Hepatitis B and C

Hepatitis B and C are viral infections of the liver. While they can both cause significant liver damage and long term scarring, they are actually very different diseases from each other.

Hepatitis B

Hepatitis B is a condition caused by the Hepatitis B virus. It is one of the most common infections worldwide, particularly in developing countries.

How do you contract Hepatitis B?

Hepatitis B is spread by coming into contact with blood or other bodily fluids from a person carrying the virus. Worldwide, most people with Hepatitis B become infected at the time of birth or in early childhood.

In adults who are not vaccinated, other modes of spread include:
– unprotected sex with an infected person
– sharing needles or piercing equipment with an infected person

What are the symptoms of Hepatitis B?

The likelihood of developing symptoms of Hepatitis B depends on a person’s age at the time of the initial infection. Children are less likely to develop symptoms compared to teenagers or adults. When symptoms do develop, these can include:

– nausea and vomiting
– loss of appetite
– fever
– jaundice (yellow colour to skin/eyes)
– abdominal pain

Hep B can also cause inflammation of blood vessels (Polyarteritis nodosa), kidney disease, autoimmune arthritis and anaemia.

The risk of a long term (chronic) infection with Hepatitis B decreases with age. This means that children infected with Hepatitis B are very likely (>95%) to remain infected for many years., while for adults this is very unlikely (<5%). The two main complications of chronic infection are (i) liver failure (cirrhosis) and (ii) liver cancer.

How do you diagnose Hepatitis B?

Hepatitis B is diagnosed on a blood test. This test looks for both the virus particles as well as measuring your body’s immune response to the virus (antibodies)

How do you treat Hepatitis B

The need for treatment is determined by the ‘phase’ of the infection. When the virus is dormant (under ‘immune control’), treatment is not needed. When the virus levels are high however, and the liver is inflamed, anti-viral medication is required. This treatment helps control the virus and prevents long term scarring to the liver.

Irrespective of the need for treatment, people with chronic Hepatitis B infection need to be carefully monitored by a doctor. This includes regular screening for liver cancer and cirrhosis.

Hepatitis B infection can be prevented by a vaccine. In Australia this is given to all children as part of the National vaccination schedule.

Hepatitis C

Hepatitis C is an infection caused by the Hepatitis C virus. This virus specifically targets the liver and can cause both short and long term damage.

How do you contract Hepatitis C?

Hepatitis C is a ‘blood borne’ virus. This means you can become infected if your blood comes into contact with blood from a person carrying the virus. Common modes of transmission include:

– sharing injecting equipment such as needles, syringes or spoons
– sharing toothbrushes or razors
– having a tattoo / body piercing with unsterile equipment
– infected blood products (pre-1990)

What are the symptoms of Hepatitis C?

Most people who are newly infected with Hepatitis C do not develop symptoms. A small minority (≈20%) will become unwell with symptoms including:

– fever
– fatigue
– nausea / vomiting
– abdominal pain
– dark urine
– jaundice (yellowing of skin / eyes)

The Hepatitis C virus can also cause inflammation of blood vessels (vasculitis), kidney damage, and skin diseases (e.g. Lichen planus). It also increases the risk of lymphoma.

Approximately 80% of patient who are infected with Hepatitis C will go on to have a life-long infection unless they receive treatment. While long term (chronic) Hepatitis C infection can go undetected for many years, it frequently causes ongoing damage to the liver. This can result in liver failure (cirrhosis) and liver cancer.

How do you diagnose Hepatitis C?

Hepatitis C is easily diagnosed with a blood test. This test detects your body’s immune response (antibodies) to the virus as well as the virus particles themselves.

How do you treat Hepatitis C?

Hepatitis C can now be treated successfully with a course of medication. These direct-acting antivirals (DAA’s) are effective in eradicating the virus in over 95% of cases. If you have Hepatitis C, you should consider getting treated to prevent liver complications and blood vessel disease. The treatments are covered by the PBS in Australia and the hope is to one day eliminate Hep C from Australia.