Hepatitis B & C

This webpage is for information purposes only and is not a substitute for professional medical advice.

Hepatitis B and C are viral infections of the liver.

Hepatitis is a virus that causes inflammations and infections in the liver. There are different types of hepatitis. There is a vaccine for hepatitis B, but there is no vaccine for hepatitis C. Having a vaccine for one type of hepatitis does not protect you from other types of hepatitis. Both hepatitis B and hepatitis C can lead to liver damage and possibly cancer.

Signs & Symptoms

Hepatitis B Hepatitis C

The symptoms of hepatitis B vary, and can include:

  • Loss of appetite
  • Nausea
  • Vomiting
  • Fatigue
  • Headache
  • Fever

These symptoms may be followed by
jaundice, which causes yellowing of the eyes, skin and body fluids (such as tears), as well as a darkening of the urine.

Other less-common symptoms of hepatitis include:

  • Itching
  • Weight loss
  • Abdominal pain
  • Sleep disturbance
  • Confusion
  • Loss of sex drive

Of those with symptoms, the most common is chronic fatigue, but may also include:

  • Lack of appetite
  • Nausea
  • Vomiting
  • Itchiness
  • Jaundice (yellowing of the skin and the white area of the eyes), joint and muscle aches.

Complications of hepatitis C include chronic liver disease such as cirrhosis, liver cancer and liver failure.

How Hepatitis B & C Are Spread

Hepatitis B Hepatitis C

Hepatitis B is spread to others through:

  • Contact with infected blood or body fluids (semen, vaginal fluids, saliva). The infected blood or body fluid must enter a break in the skin or be absorbed through a mucous membrane (eyes, mouth, vagina or anus).
  • Childbirth (mother to baby). All pregnant women must be screened for hepatitis B as part of their prenatal care.

Hepatitis C is spread to others through

  • Sharing needles, spoons, straws and other drug-related equipment with someone who has hepatitis C.
  • Getting tattoos or body parts pierced with used or non-sterile needles.
  • Receipt of blood transfusions or blood products (before 1992).

Studies show that 5% to 10% of women who have HCV pass it on to their babies before or at the time of birth.

Breastfeeding does not pass HCV from a mother to her baby. If the nipples are bleeding or cracked, breastfeeding should be avoided until the nipples are completely healed.
Hepatitis B is not spread through water, food, kissing, sneezing or coughing. While sexual transmission is unlikely, the risk increases when there are open genital sores and during menstrual periods.


Hepatitis B or C carriers are people who’ll carry the virus in their blood and body fluids for the rest of their lives. Most carriers remain symptom-free for many years.

  • Carriers look and feel well but can continue to pass the infection to others.
  • 6 - 10% of people with hepatitis B become chronic carriers.
  • 75 - 85% of people with hepatitis C become chronic carriers.
  • 25% of hepatitis C carriers develop cirrhosis (scarring) or cancer of the liver later in life.

Diagnosis & Treatment

Diagnosing Hepatitis B & C

Hepatitis B Hepatitis C
To diagnose hepatitis B your doctor will ask you:
  • About your symptoms related to hepatitis B.
  • If you’ve injected drugs or had unprotected sex.
  • If you might have been exposed to hepatitis.
  • To examine your skin and eyes for jaundice, and your abdomen to estimate the size of your liver.
  • To order blood tests to see if the virus is in your blood and to check the function of your liver.

Suspected Liver Damage

If your doctor suspects that you have liver damage, he or she will recommend a liver biopsy to see if you’re developing signs of liver cirrhosis.*

To diagnose hepatitis C your doctor will ask you:

  • About your symptoms related to acute or chronic hepatitis C.
  • If you have a history of injection drug use, nasal cocaine use or blood transfusions, especially before 1992.
  • About your sexual history and condom use.
  • If you have had a needle stick injury.
  • To examine you for evidence of liver disease, such as an enlarged liver or spleen, a swollen abdomen, ankle swelling or muscle wasting.
  • To order blood tests to see if the virus is in your blood and to check the function of your liver.

Suspected Liver Disease

If you have a hepatitis C infection, your doctor will order blood tests to determine if you have liver disease.

Special blood testing will also be done to determine which strain of the virus you have. Different subtypes respond differently to treatment.

