected by hepatitis A, the liver will get more damaged. In fact, if you have not had hepatitis A, you should be vaccinated against hepatitis A, especially for those who travel to Asian countries or to Mexico.

If your blood test shows that Hepatitis B Surface Antigen (weapon of the hepatitis B virus) is positive, and then after six months blood testing is still positive.That means you already have beeninfected by hepatitis B. In this case, you need to pay attention to whether the liver enzyme indicators such as AST, ALT are elevated (AST, ALT should be less than 45), whether the liver cancer index, Alpha-Fetoprotein (AFP) increase abnormally (normal level is below 6.1) and should have an ultrasound of the liver once a year to early detect if there is liver cancer. Liver ultrasound is also simple, inexpensive, but quite accurate because it detects most cancers larger than 3 cm.

In the case of hepatitis C, if the blood test shows that you have antibodies against hepatitis C (HCV Ab), you may have hepatitis C. In this case if you want to know make sure whether you have hepatitis C or not, you should try to see if the amount of hepatitis C virus counted by RNA is high and see if the liver enzyme indicators such as AST, ALT are abnormal. If the amount of hepatitis C counted by RNA is below 1,000 copies or less than 600 IU and the liver enzyme is below 45, then it is considered that you are immune to hepatitis C. If you want to be more careful, you can get another blood test a year after that,whichcome out the results are the same, you're for sure still immune to hepatitis C.

Unfortunately, there is currently no vaccine available for hepatitis C.

If hepatitis progresses to a stage of cirrhosis although the patient does not show any symptoms, then a blood test should be done every 6 months to monitor the amount of AFP (Alpha-Fetoprotein) to see if it is elevated to find out early liver cancer.It is also recommended to have an ultrasound of the liver once a year.

The hepatitis B and C viruses are found in the blood and saliva of an infected person, in the vaginal secretions of an infected woman, in the semen of an infected man, and these viruses usually invade to infect to others through cuts or abrasions.

The question that often arises is if my spouse has hepatitis B or C and I have not been infected yet, will the issue of intimacy between the couple and me be contagious?

Case 1: The wife has hepatitis but the husband does not.
-If the wife has hepatitis B or C, the hepatitis viruses will be in the wife's vaginal secretions. The husband will be more likely to get infected if the penis is scratched because of the invasion of hepatitis viruses in the wife's vaginal secretions that will enter the husband's bloodstream through this scratch.

If there is no scratching, it is hard for the husband to be infected.

Case 2: the husband has hepatitis but his wife does not.
-If the husband has hepatitis B or C, the hepatitis viruses will be in his husband's semen. A wife is more likely to get infected if there is abrasion in her vagina because of the entry of hepatitis virus in her husband's semen into the wife's bloodstream through this abrasion.

If there is no abrasion in the vagina, it is difficult for the wife to catch it.

But women who are at menopause whose vagina usually becomes dried, are more likely to be rubbed at risk of being infected by a husband with hepatitis. Therefore, women in menopause should be careful in this regard.

Another common question is if someone in the house has hepatitis B or C, is it easy for others in the house to get infected, how to avoid it, especially in the case of eating at same table?

Eating at the same table with someone who has hepatitis B or C is not at risk of infection but because the saliva of an infected person can get on food or dips if the person uses his or her own chopsticks or spoon to pick, scoop or dot, then these contaminated foods or dips are picked or dipped and eaten by another person sitting at the same table who has a canker sore, and viruses present in the infected food or sauce can enter through the site of canker sores to get into the bloodstream of this person so he or she can be infected. If the person does not have a cankersore, then there is no risk of infection.

As a result, if someone with hepatitis B or C sits at the table, we cancautiously suggest that the whole family when picking or dipping food should change the tip of the chopsticks or use a separate spoon and fork, especially for scooping or picking up food only.

In our community many people are also aware of the spread of hepatitis, so at parties, such as weddings, when picking up food, use the other ends of chopsticks or use the fork and spoon from food plates to scoop in. Don't use our chopsticks to pick up the food in the common dish of the center of the table with our chopsticks, as this will make other people sitting at the table feel uncomfortable.

If you use a toothbrush at home, be careful not to let it touch with other because it is easy to bleed when brushing teeth, and blood with viruses can stick from one toothbrush to another if you letthem contact. Then bacteria from an infected toothbrush can get into a canker sore or scratch on the mouth of an uninfected person to be infected.

To prevent the spread of disease in the home, each person should use separate razors and tongue scrapers for each person.
At home, people with hepatitis should wash their hands thoroughly after using tooth floss because flossing easily bleed teeth and blood sticking in infected hands can be transmitted through abrasions on the skin of others.

