Skip to main content
PMC home page
Gut logoLink to Gut
. 1996;38(Suppl 2):S13–S17. doi: 10.1136/gut.38.suppl_2.s13

Hepatitis B virus infection in Singapore.

R Guan 1
PMCID: PMC1398037  PMID: 8786046

Abstract

Although Singapore is in an endemic region for hepatitis B infection, the hepatitis B carriage rate of 5-6% is relatively low. The highest positivity rates for hepatitis B surface antigen (HBsAg) are found in the paediatric age group, with another peak in 40-49 year olds. Studies suggest that, although perinatal transmission is an important route of infection, most children acquire the virus through horizontal transmission between family members. Viral replication continues at a high rate in young carriers and tends to slow down with increasing age. Up to 50% of hepatitis B carriers in Singapore have chronic hepatitis, shown by raised serum ALT values and liver histology, and about 10% are infected with the precore mutant virus. About 20% of carriers have cirrhosis. Among patients with HCC, up to 75% are HBsAg positive, of whom 45% are still viraemic. Mass vaccination against hepatitis B was introduced into Singapore on a voluntary basis in 1983, with compulsory vaccination of babies born to HBeAg positive mothers since 1985. The number of cases of acute hepatitis B has fallen by 60% between 1989 and 1995 although the problems of the longterm complications of chronic hepatitis B still need to be tackled.

