Hepatitis B – The Forgotten STD

In my line of work I see many people with STD concerns.

I’ve counseled many patients with regards to HIV, Herpes, Chlamydia, Gonorrhea and more. I’ve however noticed that the topic of Hepatitis B hardly ever comes up. Most people are either unaware that it is an STD or are surprisingly unconcerned about it.

Perhaps this stems from the fact that Singapore has a childhood vaccination program that immunizes all our newborns against Hepatitis B. Even so, approximately 4% to 6% of our local Singaporean population carries Hepatitis B. In other words, one in every 25 people carries Hepatitis B. Think about it. Did you come across 25 people today? Well one of them is very likely to carry Hepatitis B!

It is true that most cases of Hepatitis B infection in Singapore are due to infected mothers passing the infection on to their children. Very few cases are actually sexually transmitted.

Still, Hepatitis B is a very important STD to screen for. This is because a Hepatitis B infection can become an incurable chronic infection that may lead to liver failure and liver cancer.

Despite our very comprehensive national immunization program, it is a fact that some people will lose their immunity to Hepatitis B when they reach adulthood. Getting vaccinated is a foolproof way of protecting yourself against Hepatitis B.

To find out if you need the vaccine or not, visit your doctor for a simple blood test.

Protect yourself. Don’t forget about Hepatitis B!

About Dr. Tan
Dr. Tan graduated from the National University of Singapore in 2001. His residency was in the two largest public hospitals in Singapore; Tan Tock Seng Hospital and Singapore General Hospital.

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  1. Thank you so much ,Dr Tan for your kind clarification.

    We have decided to hire her in but wonder why she feels full so fast. we need to monitor her if she is fussy eater or on diet or if she feels full fast because she is a slow eater, adjustment period,homesick result to lack of sleep hence appetite reduced, etc.

    We hope she is well otherwise lor. keeping our fingers crossed.

  2. Dear Dr Tan
    Just a last question for understanding; will HBs antibody level drop and thus make the person less immunised? Generally,how long it takes for the antibody level to drop and at which miu/ml will then consider unsafe and thus prone to risk of infection?

    • Yes it will. Generally over 10 years. Usually we like to give a booster if the levels drop below 10 for people not in the healthcare sector. There is however another school of thought that says protection is lifelong despite the antibody levels dropping to undetectable levels because of the memory of the immune cells.

  3. Dear Doc
    please advise me urgently as we hesitate if we should continue to hire this myammar maid or reselect another.

    Her hepatitis result just done for pre-employment check shows
    HBs Antigen Negative
    HBs Antibody >1000 H mIU/ml Neg (<10)
    HAV IgG Antibody Positive*
    HCV IgG Antibody Negative
    VDRL Negative
    HIV I & II Antibody Negative
    Malaria Parasite Negative

    By the results shown,is she a carrier and will she infect us if we hire her in? She has to cook n childcare thus there are always incident that a finger bleeding cut,mucous,saliva,sneeze,cough of droplets,etc? will she infect us via this channel?

    Should there be a need to run more tests to confirm if she has hepatitis or not? unlikely she is vaccinated as it is so costly at myamnar. she states that she is single and father has passed away? How did she has antibody if she is not infected right? Ant likelihood that she is a lesbian,sexual intercourse or hiv/aids?

    Please help to clarify as we really don't understand about hepatitis (only know it is fearful).

    • I cannot give you advice over the internet. You must see your family doctor and ask him for his interpretation of her blood results. From what I can see, she is free of the infectious diseases she was tested for. The presence of antibodies against Hep A and B is not an indicator of infection in fact they are indicators of being immune to Hep A and B. I cannot tell you if you should hire her or not. Again, this site is not for medical advice. Please see your doctor.

  4. Hey dr tan, 9 days ago i visited a brothel and took part in protected oral sex and protected vaginal sex, i finished inside the condom and saw there was no leakages as no semen dripped out of the tip of the condom. 5-6 days after this i began to feel nauseus and lightheaded and weak with an occasional non painless twitch in my neck, im really worried that these are symptoms of HIV or hepatitis, my question is whethere it is too soon to be experienceing these types of symptoms this early after possible exposure?

    • Hi hoi,

      Yes, 5 to 6 days is a bit too soon to be experiencing any symptoms due to either HIV or Hepatitis. Please ask any follow up questions you have on http://www.askdrtan.com.


      Dr Tan

  5. dr tan 9 days ago i visited a brothel and took part in protected oral sex and protected vaginal sex, 5 days after i exeperienced nausea and weakness and lightheadedness, i feel like throwing up but then i burp and it eases but continues once again seconds later is it too early to be feeling sypmtoms of hepatitis or HIV?

  6. Dear doctor,
    I was confuse about my hepatitis(specially hepatitis b) status and i would like to ask for your advice. Around september last year i started to feel some tight feeling along my upper right stomach(which i later found out is a common HBV symptoms), the i go on to test fot HBV and HCV but it all come out negative.

    I then took the advice to take the vaccine for HBV(test shown that im dont have the antibody).And i finish the 3 course of the vaccine this june.

    Strangely i still get the tight feeling on my stomach often and now i have no idea what cause this.

    So am i going the right direction by thinking i have hepatitis? Can my test on last september be conclusive(i have never done any HBV test after). And i think the pain feeling is caused by my risky sex practise(multiple sex partner but with condom). What should i do now after 1 year?

    • Hi Dan,

      You are right to say that the liver is in the upper right quadrant of the abdomen. However, Hepatitis infections usually come with other symptoms like fever, loss of apetite, loss of desire to smoke and sometimes even jaundice. Furthermore your tests for Hepatitis all came out negative. That said, if the tests were done too early, sometimes the tests are false negative. This of course depends on what kind of tests are done (IgG or IgM). You should certainly see a doctor to get examined. You will need a repeat hepatitis screen and a blood liver function test. You might also need an ultrasound of the liver. There are many other illnesses and diseases that can affect the liver other than hepatitis. Please keep me updated on your progress and I will give whatever input I can.


      Dr Tan


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