What is the difference between Hepatitis B and Hepatitis C?

The hepatitis virus family has five types: Hepatitis A, B, C, D, and E. Different viruses cause each of these infections, and they each affect the liver in one way or another.

Hepatitis A and E are typically spread through contaminated food and water, leading to acute infections that usually resolve on their own.

Hepatitis B, C, and D, on the other hand, are primarily transmitted through blood and bodily fluids, often resulting in chronic infections that can lead to serious liver damage, including cirrhosis and liver cancer.

Hepatitis B and C are particularly concerning due to their potential to cause long-term health issues, and how easily they can be passed from person to person through sex and/or blood-to-blood contact.

Hepatitis B is a liver infection caused by the Hepatitis B virus (HBV). It spreads through contact with infectious body fluids, such as blood, semen, and vaginal secretions, often via unprotected sex, sharing sex toys, sharing needles, or from mother to child during childbirth. We also see higher levels of Hepatitis B in poor living conditions.

Most people who catch the Hepatitis B virus won’t get sick – their immune system will clear the infection, usually within a couple of months. This is known as an acute infection.

However, some people will get a chronic infection, which can lead to severe liver damage, cirrhosis, or liver cancer.

While Hepatitis B is a fairly common infection worldwide, it is fairly uncommon in Australia, with just over 200,000 people living with a chronic infection as of 2021. It tends to be more common among people who grow up in parts of the world where the infection is endemic including Southeast Asia, China and sub-Saharan Africa.

Hepatitis C is also a viral infection that affects the liver. It is caused by the Hepatitis C virus (HCV).

It’s primarily spread through blood-to-blood contact, often via sharing needles, unscreened blood transfusions, or less commonly, through sexual contact. As it requires blood to blood transfer, we generally only see its sexual transmission if blood to blood contact has happened, such as sharing sex toys or during anal sex in groups. The infection can be acute, lasting a few months, or chronic, potentially leading to severe liver damage, cirrhosis, or liver cancer over time.

Hepatitis C is less common in Australia than Hepatitis B, with just over 117,000 people living with a chronic infection.

The symptoms of both Hepatitis B and Hepatitis C can be very similar, but there are some small variations.

Hepatitis B symptoms

Acute Hepatitis B symptoms typically appear 1 to 4 months after infection and can include:

• Abdominal pain
• Dark urine
• Fever
• Joint pain
• Loss of appetite
• Nausea and vomiting
• Weakness and extreme tiredness
• Jaundice (yellowing of the skin and eyes)

Chronic Hepatitis B symptoms might be less noticeable and can vary depending on the extent of liver damage. Some people may not experience any symptoms, while others might have:

• Persistent fatigue
• Loss of appetite
• Low-grade fever

Hepatitis C symptoms

Symptoms of acute Hepatitis C can appear 2 to 12 weeks after exposure and may include:

• Jaundice
• Fatigue
• Fever
• Joint pain
• Loss of appetite
• Nausea, stomach pain, and vomiting

Chronic Hepatitis C often has no symptoms for many years. When symptoms do appear, they can include:

• Fatigue
• Loss of appetite
• Nausea
• Abdominal pain, especially in the upper right quadrant
• Jaundice
• Bruising easily
• Bleeding easily
• Dark-colored urine
• Itchy skin
• Fluid buildup in the abdomen (ascites)
• Swelling in the legs
• Weight loss
• Confusion, drowsiness, and slurred speech (hepatic encephalopathy)
• Spider-like blood vessels on the skin (spider angiomas)

If left untreated, both infections can lead to severe liver damage over time. This is much more likely to occur with Hepatitis C. This includes cirrhosis (scarring of the liver), liver failure, and an increased risk of liver cancer. Regular monitoring and antiviral treatments can help manage the disease and reduce these risks. Newer treatments can completely eradicate the infection.

Avoiding Hepatitis B

Vaccination is the most effective method of avoiding contracting Hepatitis B. Hepatitis B vaccines are offered to most infants in Australia. If you’re an adult, you should get vaccinated if you’re part of a high-risk group, which includes:

• People who are immunocompromised
• People with Hepatitis C, chronic liver disease, or some other medical risk factor
• People whose work puts them at risk for Hepatitis B, like healthcare workers
• Anyone travelling to a part of the world where Hepatitis B is endemic
• Men who have sex with men
• Sex workers
• People who inject drugs

Additionally, practising safe sex by using condoms can reduce the risk of transmission through sexual contact. Also, avoid sharing needles, syringes, or any drug-injection equipment. Healthcare workers should follow standard precautions, such as using protective gear and safely handling needles and other sharp instruments.

Avoiding Hepatitis C

Unfortunately, there is no vaccine for Hepatitis C.

To avoid infection, do the following:

• Avoid exposing yourself to infected blood
• Don’t share personal hygiene products like toothbrushes and razors
• Don’t share needles or other drug-injection equipment
• Ensure that any tattoos or body piercings are done with sterile equipment in a professional setting
• Make sure that you think carefull about the possibility of blood to blood transfer of the virus if you engage in sex in groups (especially anal sex) or when you share sex toys

If you are at risk of getting Hepatitis C (for example, if you regularly inject drugs), get tested often.

Hepatitis B and Hepatitis C are serious infections that, if left untreated, can cause lasting damage to your health.

If you are worried about the possibility of having Hepatitis B or C, get in touch with Better2Know today to protect your sexual health.

This article has been medically reviewed by Dr. Steve Chapman, 10/12/2024.