By Dr. D. Chandra Sekhar Reddy, Dr. D. Chandra Sekhar Reddy, Senior Consultant Gastroenterologist, Hepatologist and Therapeutic Endoscopist, Yashoda Hospitals, Hyderabad.
India has set a goal to eliminate hepatitis B and hepatitis C as public health threats by 2030. Achieving this will require more than treatment alone. Early testing and diagnosis are important because hepatitis can remain silent for years while gradually affecting the liver.
Hepatitis B and C are viral infections that can cause long-term liver inflammation, cirrhosis and liver cancer. However, many people may not have obvious symptoms, especially in the early stages. This makes testing important for people who may have been exposed to the viruses, even if they feel healthy.
Why testing matters
Hepatitis B and C do not always cause noticeable symptoms in the early stages. A person may therefore live with an infection without knowing it and may unknowingly transmit it to others.
Testing can help:
- Identify an infection before significant liver damage develops.
- Determine whether further evaluation or treatment is required.
- Reduce the risk of transmission to family members and others.
- Allow people with chronic infection to receive appropriate medical follow-up.
Who should consider hepatitis B testing?
Testing is particularly important for people who may have had contact with infected blood or body fluids.
People who may need testing include:
- Individuals whose mother had hepatitis B, particularly when exposure may have occurred around birth.
- People living with someone who has hepatitis B.
- Those with a spouse or sexual partner who has hepatitis B.
- People who have shared needles or other equipment used for injecting drugs.
- Individuals with a history of unsafe injections or procedures involving inadequately sterilised equipment.
- People who have received medical or dental procedures in settings where infection-control practices may have been inadequate.
- Healthcare workers who may be exposed to blood or body fluids.
- People with HIV or certain other conditions that increase the risk of viral hepatitis.
- Pregnant women, as identifying hepatitis B during pregnancy helps protect the newborn from infection.
A doctor may also recommend testing based on an individual’s medical history and possible exposure.
Who should consider hepatitis C testing?
Unlike hepatitis B, there is currently no vaccine that prevents hepatitis C, making prevention and early detection particularly important.
Testing may be recommended for:
- People who have ever injected drugs, even if it happened many years ago.
- Individuals who received blood transfusions or blood products before reliable screening was routinely available.
- People with a history of sharing needles or other equipment that may have been contaminated with blood.
- Those who have undergone procedures such as tattooing, piercing or injections using potentially unsterile equipment.
- People living with HIV.
- Individuals with unexplained abnormal liver tests or known liver disease.
- People who may have had other significant exposure to infected blood.
The exact testing approach depends on the person’s exposure history and medical assessment.
Hepatitis B and C are not the same
Although both viruses affect the liver, their prevention and treatment differ.
Hepatitis B:
- A vaccine is available for prevention.
- The infection can be acute or become chronic.
- People with chronic hepatitis B may require regular monitoring and, in some cases, long-term antiviral treatment.
Hepatitis C:
- There is currently no vaccine.
- The infection can become chronic if it is not treated.
- Modern antiviral medicines can cure most hepatitis C infections when appropriately prescribed.
This is why knowing which virus is involved is important before deciding on further management.
What happens after a positive test?
A positive screening result does not by itself tell the complete story. Further testing may be needed to confirm infection, determine whether it is active or chronic, and assess the condition of the liver.
Doctors may consider:
- Confirmatory viral testing.
- Liver function tests.
- Assessment of the amount of virus in the blood, where appropriate.
- Evaluation for liver fibrosis or other liver damage.
- Screening for other infections or health conditions when indicated.
Treatment decisions should be based on these findings rather than on a single screening result.
What can people do to reduce their risk?
Along with testing, prevention remains important.
- Get vaccinated against hepatitis B if recommended.
- Do not share needles, syringes, razors or toothbrushes that may have blood on them.
- Ensure tattooing, piercing and medical procedures use properly sterilised or single-use equipment.
- Practise safer sex, particularly when there is a known risk of hepatitis B.
- Pregnant women should discuss hepatitis B testing with their healthcare provider.
- People diagnosed with hepatitis should follow medical advice and avoid donating blood.
The importance of testing for India’s 2030 goal
Eliminating hepatitis as a public health threat requires people with undiagnosed infections to be identified and linked to care. Testing should therefore focus not only on people who have symptoms, but also on those with a possible history of exposure.
For individuals who may have been exposed to hepatitis B or C, speaking to a doctor about appropriate testing can be an important first step. Early diagnosis allows timely medical care and can also help prevent further transmission.
Dr. D. Chandra Sekhar Reddy is a Senior Consultant Gastroenterologist, Hepatologist and Therapeutic Endoscopist at Yashoda Hospitals, Somajiguda, Hyderabad. He has over 33 years of experience in the field of gastroenterology and hepatology.
He completed his MD from Kurnool Medical College in 1998 and DM in Gastroenterology from Osmania Medical College. He has also worked at leading medical institutions including the Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, and the GB Pant Institute of Postgraduate Medical Education and Research, New Delhi. His professional experience includes serving as a Senior Resident in Gastroenterology at GB Pant Institute and as a Senior Research Associate in Hepatology at PGIMER.
His areas of expertise include liver diseases, advanced endoscopic procedures, Endoscopic Retrograde Cholangiopancreatography (ERCP), Endoscopic Ultrasound (EUS), GI motility and functional bowel disorders.
Dr. Chandra Sekhar Reddy has received the Best Oral Paper award at ISGCON and is a life member of the Indian Society of Gastroenterology and the Indian National Association for Study of Liver. He is also a member of the American Society of Gastrointestinal Endoscopy and the American College of Gastroenterology.