Sun Apr 23 23:43:57 +08 2017  
SINGAPORE
GUM™
    Hepatitis B
SINGAPORE GUM™
HIV PEP (post-exposure prophylaxis): Stop HIV infection within 3 days after unprotected sex.
HIV test: 20 minute rapid test to accurately detect HIV infection 28 days after unprotected sex.
STD testing: Full & comprehensive sexually transmitted disease testing.

Hepatitis B | SINGAPORE GUM™

Summary

Hepatitis B | SINGAPORE GUM™ @singaporegum_com: Hepatits B symptoms in men/women, Singapore. Private & confidential service.

Advertisement: Come to sunny Singapore to have your testing and treatment. Singapore Ministry of Health registered general practice (GP) clinic:
SHIM CLINIC
SINGAPORE GUM™
168 Bedok South Avenue 3 #01-473
Singapore 460168
Tel: (+65) 6446 7446
Fax: (+65) 6449 7446
24hr Answering Tel: (+65) 6333 5550
Web: www.shimclinic.com
Opening Hours
Monday to Friday: 9 am to 3 pm, 7 pm to 11 pm
Saturday & Sunday: 7 pm to 11 pm
Public Holidays: Closed
Last registration: one hour before closing time.
Walk-in clinic. Appointments not required.
Bring NRIC, Work Pass or Passport for registration.

Description

Contents

Hepatitis B infection is caused by the Hepatitis B virus and is usually screened for by detecting HBsAg in the blood. Immunity may be discerned by detecting HBsAb, and if absent, the Hepatitis B vaccine or Twinrix® vaccine may be given.

  • The hepatitis B virus is 100 times more infectious than HIV, the virus that causes AIDS, and infects about 10 times more people than HIV worldwide.
  • Hepatitis B virus infects the liver, and more than 350 million people in the world are lifelong hepatitis B virus carriers.
  • Long-term hepatitis B virus infection causes at least one million premature deaths every year from cirrhosis of the liver or liver cancer. It is second only to tobacco as the leading cause of cancer in humans.
  • Among the Hepatitis B carriers, 25% will develop serious liver diseases, including chronic hepatitis, cirrhosis, and hepatocellular carcinoma.
  • The hepatitis B virus can be passed from an infected mother to her baby during childbirth, 1 in 20 Singaporeans are chronically infected with hepatitis B virus.
Hepatitis B Screening / Hepatitis B Testing / Hepatitis B Check

Abbreviation Name Presence in blood indicates
HBsAg Hepatitis B Surface Antigen
(Australia antigen)
Carrier
HBsAb Hepatitis B Surface Antibody Immunity
HBeAg Hepatitis B Envelope Antigen Infectivity/Activity
HBeAb Hepatitis B Envelope Antibody Favourable prognosis
HBcAg Hepatitis B Core Antigen Not detectable in blood
Detectable in liver biopsy
HBcAb Hepatitis B Core Antibody HBsAb presence
due to infection

Blood testing is available for all the above except HBcAg

Hepatitis B Treatment (in collaboration with a hepatologist)

  • Nucleoside analog reverse transcriptase inhibitors
  • Nucleotide analog reverse transcriptase inhibitors

TORCH

TORCH complex is a medical acronym for a set of perinatal infections (i.e. infections that are passed from a pregnant woman to her fetus), that can lead to severe fetal anomalies or even fetal loss.
Other agents are:

STD vaccine / hepatitis vaccine shot/jab/injection to prevent some STDs

Vaccine Against Disease Age D
o
s
e
s
Dose schedule Price
per
dose
(SG$)
Havrix™ 1440 Adult Hepatitis A virus Hepatitis A ≥19y 2 m 0 & 6-12 $90/=
Twinrix® Hepatitis A virus
Hepatitis B virus
Hepatitis A
Hepatitis B
1-15y 2 m 0, 6-12 $135/=
≥16y 3 m 0, 1, 6
4 d 0, 7, 21 & m 12
Inactivated / Fractional / Protein / Subunit / Recombinant
Engerix™-B 20 μg Hepatitis B virus Hepatitis B 11-15y 2 m 0, & 6 $50/=
≥20y 3 m 0, 1, & 6
4 m 0, 1, 2, & 12 or
d 0, 7, 21 & m 12
Gardasil® HPV
types 6, 11, 16, & 18
Genital warts
Cervical cancer
9-26y 3 m 0, 2, & 6 or
m 0, 1, & 4
$195/=
Cervarix® HPV
types 16, & 18
(31, 33, & 45)
10-25y 3 m 0, 1, & 6
m 0, 1, & 5
m 0, 2½, 12
$195/=
V503 HPV
types 6, 11, 16, 18,
31, 33, 45,
52, & 58
3 m 0, 2, & 6 or
m 0, 1, & 4
$???/=