Full text

PDF
S13

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Carman W. F., Zanetti A. R., Karayiannis P., Waters J., Manzillo G., Tanzi E., Zuckerman A. J., Thomas H. C. Vaccine-induced escape mutant of hepatitis B virus. Lancet. 1990 Aug 11;336(8711):325–329. doi: 10.1016/0140-6736(90)91874-a. [DOI] [PubMed] [Google Scholar]
  2. Chan S. H., Oon C. J. Epidemiology of HBV infection in Singapore. Asian Pac J Allergy Immunol. 1984 Jun;2(1):139–143. [PubMed] [Google Scholar]
  3. Chan S. H., Tan K. L., Goh K. T., Lim C., Tsakok M., Oon C. J., Ratnam S. S. Maternal-child hepatitis B virus transmission in Singapore. Int J Epidemiol. 1985 Mar;14(1):173–177. doi: 10.1093/ije/14.1.173. [DOI] [PubMed] [Google Scholar]
  4. Coursaget P., Yvonnet B., Chotard J., Vincelot P., Sarr M., Diouf C., Chiron J. P., Diop-Mar I. Age- and sex-related study of hepatitis B virus chronic carrier state in infants from an endemic area (Senegal). J Med Virol. 1987 May;22(1):1–5. doi: 10.1002/jmv.1890220102. [DOI] [PubMed] [Google Scholar]
  5. Goh K. T. Hepatitis B surveillance in Singapore. Ann Acad Med Singapore. 1980 Apr;9(2):136–141. [PubMed] [Google Scholar]
  6. Guan R., Ho K. Y., Yap I., Kang J. Y., Tan C. C., Ng C., Smith R., Wee A. Treatment of hepatitis B surface antigen carriers in the early stage of the infection using recombinant alpha-interferon with steroid priming. Aliment Pharmacol Ther. 1995 Oct;9(5):535–540. doi: 10.1111/j.1365-2036.1995.tb00417.x. [DOI] [PubMed] [Google Scholar]
  7. Guan R., Oon C. J., Wild C., Motesano R. A preliminary survey on aflatoxin exposure in Singapore. Ann Acad Med Singapore. 1986 Apr;15(2):201–205. [PubMed] [Google Scholar]
  8. Guan R., Yap I., Tay H. H. Hepatitis B vaccination: half dose recombinant DNA hepatitis B vaccine (B-Hepavac II) is as immunogenic as the full recommended dose in healthy adults. J Gastroenterol Hepatol. 1991 Jul-Aug;6(4):374–376. doi: 10.1111/j.1440-1746.1991.tb00874.x. [DOI] [PubMed] [Google Scholar]
  9. Guan R., Yap I., Wong L., Tan L. H., Oon C. J., Wee A. Evidence of viral replication in HBsAg positive patients with hepatocellular carcinoma: measurement of serum hepatitis B virus deoxyribonucleic acid (HBV-DNA). Ann Acad Med Singapore. 1989 Jan;18(1):8–11. [PubMed] [Google Scholar]
  10. Harrison T. J., Hopes E. A., Oon C. J., Zanetti A. R., Zuckerman A. J. Independent emergence of a vaccine-induced escape mutant of hepatitis B virus. J Hepatol. 1991;13 (Suppl 4):S105–S107. doi: 10.1016/0168-8278(91)90037-c. [DOI] [PubMed] [Google Scholar]
  11. Lai C. L., Lok A. S., Lin H. J., Wu P. C., Yeoh E. K., Yeung C. Y. Placebo-controlled trial of recombinant alpha 2-interferon in Chinese HBsAg-carrier children. Lancet. 1987 Oct 17;2(8564):877–880. doi: 10.1016/s0140-6736(87)91371-7. [DOI] [PubMed] [Google Scholar]
  12. Lee B. W., Yap H. K., Tan M., Guan R., Quak S. H., Choong L., Murugasu B., Woo K. T., Jordan S. C. Cell-mediated immunity in patients on hemodialysis: relationship with hepatitis B carrier status. Am J Nephrol. 1991;11(2):98–101. doi: 10.1159/000168283. [DOI] [PubMed] [Google Scholar]
  13. Lin Y., Shi C. Y., Li B., Soo B. H., Mohammed-Ali S., Wee A., Oon C. J., Mack P. O., Chan S. H. Tumour suppressor p53 and Rb genes in human hepatocellular carcinoma. Ann Acad Med Singapore. 1996 Jan;25(1):22–30. [PubMed] [Google Scholar]
  14. Lok A. S., Wu P. C., Lai C. L., Lau J. Y., Leung E. K., Wong L. S., Ma O. C., Lauder I. J., Ng C. P., Chung H. T. A controlled trial of interferon with or without prednisone priming for chronic hepatitis B. Gastroenterology. 1992 Jun;102(6):2091–2097. doi: 10.1016/0016-5085(92)90337-x. [DOI] [PubMed] [Google Scholar]
  15. Pol S., Driss F., Carnot F., Michel M. L., Berthelot P., Brechot C. Efficacité d'une immunothérapie par vaccination contre le virus de l'hépatite B sur la multiplication virale B. C R Acad Sci III. 1993 Jul;316(7):688–691. [PubMed] [Google Scholar]
  16. Quak S. H., Singh R., Oon C. J., Wong H. B. The immune status of Singapore children to hepatitis B virus. Aust Paediatr J. 1983 Jun;19(2):100–103. doi: 10.1111/j.1440-1754.1983.tb02067.x. [DOI] [PubMed] [Google Scholar]
  17. Stevens C. E., Beasley R. P., Tsui J., Lee W. C. Vertical transmission of hepatitis B antigen in Taiwan. N Engl J Med. 1975 Apr 10;292(15):771–774. doi: 10.1056/NEJM197504102921503. [DOI] [PubMed] [Google Scholar]
  18. Tan C. C., Guan R., Yap I., Tay H. H., Kang J. Y. Horizontal or vertical transmission of hepatitis B virus? A serological survey in family members of hepatitis B carriers in Singapore. Trans R Soc Trop Med Hyg. 1991 Sep-Oct;85(5):656–659. doi: 10.1016/0035-9203(91)90384-b. [DOI] [PubMed] [Google Scholar]
  19. Wong D. K., Cheung A. M., O'Rourke K., Naylor C. D., Detsky A. S., Heathcote J. Effect of alpha-interferon treatment in patients with hepatitis B e antigen-positive chronic hepatitis B. A meta-analysis. Ann Intern Med. 1993 Aug 15;119(4):312–323. doi: 10.7326/0003-4819-119-4-199308150-00011. [DOI] [PubMed] [Google Scholar]
  20. Yap I., Guan R., Kang J. Y., Tay H. H., Lee E., Choong L., Woo K. T. Seroprevalence of antibodies to the hepatitis C virus in Singapore. Southeast Asian J Trop Med Public Health. 1991 Dec;22(4):581–585. [PubMed] [Google Scholar]
  21. Yap I., Wee A., Guan R. Chronic hepatitis B infection in Singapore. Singapore Med J. 1991 Oct;32(5):352–355. [PubMed] [Google Scholar]

Articles from Gut are provided here courtesy of BMJ Publishing Group

RESOURCES