Hepatitis B & C

Hepatitis B and hepatitis C are viral infections of the liver, both spread through blood and, for hepatitis B especially, through sex and from mother to baby at birth. Either can become chronic and, over decades, scar the liver and lead to cirrhosis and liver cancer.

The two now have very different outlooks. Hepatitis C can be cured in more than 95 in 100 people with 8 to 12 weeks of tablets. Hepatitis B can be prevented by vaccine and controlled with long-term antiviral tablets, but is rarely cleared completely. Many people with either infection have no symptoms and do not know they carry it.

Symptoms

• No symptoms for years in most people with chronic infection
• Tiredness and a general feeling of being unwell
• Discomfort under the right ribs
• Nausea, poor appetite, dark urine and jaundice in acute infection
• Joint aches
• Abdominal swelling, easy bruising, confusion or vomiting blood once cirrhosis is advanced

Causes and risk factors

Hepatitis B passes from mother to child at birth, through unprotected sex, shared needles, unscreened blood products, unsterile medical, dental, tattoo or piercing equipment, and close household contact such as shared razors. Infection in infancy becomes chronic in about nine in ten cases, but in adults in fewer than one in twenty. Hepatitis C spreads mainly through blood: injecting drug use, transfusions before screening began in the early 1990s, and unsterile procedures. Sexual and mother-to-baby spread of hepatitis C is uncommon. Neither virus spreads by food, coughing, hugging or sharing cutlery.

How it is diagnosed

• Screening blood tests: HBsAg for hepatitis B and anti-HCV antibody for hepatitis C. A positive hepatitis C antibody needs an HCV RNA test to show whether the virus is still present.
• Viral load and hepatitis B markers: HBV DNA, HBeAg and anti-HBe define the phase of hepatitis B and whether treatment is needed. Hepatitis D is checked in those with hepatitis B.
• Liver blood tests and blood count: ALT, AST, bilirubin, albumin, clotting and platelets indicate inflammation and liver function.
• Fibrosis assessment: Transient elastography (FibroScan) or blood-based scores estimate scarring without a biopsy. Biopsy is now seldom required.
• Ultrasound and AFP: Liver ultrasound every 6 months screens for liver cancer in people with cirrhosis and in higher-risk hepatitis B carriers.

Treatment options

• Direct-acting antivirals for hepatitis C: Combination tablets such as sofosbuvir with velpatasvir, or glecaprevir with pibrentasvir, once daily for 8 to 12 weeks. Cure is confirmed by an undetectable virus 12 weeks after finishing.
• Antiviral tablets for hepatitis B: Entecavir or tenofovir once daily suppress the virus and protect the liver. Treatment is usually long term and should not be stopped without specialist advice because of flare risk.
• Monitoring without treatment: Many hepatitis B carriers with low viral load and normal liver tests need only checks every 6 to 12 months.
• Vaccination and protection of contacts: Hepatitis B vaccine for partners and household members, and vaccine plus immunoglobulin for babies of infected mothers within hours of birth. No vaccine exists for hepatitis C.
• Liver protection: Avoiding alcohol, keeping a healthy weight, and hepatitis A vaccination.
• Liver transplant: For liver failure or selected liver cancers. In Türkiye this requires a living related donor and ethics committee approval.

When it is urgent

Seek emergency care locally for vomiting blood or passing black stools, new confusion or unusual drowsiness, a rapidly swelling abdomen with fever, or deepening jaundice with bruising or bleeding. These are signs of liver failure or complications of cirrhosis. After a needlestick or other exposure, attend a local clinic within 24 to 48 hours for preventive treatment.

Travelling to Türkiye for treatment

A visit can deliver a complete assessment in a few days: viral load, genotype where needed, FibroScan and ultrasound, with a specialist plan. Hepatitis C treatment is a short, defined course, so starting it after assessment and completing it at home with a cure test 12 weeks later is realistic if your local doctor can do the blood tests. Hepatitis B needs lifelong monitoring, which should be based where you live.

Send your reports, scans and a short history and a Clinic-Y coordinator replies within 24 hours with suitable teams and written, all-inclusive proposals side by side. Reviewing your case is free.

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