Hepatitis Vaccine Schedule

Hepatitis A
antibody
test
Hepatitis B
antibody
test
0 mo.1 mo.6 mo.7 mo.
00Twinrix®
vaccine
1st dose
Twinrix®
vaccine
2nd dose
Twinrix®
vaccine
3rd dose
Hepatitis A&B
antibody
test
0<100Twinrix®
vaccine
1st booster
Hepatitis B
antibody
test
Hepatitis A
vaccine
2nd dose
Hepatitis A
antibody
test
0≥100Hepatitis A
vaccine
1st dose
Hepatitis A
vaccine
2nd dose
Hepatitis A
antibody
test
+0Hepatitis B
vaccine
1st dose
Hepatitis B
vaccine
2nd dose
Hepatitis B
vaccine
3rd dose
Hepatitis B
antibody
test
+<100Hepatitis B
vaccine
1st booster
Hepatitis B
antibody
test
+≥100

Sexual risk (of HIV/STD/pregnancy), and what you can do before and after exposure.

Timeline HIV STD Pregnancy
Before exposure
Abstain from sex, Be faithful, or Condom use
Circumcision (males only)
Contraception (females only)
HIV PrEP (pre-exposure prophylaxis) STD vaccine:
- Hepatitis vaccine
- HPV vaccine
STD / HIV exposure
Unsafe sex / unprotected sex:
No condom / Condom broke / Condom slip
0-72 hours HIV prevention
HIV PEP (post-exposure prophylaxis) treatment
- Stop HIV infection after exposure.
STD testing.
If STD symptoms appear, then do STD treatment.
- Males: Do not urinate for at least 4 hours before arriving.
- Females: testing is more accurate when you are not menstruating.
Emergency contraception (females only)
2 weeks HIV DNA PCR test
1 month 20 minute rapid HIV test - SD Bioline HIV Ag/Ab Combo:
- Fingerprick blood sampling.
3 months 20 minute rapid HIV test - OraQuick®:
- Oral saliva or
- Fingerprick blood sampling.
Full & comprehensive STD testing
- Males: Do not urinate for at least 4 hours before arriving.
- Females: testing is more accurate when you are not menstruating.

References


Latest News

Challenges and opportunities in the management of chronic hepatitis B infection
Tue, 29 Mar 2016 09:23:41 +0100 | International Journal of Infectious Diseases
Abstract: HBsAg seroclearance before the age of 50 years of age is associated with decreased incidence of hepatocellular carcinoma. Studies of spontaneous HBsAg seroclearance select special population with low viral activities. However HBsAg seroclearance is only achievable in 8-11% of patients with the current treatment agents (interferon and nucleoside analogues [NAs]). The pattern of HBsAg level decline during NA treatment is variable. (Source: International Journal of Infectious Diseases)

The long-term impact of antiretroviral therapy in resource-limited settings
Tue, 29 Mar 2016 09:23:40 +0100 | International Journal of Infectious Diseases
Abstract: With the advent of antiretroviral therapy (ART), HIV has shifted to a chronic manageable condition, even in resource-limited settings. Now, the long-term effects of being on ART and living with HIV are emerging. These include the adverse effects of long-term ART and morbidity due to non AIDS complications such as cardiovascular, hepatic, renal, metabolic and neurocognitive disease, cancers and ageing as well as complications due to hepatitis B and C co-infection. Although first and second-line antiretrovirals are available in resource-limited settings, new antiretrovirals are urgently needed in order to sustain HIV as a chronic manageable condition. (Source: International Journal of Infectious Diseases)

Safety, immune lot-to-lot consistency and non-inferiority of a fully liquid pentavalent DTwP-HepB-Hib vaccine: Results from Phase III licensure study of Shan5™
Tue, 29 Mar 2016 09:23:40 +0100 | International Journal of Infectious Diseases
Background: Pentavalent combination vaccines perform a key role in increasing vaccine coverage rate; and provide an efficient and reliable method of implementing WHO recommendations for controlling diphtheria, tetanus, pertussis, hepatitis B and Hib infections on a worldwide basis. (Source: International Journal of Infectious Diseases)

