Dr Yami Shapira*

Hepatitis B and Hepatitis C are common, contagious and largely preventable — all compelling reasons to focus on them this July 28, especially in the case of hepatitis in Hà Nội.

Acute vs chronic hepatitis

Acute hepatitis is sudden liver inflammation triggered by viruses (A–E), medications, herbal drugs, binge drinking or rare toxins. Jaundice, dark urine and fatigue may be dramatic and, without transplantation, occasionally fatal. Survivors usually heal without permanent liver damage.

Chronic hepatitis is different. When the immune system fails to clear Hepatitis B (HBV) or Hepatitis C (HCV) after six months, smouldering inflammation can replace healthy cells with scar tissue (fibrosis) that can progress to cirrhosis or liver cancer. 

An estimated 296 million people live with chronic HBV and 57 million with chronic HCV, together causing more than a million deaths each year — equivalent to one life lost every 30 seconds. Hepatitis in Hà Nội accounts for a significant public health burden, especially among adults unaware of their infection status.

Beyond viruses, the fastest-growing cause of chronic hepatitis is metabolic dysfunction-associated steatotic liver disease (MASLD), formerly called non-alcoholic fatty liver disease (NAFLD). Driven by sedentary lifestyles and insulin resistance, MASLD already affects around 40 per cent of adults, more than all chronic viral infections combined.

HBV: vaccine-preventable cancer risk

Việt Nam lies in the 'intermediate-to-high' HBV zone; many residents were infected at birth or in early childhood. HBV spreads via blood and body fluids, mostly through unprotected sex, shared needles, childbirth or non-sterile tattoos or piercings.

A three-dose recombinant HBV vaccine is 95 per cent protective. A birth dose within 24h blocks almost all mother-to-child transmission, yet only 45 per cent of newborns worldwide receive it. Adults who missed vaccination — especially men who have sex with men, healthcare staff, sex industry workers or people with HIV or prior STIs should get tested and complete the vaccine series without delay. It's a key step in controlling hepatitis in Hà Nội.

No oral drug eradicates HBV, but nucleoside or nucleotide analogues (tenofovir, entecavir) suppress the virus, halt fibrosis and lower cancer risk when taken long-term. Curative approaches (siRNA, Capsid Assembly Modulators, CRISPR genome editing) are in early trials. Until then, lifelong monitoring — including liver enzymes, HBV DNA, ultrasound and AFP tests every six months — remains essential in order to make sure treatment is effective and to diagnose liver cancer cases at a curable stage.

HCV: curable if detected

No vaccine exists, so strict avoidance of contaminated needles, razors, poorly sterilised equipment and unscreened blood is vital. Vietnamese hospitals now screen every blood unit, so transfusion-related HCV is extremely rare.

Therapy is the good news: one daily tablet of a pan-genotypic direct-acting antiviral (sofosbuvir/velpatasvir or glecaprevir/pibrentasvir) for 8–12 weeks cures over 95 per cent of patients with mild side-effects. Cures can delay progression to advanced liver disease but cannot reverse established damage, so if you already have cirrhosis you need to stay under strict surveillance. 

Cures stop transmission but do not confer immunity, so reinfection can occur. If you are HCV positive, get your treatment ASAP before irreversible damage occurs!

Who should be screened?

• All adults (18 years or older) at least once

• People with multiple partners, or who have had unprotected sex or past STIs

• Household or sexual contact with HBV/HCV carriers

• Anyone who received a blood transfusion or tissue transplant before 1990s screening

• All pregnancies

• Individuals with obesity, diabetes, metabolic syndrome or unexplained liver-enzyme elevation

Screening is a simple blood draw: HBV panel (HBsAg, anti-HBs, anti-HBc), anti-HCV antibody and basic liver tests (AST, ALT, platelets). If antibodies are positive, viral-load PCR confirms active infection.

Practical tips

• Keep a record of HBV vaccination; finish the series if incomplete.

• Insist on single-use needles and rigorous sterilisation for medical, dental or cosmetic procedures.

• If you once 'failed' HCV therapy, ask about modern medications like direct-acting antivirals — treatment is shorter, safer and far more effective than in the past.

• Limit alcohol (current recommendations are complete avoidance!), avoid unsupervised supplements and maintain a healthy waistline.

• If you have chronic HBV, HCV or MASLD, try to avoid other liver insults. Hepatitis A remains common in Southeast Asia, so consider HAV vaccination. Ask your physician before taking any medication if it has a potential for liver toxicity.

Conclusion

Hepatitis in Hà Nội is a public health concern, but it is also an opportunity. The liver suffers in silence. Whether the threat is a viral assault or decades of metabolic stress, early detection is our best defence. Vaccines, curative pills and lifestyle medicines exist, but awareness lags behind. Ask your doctor for a simple blood test, and encourage relatives, especially those born before universal newborn immunisation, to do the same. Combine screening, vaccination, safe behaviours and timely treatment, and hepatitis in Hà Nội can become history rather than a headline. Family Medical Practice

*Dr Yami Shapira is a highly experienced physician specialising in both internal medicine, gastroenterology and hepatology. He earned his medical degree from the prestigious Hebrew University of Jerusalem Medical School. Following this, he completed his residency in internal medicine at Hadassah University Hospital, and subsequently pursued advanced training in gastroenterology at Tel Aviv Sourasky Medical Centre (TASMC).

Born and raised in Israel, Dr Yami is fluent in English and Hebrew.

FMP Healthcare Group operates medical centres in major cities including HCM City, Hà Nội and Đà Nẵng, offering consultations with international doctors, check-up centres, and emergency ambulance services.

Visit FMP Hanoi 24/7 at 298I Kim Mã Street, Ba Đình Ward.

To book an appointment, please call (024).3843.0748, chat via Whatsapp, Viber or Zalo on +84.944.43.1919 or email hanoi@vietnammedicalpractice.com.