Hepatitis B & C

Hepatitis B and hepatitis C both damage the liver, and both can persist for years with no symptoms while quietly progressing towards cirrhosis and liver cancer. Hepatitis B transmits efficiently through sexual contact, blood and from mother to child; hepatitis C transmits mainly through blood contact, with a lower but real sexual transmission risk that rises with anal sex and HIV co-infection. Testing differs between them. Hepatitis B screening uses a panel — surface antigen (HBsAg, current infection), surface antibody (anti-HBs, immunity from vaccination or cleared infection) and core antibody (anti-HBc, past exposure) — which together distinguish four quite different situations. Hepatitis C starts with an antibody test; because antibodies persist after clearance, a positive antibody result must be followed by an HCV RNA test to establish whether the infection is still active. The outlook has changed dramatically. Hepatitis B is preventable with a safe vaccine and controllable with antiviral therapy, and hepatitis C is curable in more than 95% of cases with 8–12 weeks of direct-acting antiviral tablets. The barrier is almost never treatment availability — it is that people never got tested.