Prevalence of hepatitis delta virus in Sindh and Punjab (Pakistan) epidemiological survey.
Tue, 29 Mar 2016 09:23:38 +0100 | International Journal of Infectious Diseases
Background: Hepatitis D virus or delta virus (HDV) is a small, defective RNA virus that can infect only individuals who have hepatitis B virus which acts as the carrier host. The prevalence of HDV antibodies in Pakistani hepatitis B surface antigen (HBsAg) positive individuals is approximately 16.6%. So there is a pool of at least 800,000 anti-HDV positive HBsAg positive individuals in the country. Although the prevalence of hepatitis virus infections in Pakistan is still unknown, limited data indicate that the exposure rate to HBV is 35-38% with 4% being carriers and 32% having anti-HBV surface antibodies through natural conversion. (Source: International Journal of Infectious Diseases)

Hepatitis B and Human immunodeficiency virus co-infection among pregnant women in resource limited high endemic setting, Addis Ababa, Ethiopia: Implications for current and emerging prevention and control measures
Tue, 29 Mar 2016 09:23:38 +0100 | International Journal of Infectious Diseases
Background: Pregnant women infected with hepatitis B virus (HBV) and HIV can transmit the infection to their fetuses and newborns. The study was intended to determine co-infection of hepatitis B and Human immunodeficiency virus and assessing risk factors among ANC visiting women. (Source: International Journal of Infectious Diseases)

Mother T follicular helper cells prevent vertical transmission of Hepatitis B to their babies
Tue, 29 Mar 2016 09:23:38 +0100 | International Journal of Infectious Diseases
Background: Chronic Hepatitis B infection (CHBV) is a leading cause of advanced liver diseases. Mother to child transmission accounts for most cases of CHBV infections. The risk is highest in HBsAg+ve and HBeAg+ve mothers (transmission rate: 70%–90%). Follicular T helper cells (TFH) have shown a preventive role against HBV through activating the B cell mediated humoral immunity in patients. Role of TFh cells in HBV Transmission is elusive. Hypothesis: TFH cells are essential for preventing HBV transmission and impairment of these cells may leads to vertical HBV transmission. (Source: International Journal of Infectious Diseases)

Hospital based sentinel surveillance of bacterial meningitis in India
Tue, 29 Mar 2016 09:23:37 +0100 | International Journal of Infectious Diseases
Background: Pentavalent vaccine (a combination vaccine which protects against five killer diseases- diphtheria, pertussis, tetanus, hepatitis B and Haemophilus influenzae type B) is being introduced in various states of India as a part of Universal Immunization Programme. In this context it is critical to establish sentinel sites across India for surveillance of H.influenzae type B meningitis and use this opportunity also for surveillance of pneumococcal and meningococcal meningitis. Keeping this in mind a hospital-based sentinel surveillance network was established at 11 places across the country and this study reports the results of first three years of this surveillance program (Source: International Journal of Infectious Diseases)

Survey of Hepatitis B surface Antigen (HBsAg) prevalence and its risk factors among pregnant women at Bishoftu Hospital, Oromia Regional State, Ethiopia
Tue, 29 Mar 2016 09:23:35 +0100 | International Journal of Infectious Diseases
The objective of the study was to investigate sero-prevalence of hepatitis B surface antigen and assess risk factors among pregnant women. (Source: International Journal of Infectious Diseases)

Characterisation of chronic hepatitis B virus carriers with viral load and correlation with other viral markers
Tue, 29 Mar 2016 09:23:35 +0100 | International Journal of Infectious Diseases
This study was carried out with objectives; profiling of viral markers in HBV carriers with viral load, correlation of ALT levels, HBe Ag status with their viral load, to determine the mutation and response to antiviral therapy in treated and treatment naïve individuals. (Source: International Journal of Infectious Diseases)

Genetic variability and molecular evolution of hepatitis B virus in HIV co-infected patients on lamivudine based anti-retroviral therapy: A 5 year longitudinal study
Tue, 29 Mar 2016 09:23:35 +0100 | International Journal of Infectious Diseases
Background: Reports on the concomitant impact of HIV infection and long term cross-reactive HAART on the genetic variability and molecular evolution of HBV over time are limited. This longitudinal study retrospectively investigated the molecular characteristics of chronic HBV in HIV co-infected patients on lamivudine (3TC)-based HAART, over the course of a 5 year period. (Source: International Journal of Infectious Diseases)