Epidemiology and Risk Factors for Hepatitis C Infection in Malaysia: A Narrative Review

Epidemiology and Risk Factors for Hepatitis C Infection in Malaysia: A Narrative Review

Mohd Azri Mohd Suan1,2, Salmiah Md Said1*, Ahmad Zaid Fattah Azman1, Muhammad Radzi Abu Hassan2,3

1Department of Community Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia. 2Clinical Research Centre, Hospital Sultanah Bahiyah, KM 6, Jalan Langgar, 05460 Alor Setar, Kedah, Malaysia. 3Department of Medicine, Hospital Sultanah Bahiyah, KM 6, Jalan Langgar, 05460 Alor Setar, Kedah, Malaysia.

Hepatitis C infection is a growing public health issue in Malaysia. A large number of people living with hepatitis C virus (HCV) are unaware of the infection. The treatment complexity warrants a comprehensive understanding of this infectious disease to support planning for strategies to reduce the burden of disease associated with hepatitis C. This study aimed to summarise the epidemiology and risk factors attributable to hepatitis C acquisition in Malaysia based on local published articles. Published articles related to epidemiology and risk factors for hepatitis C infection in Malaysia between 2005 and 2017 were searched through several online databases. Related information from the Ministry of Health official website was also compiled. An increasing trend in the incidence and mortality rate of hepatitis C infection is noted over the last decades. In 2009, the national prevalence of people infected with HCV was approximately 2.5%, with the prevalence rate varying according to different high-risk groups. The most common genotypes reported are genotypes 3 and 1. Frequently reported risk factor for HCV acquisition is injection drug use. Other identified risk factors are being a blood product recipient, haemodialysis patient or participant in high-risk sexual activity. Nevertheless, a considerable number of patients had no known risk factors. The prevalence and burden of HCV-related disease are substantial and can be attributed to many factors. High-quality design studies are needed to provide stronger evidence of the risk factors for hepatitis C infection in local populations for future public health planning.

Keywords: epidemiology, hepatitis C, infection, Malaysia, risk factor

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How to cite this article:
Mohd Azri Mohd Suan, Salmiah Md Said, Ahmad Zaid Fattah Azman, Muhammad Radzi Abu Hassan.Epidemiology and Risk Factors for Hepatitis C Infection in Malaysia: A Narrative Review. Open Journal of Gastroenterology and Hepatology, 2021; 4:53. DOI: 10.28933/ojgh-2021-05-2805


