Patient information · Infectious disease
Hepatitis B and C
one is curable, the other is controllable — both are usually silent
Hepatitis B and C are viral infections of the liver that often cause no symptoms for decades while quietly causing damage. Hepatitis C is now curable in over 95% of people with a short course of tablets. Hepatitis B is not curable but is very effectively controlled. Both are substantially under-diagnosed.
Seek urgent assessment if you have
- yellowing of the skin or eyes, dark urine or pale stools
- vomiting blood, or black tarry stools
- abdominal swelling, or new confusion and drowsiness
- severe abdominal pain with fever
- easy bruising or bleeding
- a needlestick or blood exposure — post-exposure treatment is time-critical
Hepatitis B post-exposure prophylaxis works best within 24 hours and can be given up to seven days after exposure. If you have had a needlestick injury or blood exposure, seek help immediately rather than waiting. In an emergency call 999, or go to the Royal London Hospital Emergency Department, Whitechapel Road, London E1 1FR.
Who should be tested
- anyone born in, or whose parents were born in, a country with higher prevalence — much of Asia, Africa, Eastern Europe, the Middle East. This includes a large proportion of families in East London
- anyone who has ever injected drugs, even once, decades ago
- anyone who received a blood transfusion in the UK before 1991, or abroad
- anyone with tattoos, piercings or medical or dental treatment where sterility was uncertain
- household or sexual contacts of someone infected
- anyone with unexplained abnormal liver tests
- everyone in pregnancy is offered hepatitis B testing as part of antenatal screening
- healthcare workers, and people with HIV
Hepatitis C is curable — and many people do not know
Treatment changed completely around 2015. Modern direct-acting antivirals cure over 95% of people with an 8 to 12 week course of well-tolerated tablets — no injections, few side effects. Many people diagnosed years ago remember the old interferon treatment, which was gruelling and often failed, and have never come back. If you were told you had hepatitis C at any point and did not complete treatment, it is worth returning. Treatment on the NHS is free regardless of immigration status.
Hepatitis B
- Most adults who catch it clear it; those infected as babies or young children usually do not, which is why mother-to-child transmission matters so much.
- Not everyone with chronic hepatitis B needs treatment — it depends on the viral load, liver enzymes and the degree of liver damage. Many are simply monitored, which is appropriate rather than neglectful.
- Treatment is a daily tablet, usually long term, which suppresses the virus and prevents liver damage.
- Lifelong monitoring is required, including six-monthly ultrasound and blood tests for liver cancer surveillance in those at risk.
- Do not stop treatment without advice — stopping can cause a severe flare.
Protecting others
Hepatitis B
- Vaccinate all household and sexual contacts — it is highly effective
- Babies of infected mothers get vaccine and immunoglobulin at birth, which prevents most transmission
- Do not share razors, toothbrushes or nail clippers
- Cover cuts; clean blood spills with diluted bleach
- Use condoms until partners are vaccinated and immune
Hepatitis C
- There is no vaccine — prevention is avoiding blood contact
- Never share injecting equipment, including spoons and filters
- Do not share razors or toothbrushes
- Transmission through sex is uncommon but higher with HIV or rough sex
- Reinfection is possible after cure, so precautions continue
Looking after your liver
- Avoid alcohol, which accelerates damage substantially in both infections.
- Maintain a healthy weight — fatty liver on top of viral hepatitis compounds the damage.
- Have hepatitis A vaccination if you have B or C.
- Check with a pharmacist before herbal remedies and supplements, several of which are liver-toxic.
- Keep up with monitoring appointments even when you feel completely well — that is the entire point.
Why come to us. Testing is a single blood test and most people who should have it never have. We offer hepatitis B and C testing in-house with results back quickly, alongside liver function and a FIB-4 fibrosis score, plus liver ultrasound on site. We provide hepatitis B vaccination for you and your household, and refer to hepatology through our CQC-registered partners for treatment. Confidential, seven days a week, with clinicians speaking many community languages.
Testing, vaccination and liver ultrasound on site
Confidential, results back quickly. Seven days a week.
Tower Bridge Hospital London
97–99 Whitechapel Road, London E1 1DT
WhatsApp 07903 284 189
info@mhwclinic.co.uk
Open Mon–Sat, 9am–7pm (closed Sundays until September)
In an emergency
Call 999, or go to the Royal London Hospital Emergency Department, Whitechapel Road, London E1 1FR.
When we are closed and it is not an emergency
Call NHS 111 or visit 111.nhs.uk.