In short, hepatitis B or C viruses, whether present in the blood, saliva, vaginal discharge, or semen of an infected person, can only be spread directly into the bloodstream of another person through abrasions, cuts, or canker sores.

Another question that is often asked is if I have hepatitis B or C then how to eat and drink to prevent the liver from being damaged or injured

– If you already have hepatitis, try to keep your body healthy in order to strengthen the immune system to fight againstviruses by eating a healthy diet and avoiding the factors and causes that harm to the body in general and the liver in particular.

The following are the factors and causes to look out for:

  • Absolutely should not drink alcohol. Avoid medicines having side effects that harm the liver; Tylenol, for example, taking only when it’s necessary and should not be taken long term. Moreover, Tylenol, which is taken at the same time with alcohol, is at risk of complete and permanent damage to the liver.
  • Avoid MSG foods, even vegetarian MSG made from mushrooms are harmful. 
  • Avoid foods that contain borax or alum.
  • Wash fruits and vegetables thoroughly before eating to avoid eating the harmful chemicals of pesticides irrigated by farmers when they grow.
  • Avoid eating greasy and sugar-sweetened foods as the liver may become fatty liverdue to the absorption of too much fat and sugar, which impair liver function. 
  • In the season when riveris easily polluted, avoid eating shellfish in the sea, such as oyster, shrimp, crab, squid ... and especially should not eat shrimp heads or crab roe because they contain harmful minerals for the body such as lead or mercury.
  • Avoid frying foods that contain protein such as fish or meat at very high temperatures (above 180 degrees Celsius / 350 degrees Fahrenheit) as this will cause the fish or meat to burn (carbonize), creating a toxic substance that can cause liver cancer. This toxic substance is called Heterocyclic Aromatic Amines. Boiled food, cooked in water as stewed, simmered (temperature not exceeding 100 degrees C / 212 degrees F) ... almost does not contain the toxic Heterocyclic Aromatic Amines. In contrast, meat or fish grilled, baked deeply (temperatures above 180 degrees C / 350 degrees F), the crunchy, burnt part of fried or grilled meat and fish contains many toxic carcinogen substances. Even the toast crust contains many toxic substances that cause cancer.
  • Avoid eating fermented sea food paste and long-standing foods which cause poisoning to the body.
  • Avoid reheating foods to go that remain in white foam boxes into the microwave because heat can melt the foam of the containers, so that these harmful chemicals seep into the food will not be good for the body if we eat it by accident without knowing.
  • Avoid eating heavily processed foods that contain lots of preservatives as chemicals to keep food fromspoiling, such as canned foods with lots of preservatives will be bad for the body. Eating fresh, daily cooking foods is best.
  • If canned foods are eaten, when opening the tin can, be sure to take the food in the can out and put it in glass or plastic food containers because in the laminating industry to make tin cans, they use lead. So, when the opened can contacts air (oxygen) the tin will slowly seep through the food if you leave the food in the can too long after opening it. Food contaminated with lead will be toxic to the body and liver. Vietnamese people often drink coffee with condensed milk in the can, so when opening the condensed milk can, remember to pour it into another container made of glass or plastic.
  • Should cook food with stainless steel pots and pans, do not use aluminum ones because aluminum from cookware when using to cook for long time aluminum will be absorbed through food; Aluminum ingestion affects the brain and nervous system, leading to the risk of Alzheimer's disease (confusion, dementia happenedusually in older people). Do not use non-stick cookware made from Teflon because this type of cookware when using for long time will peel off this layer of chemicals, from which it will mix with the food you eat, which will be very harmful to the body.
  • Should live in a clean air environment, not polluted by car exhaust, smoke and toxic chemicals.
  • Should exercise to keep the body healthy and avoid stress because stress weakens the immune system, thereby preventing to fight against hepatitis virus.
  • Finally, if you like Herbal Medicine, we recommend Doctor’s Super Liver (bottle #9), which contains all the natural herbs and vitamins used to nourish the liver.


* People infected with hepatits (B or C) when taking blood test, should ask your doctor to test the followings:

  • AST (SGOT), ALT (SGPT). These are liver enzymes. Average normal level is under 45
  1. If infected with hepatitis B, test the additional items:
    • Hepatitis B Virus Antibodies
    • Hepatitis B Surface Antigen
    • Hepatitis B Virus DNA (amount of Hepatitis B virus in blood)
  2. If infected with hepatitis C, test the additional items:
    • Hepatitis C Virus Antibodies
    • Hepatitis C Virus RNA (amount of hepatitis C virus in blood)


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