1. Choo QL, Kuo G, Weiner AJ, et al. Isolation of a cDNA clone derived from a blood-borne non-A, non-B viral hepatitis genome. Science. 1989; 244:359–62.
2. Lauer GM, Walker BD. Hepatitis C virus infection. N Engl J Med. 2001; 345:41–52.
3. Zein NN. Clinical Significance of Hepatitis C Virus Genotypes. Clin Microbiol Rev. 2000; 13:223–35.
4. Pozzetto B, Memmi M, Garraud O, Roblin X, Berthelot P. Health care-associated hepatitis C virus infection. World J Gastroenterol. 2014; 20:17265–78.
5. Westbrook RH, Dusheiko G. Natural history of hepatitis C. J Hepatol. 2014; 61:S58–68.
6. Modi AA, Liang TJ. Hepatitis C: a clinical review. Oral Dis. 2008; 14:10–4.
7. World Health Organization. Global Hepatitis Re-port 2017. Available at: http://www.who.int/hepatitis/publications/global-hepatitis-report2017/en/. Accessed May 17, 2017.
8. Gower E, Estes C, Blach S, Razavi-Shearer K, Razavi H. Global epidemiology and genotype distribution of the hepatitis C virus infection. J Hepatol. 2014; 61(1 Suppl):S45-57.
9. Lavanchy D. Evolving epidemiology of hepatis C virus. Clin Microbiol Infect. 2011; 17:107–15.
10. Ministry of Health Malaysia. Health Indicators 2011 – 2017. Available at: http://vlib.moh.gov.my/cms/content.jsp?id=com.tms.cms.section. Sec-tion_3296f5dc-a0188549-72493700-64325650. Accessed December 22, 2017.
11. Ministry of Health Malaysia. Health Indicators 2005 – 2010. Available at: http://vlib.moh.gov.my/cms/content.jsp?id=com.tms.cms.section. Sec-tion_3296b2e7-a0188549-72493700-9226a980. Accessed December 22, 2017.
12. Ministry of Health Malaysia. Health Facts 2018. Available at: http://www.moh.gov.my/resources/index/Penerbi-tan/Penerbitan%20Utama/Fakta%20 kesihatan/KKM_HEALTH_FACTS_2018.pdf. Accessed November 17, 2017.
13. McDonald SA, Mohamed R, Dahlui M, Naning H, Kamarulzaman A. Bridging the data gaps in the epidemiology of hepatitis C virus infection in Malaysia using multi-parameter evidence synthe-sis. BMC Infect Dis. 2014; 14:564.
14. McDonald SA, Dahlui M, Mohamed R, et al. Projections of the current and future disease burden of hepatitis C virus infection in Malaysia. PLoS One. 2015; 10:e0128091.
15. Chan HLY, Chen CJ, Omede O, et al. The present and future disease burden of hepatitis C virus infections with today’s treatment paradigm: Volume 4. J Viral Hepat. 2017; 24:25–43.
16. Clare THH, Chow YW, Lawrence HWS, Loh CL, Teo SM. Hepatitis on dialysis. In: 22nd Report of The Malaysian Dialysis & Transplant Registry 2014. Available at: https://msn.org.my/nrr/mdtr2014.jsp. Accessed May 25, 2017.
17. Jaafar R, Isahak I, Wong K, et al. Prevalence and predisposing factors for hepatitis C virus in haemodialysis unit at the Universiti Kebangsaan, Malaysia Medical Centre. BMC Proc. 2011; 5:P210.
18. Vicknasingam B, Narayanan S, Navaratnam V. Prevalence rates and risk factors for hepatitis C among drug users not in treatment in Malaysia. Drug Alcohol Rev. 2009; 28:447–54.
19. Chawarski MC, Mazlan M, Schottenfeld RS. Her-oin dependence and HIV infection in Malaysia. Drug Alcohol Dependence. 2006; 82 (Suppl 1):S39-42.
20. Choo MKK, El-Bassel N, Adam PCG, et al. Prev-alence and correlates of HIV and hepatitis c virus infections and risk behaviors among Malaysian fishermen. PloS One. 2015; 10:e0118422.
21. Haslina MNN, Khairiah Y, Zainy DZ, et al. Sero-prevalence of hepatitis C virus infection among blood donors in a teaching hospital in northeast-ern Malaysia. Southeast Asian J Trop Med Public Health. 2012; 43:668–73.
22. Nafishah A, Asiah MN, Syimah ATN, et al. Rate of seroconversion in repeat blood donors at the na-tional blood centre, Kuala Lumpur. Indian J He-matol Blood Transfus. 2014; 30:105–10.
23. Tan WL, Yihui G, Abu Hassan MR. Demographic characteristics and intravenous drug use among hepatitis C patients in the Kota Setar District, Kedah, Malaysia. Epidemiology Health. 2015; 37:e2015032.
24. Tan SS, Adlin Nadia Z. The clinical features and treatment outcome of chronic hepatitis C with pegylated interferon and ribavirin in routine care. Med J Malaysia. 2017; 72:165–74.
25. Maaroufi A, Vince A, Himatt SM, et al. Historical epidemiology of hepatitis C virus in select coun-tries, vol. 4. J Viral Hepat. 2017; 24 (Suppl 2):8–24.
26. Ho SH, Ng KP, Kaur H, Goh KL. Genotype 3 is the predominant hepatitis C genotype in a multi-ethnic Asian population in Malaysia. Hepatobiliary Pan-creatic Disease Int. 2015; 14:281–6.
27. Mohamed NA, Zainol Rashid Z, Wong KK, Ab-dullah SA, Rahman MM. Hepatitis C genotype and associated risks factors of patients at the Uni-versity Kebangsaan Malaysia Medical Centre. Pak J Med Sci. 2013; 29:1142–6.
28. Hamzah H, Hasmoni M, Saad M, et al. Hepatitis C genotyping in haemodialysis patients and the development of genotyping method based on TaqMan probe real-time PCR. Hepatol Int. 2010; 4:179.
29. Durier N, Yunihastuti E, Ruxrungtham K, et al. Chronic hepatitis C infection and liver disease in HIV-coinfected patients in Asia. J Viral Hepat. 2017; 24:187–96.
30. Tan SS, Leong CL, Lee CKC. Treating hepatitis C in HIV/HCV co-infected patients in Malaysia – the outcomes and challenges. Med J Malaysia. 2015; 70:281–7.
31. Siti Nurul Fazlin AR, Hairul Aini H, Hadzri HM. Study of Hepatitis C virus infection in tertiary hospital: genotyping, risk factors and comorbidi-ties. International Medical Journal Malaysia. 2017; 16:11-20.
32. Hairul Aini H, Mustafa MIA, Seman MR, Nasuruddin BA. Mixed-genotypes infections with hepatitis C virus in haemodialysis subjects. Med J Malaysia. 2012; 67:199–203.
33. O’Keefe D, Stoové M, Doyle J, Dietze P, Hellard M. Injecting drug use in low and middle-income countries: opportunities to improve care and prevent harm. J Viral Hepat. 2017; 24:714–24.
34. Gillani SW, Sulaiman SAS. Chronic infections and management setting in drug addicts of MMT program in Pinang, Malaysia. Int J Collab Res Intern Med Public Health. 2009; 1:48-54.
35. World Health Organization. Hepatitis C Fact Sheet 2017. Available at: http://www.who.int/mediacentre/factsheets/fs164/en/. Accessed April 28, 2017.
36. Tan S, Menon J, Radzi M, et al. The demography and risk profiles for chronic hepatitis B and C from the Malaysian liver registry. Med J Malaysia. 2011; 66:31.
37. Lee WS, Teh CM, Chan LL. Risks of seroconver-sion of hepatitis B, hepatitis C and human im-munodeficiency viruses in children with multi-transfused thalassaemia major. J Paediatr Child Health. 2005; 41:265–8.
38. Johnson DW, Dent H, Yao Q, et al. Frequencies of hepatitis B and C infections among haemodi-alysis and peritoneal dialysis patients in Asia-Pacific countries: analysis of registry data. Nephrol Dial Transplant. 2009; 24:1598–603.
39. Wait S, Kell E, Hamid S, et al. Hepatitis B and hepatitis C in southeast and southern Asia: chal-lenges for governments. Lancet Gastroenterol Hepatol. 2016; 1:248–55.
40. McDonald SA, Dahlui M, Mohamed R, et al. Projections of the current and future disease burden of hepatitis C virus infection in Malaysia. PloS One. 2015; 10:e0128091.
41. Mukherjee TI, Pillai V, Ali SH, et al. Evaluation of a hepatitis C education intervention with clients enrolled in methadone maintenance and nee-dle/syringe programmes in Malaysia. Int J Drug Policy. 2017; 47:144–52.
42. Lewallen S, Courtright P. Epidemiology in prac-tice: case-control studies. Community Eye Health. 1998; 11:57–8.

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