Hepatitis B, C and D

Hepatitis B

Hepatitis B is a virus that affects the liver, causing inflammation, but often no symptoms are felt. Hepatitis B can go on to cause permanent damage to the liver (known as cirrhosis) and liver cancers if it is not first identified and then managed by a doctor or nurse.

It is mainly spread by direct contact with the bodily fluids of an infected person – this can be blood-to-blood contact, sexual contact, or mother-to-child transmission (during the birth and, on very rare occasions, via breast milk).

There is a vaccine available that protects against hepatitis B. The vaccination can be given to newborn babies to protect them from mother-to-child transmission. If the child is vaccinated, the mother can safely breastfeed.

If you have hepatitis B family members, sexual partners, and household contacts must be tested and vaccinated to prevent them from catching it. If you have hepatitis B you must take precautions such as using condoms with sexual partners and not sharing razors, needles, or nail clippers with anyone else. Hepatitis B is found in saliva but it is not transmitted to others by sharing household items such as cups, knives, and forks. It’s, therefore, safe to share these items.


Many people with hepatitis B don’t need treatment, they just require monitoring. This is done by a blood test and, in some people a scan, usually every 6 months. Some people will clear the virus spontaneously themselves (this usually happens within 6 months of infection if it is going to happen). However, hepatitis B is often a long-term (chronic) condition that sometimes requires lifelong management. Treatment is typically a tablet once a day which has few if any, side effects.

Hepatitis C

What is hepatitis C?

Hepatitis C virus (HCV) is widely regarded as a “silent killer.” Although it can be detected in the blood in as little as 1–3 weeks after exposure, patients may not display any symptoms of this deadly disease for years, even decades. Chronic HCV infection develops in 70–85% of infected persons, 60–70% of whom display evidence of liver disease.


Roughly 20–30% of newly infected patients will experience fatigue, abdominal pain, poor appetite, or jaundice. While chronic liver disease in HCV-infected patients progresses slowly, other symptoms that should trigger further investigation include joint pain, fever, dark urine, clay-colored stools, nausea, and vomiting. Again, with any type of “silent” disease, symptoms may be mild and less likely to prompt a visit to a doctor.


Hepatitis C virus is transmitted through contact with infectious blood, usually by persons who have injected drugs, even if it was only once many years ago. HCV can also be contracted through donated blood, blood products, and donated organs (although this is much rarer these days due to better screening procedures); needle-stick injuries in health care settings; and mother-to-child transmission in cases in which the pregnant mother is infected with HCV.

Hepatitis C virus can also be spread through other, less frequent, ways, such as by having unprotected sex with an HCV-infected person or sharing personal items that may be contaminated with infectious blood—toothbrushes, razors, and tools for tattooing or body piercing, for example. Some invasive medical procedures may also be at fault, although this is rare. Contrary to popular belief, breastfeeding, sneezing/coughing, and hugging do not transmit the virus, nor is it spread through food and water


An anti-HCV test detects the presence of antibodies to the virus, but it can’t tell the difference between an active or previous HCV infection. To confirm a weakly positive result, an HCV RNA test should be ordered to confirm the presence of the Hepatitis C virus.


While there is no vaccine to protect against the hepatitis C virus, people with hepatitis C are recommended to get vaccinated for Hepatitis A and B.

Recently Directly acting antivirals (DAA’s) against HCV have become widely available and they have an excellent cure rate. Treatment is with oral tablets and is given for 12-24 weeks.