A liver biopsy will likely be performed before medical treatment is started.*

* Source: InteliHealth


Hepatitis B

Hepatitis C

There is no specific treatment of hepatitis B.

Sometimes hepatitis B symptoms can be severe enough to require hospital treatment.

Not all people with chronic hepatitis B require treatment. Your doctor might consider treating you with antiviral medications if your blood contains viral particles (antigens), your liver isn’t functioning properly or your liver biopsy has shown some liver damage.

People with chronic liver disease can be considered for a liver transplant, although the new liver usually becomes infected in time.

Not everyone infected with hepatitis C needs treatment. If you’re infected, your doctor will discuss the benefits and side effects of treatment and the likelihood that treatment will improve your condition.

Hepatitis C is commonly treated with a combination of two drugs: alpha interferon and ribavirin (Virazole). About 60% of patients who take this combination therapy will clear the virus from their blood.

Your doctor will also likely recommend that you receive vaccinations against hepatitis A and B, unless you already have been infected with these viruses, to reduce the chance that you will have further liver damage.

* Source: InteliHealth


Hepatitis B

Hepatitis C

Your can reduce your risk of contracting (or spreading) hepatitis B by:

  • Getting the hepatitis B vaccine. (Peel Health provides free vaccinations to household and sexual contacts, babies of chronic carriers and Grade 7 students.)
  • Practicing safer sex. Use a latex  or polyurethane barrier (condom or dam) every time you have sex.
  • Never sharing needles and syringes for injection drug use, including steroids. Never sharing other drug using equipment such as spoons, straws and crackpipes.
  • Never sharing toothbrushes, razors, nail files or other personal items that may have tiny amounts of blood on them. (The hepatitis B virus can live in dry blood for up to seven days).
  • Ensuring that tattooing or body piercing equipment is brand new or sterilized.
  • Disposing blood-stained articles (tampons, dental floss, bandages) in a tied plastic bag.
  • Using routine practices in any situation where blood/body fluids are involved, such as:

    • Wearing a household rubber glove to reduce the risk of the fluid entering your body through breaks in the skin.
    • Cleaning up blood/body fluids spills with soap and water then wiping the surface with freshly made bleach solution 1:10 (¼ cup bleach to 2¼ cups water).
    • Letting the area dry 10 minutes so the bleach can kill any germs left on the surface.
    • Placing blood-soiled materials in a sealed bag first before disposing them in the garbage.
    • Removing your gloves and washing hands with soap and water for at least 15 seconds.

Your can reduce your risk of contracting (or spreading) hepatitis C by:

  • Not sharing any equipment for injection drug use (including steroids), tattooing and body piercing. Never sharing other drug using equipment such as spoons, straws and crackpipes.
  • Not donating any blood or organs for transplants (if you are a hepatitis C carrier).
  • Practicing safer sex by using a latex barrier (condom or dental dam) every time you have sex.

The Hepatitis B Vaccine

There are 2 types of the hepatitis B vaccine in Canada. Both are yeast-based and neither contains any blood products.

Hepatitis B Screening (Blood Test)

A Hepatitis B screening (blood test) will show if you’re susceptible, immune or a carrier of hepatitis B. This screening is only necessary for sexual partners of hepatitis B carriers, household contacts and babies born to carrier mothers. It is also necessary for an un-immunized person who has sustained a needle stick injury or someone who works in a high risk environment and wants to be sure their immune status is strong from previous immunization.

  • If you’re susceptible, you’ve never had hepatitis B and would benefit from hepatitis B vaccination.
  • If you’re immune, you’ve either had the hepatitis B vaccine or the disease in the past. This means you are already protected and the vaccine isn’t necessary.
  • If you’re a carrier, you don’t need the vaccine. The vaccine will, however, protect your sexual partners and other people in your household from getting infected.

Who Shouldn’t Get Vaccinated?

You should NOT get the hepatitis B vaccine if you’re:

  • Sensitive to yeast, thimersol (contact lens solution), mercury or aluminum.
  • Sick with a high fever, respiratory infection or contagious disease.
  • Pregnant. (Vaccination may be considered for females at risk of hepatitis B).
  • Already a carrier or immune.

Vaccine Side Effects

Serious side effects from the hepatitis B vaccine are very rare.

Minor side effects include:

  • A redness, soreness or swelling at the needle site.
  • Tiredness.
  • Headaches.
  • A slight fever.

Types of STIs

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