Hepatitis B & C -- Symptoms, Treatment & Cure in India

You are not alone

India carries one of the world's largest burdens of viral hepatitis -- and most infected people don't know it.

40M

Indians are chronic hepatitis B carriers -- 10-15% of the entire global HBV pool.

PMC / Hepatitis B Burden India

12M

Indians are estimated to have chronic hepatitis C infection -- many undiagnosed for years.

PubMed / HCV Burden India

>95%

Cure rate for hepatitis C with modern direct-acting antiviral treatment -- a 12-week course.

WHO India / Hepatitis

Hepatitis B and C: how are they different?

Both are viral infections that inflame the liver. Both can become chronic. Both can cause cirrhosis and liver cancer over years. But they are caused by different viruses, spread differently, and are treated very differently.

Hepatitis B

Chronic but controllable

Spread by blood, unprotected sex, or mother to child at birth

Vaccine exists -- 3-dose course is highly protective

No cure, but antivirals (tenofovir, entecavir) suppress virus effectively

Lifelong monitoring required -- 6-monthly review minimum

15-25% of untreated carriers develop cirrhosis or liver cancer

Hepatitis C

Now curable in 12 weeks

Spread primarily through blood -- shared needles, unscreened transfusions, reused equipment

No vaccine exists -- testing and treatment are the only defence

Cured with direct-acting antivirals (DAAs) in a 12-week course, >95% success rate

Many patients had infections for 20-30 years without knowing

If cirrhosis has developed, cure stops further damage but cannot reverse scarring

Who should be tested?

Both hepatitis B and C can be present for years without any symptoms. Testing is the only way to know. If you fall into any of these groups, ask your doctor for a test.

Test for Hepatitis B if you:

Were born to a mother with hepatitis B

Have not been vaccinated against hepatitis B

Have had unprotected sex with multiple partners

Have elevated liver enzymes on a blood test

Are a healthcare worker

Are pregnant (routine screening is recommended)

Test for Hepatitis C if you:

Received a blood transfusion before 2000

Have had any injectable drug use (even once)

Had medical or dental procedures with reused equipment

Have unexplained elevated liver enzymes

Have a family history of liver disease or cirrhosis

Are HIV positive (co-infection is common)

Recognise the signs

Most people with chronic hepatitis B or C have no symptoms for years or even decades. When symptoms do appear, liver damage is often already significant.

Symptoms (When Present)

Persistent fatigue and weakness

Loss of appetite and mild nausea

Discomfort in the upper right abdomen

Mild joint pain (more common in hepatitis B)

Elevated ALT/AST on routine blood tests

Warning Signs -- Disease Has Advanced

Jaundice -- yellowing of skin and eyes

Abdominal swelling (ascites)

Confusion or memory problems

Vomiting blood or black stools

Sudden sharp deterioration in general health

Treatment Plan

Treatment differs completely between B and C

Hepatitis B requires long-term suppression. Hepatitis C can be eliminated. Both need specialist-guided management to prevent liver damage from accumulating silently.

Hepatitis B

Suppress & Monitor

No cure -- but full control is achievable

Antiviral therapy (tenofovir or entecavir) -- suppresses the virus to undetectable levels
Treatment is lifelong in most patients -- stopping can trigger dangerous flares
Liver function tests and HBV DNA levels every 6 months
Ultrasound + AFP every 6 months for liver cancer surveillance
Vaccination of all close family members not already immune
Alcohol strictly avoided -- accelerates liver damage

Hepatitis C

Cure in 12 Weeks

Direct-acting antivirals -- >95% cure rate

Genotype testing first -- determines which antiviral combination to use
Pan-genotypic regimens (sofosbuvir/velpatasvir) work across all genotypes
12-week oral course -- no injections, well tolerated
SVR12 (undetectable virus 12 weeks after treatment) = cure
If cirrhosis present: cure stops progression but surveillance for liver cancer continues lifelong
Treatment available and affordable in India through government programmes

Cirrhosis Stage

When Liver Is Damaged

Advanced disease needing transplant assessment

Antiviral therapy continues even at cirrhosis stage
Management of complications: ascites, varices, encephalopathy
MELD score assessment for transplant priority
Living donor liver transplant -- HBV prophylaxis given post-transplant to prevent recurrence
Post-transplant hepatitis C: cure with DAAs before or after transplant

This treatment overview is for general information only and has not yet been formally reviewed for this publication. Your care plan will be determined by Dr. Sahota after a personal evaluation. Do not make treatment decisions based on this page alone.

Hepatitis B & C