How are Hepatitis B and Hepatits C different?

New Delhi: Hepatitis is a crucial public health concern because it affects liver health to a considerable extent. Hepatitis means liver inflammation associated with a spectrum of liver cell swelling to cell death. It can result in morbidity and infrequently lead to mortality. According to the 2024 Global Hepatitis Report by the World Health Organization (WHO), India accounted for 11.6 per cent of global hepatitis cases in 2022. It represents over 35.3 million hepatitis infections in the country, with 29.8 million cases attributed to hepatitis B and 5.5 million cases to hepatitis C. This places India second after China, which had 83.8 million cases. It’s crucial to understand hepatitis, its impact on the liver, and the measures needed to control its spread to mitigate its effects.

In an interaction with News9Live, Dr. Subrat Kumar Acharya, Executive Director of Gastroenterology at Fortis Escorts Liver & Digestive disease (FELDI), Okhla, New Delhi and Pro Chancellor, KIIT University, Bhubaneswar, explained the differences between Hepatitis B and Hepatitis C.

Understanding Hepatitis and Its Types

Both viral and non-infectious causes (drugs, alcohol, fat infiltration) can cause hepatitis. Hepatitis viruses that specifically cause liver damage include five types of viruses – A, B, C, D, and E. The transmission routes of these viruses, the severity of liver disease caused by them, their diagnostic serological methods, and their treatment and preventive strategies are distinct. While hepatitis A and E viruses are transmitted through contaminated water and food (faecal-oral transmission), hepatitis B and C are transmitted parenterally (through blood by injection, injury, transfusion, dialysis, unsafe injection practices and sexual route). Hepatitis A and E viruses cause only acute liver injury (acute viral hepatitis), although most patients spontaneously recover within four to eight weeks.

Very rarely can they cause severe liver injury leading to liver failure (acute liver failure or ALF). On the other hand, hepatitis B and C can cause both acute live injuries. They may persist in the human body for a long time, causing ongoing varying degrees of liver injury simultaneously associated with healing in the form of fibrosis (scar) and leading to chronic liver diseases like cirrhosis and liver cancer.

Hepatitis B and C: the Differences and Similarities

While both Hepatitis B (HBV) and Hepatitis C (HCV) are viral infections that affect the liver, they have distinct differences in their modes of transmission, potential outcomes, and treatment options.

Transmission: Although the ways for their transmission vary, both viruses spread when they come into contact with infected blood or other bodily fluids. Using contaminated needles for drug use or medical procedures, unprotected sex, or birth are the main ways that hepatitis B is transmitted from mother to child. However, direct blood-to-blood contact—such as sharing needles for drug use, using unsterilized medical equipment, or receiving tainted blood transfusions—is the primary way that hepatitis C is transmitted.
Symptoms: Both conditions can cause fatigue, appetite loss, nausea, vomiting, abdominal discomfort, dark urine, bowel movements that are the colour of clay, joint pain, and jaundice However, many people with hepatitis B or C may not have any symptoms, and they might not even be aware that they have the illness until years later when regular medical testing reveals liver damage or when they present features of cirrhosis or liver cancer.
Chronicity: Around 90 per cent of infants and 5 to 10 per cent of adults with HBV develop chronic infection, which can lead to liver cirrhosis or liver cancer over time. Conversely, approximately 75 to 85 per cent of people infected with HCV will develop chronic infection, with 15 to 30 per cent of those progressing to liver cirrhosis within 20 years.
Therapy: Antiviral drugs such as entecavir and tenofovir are used to treat HBV while direct-acting antivirals (DAAs) have made substantial progress in treating HCV.
Vaccination: There is an effective vaccine for HBV, but currently, there is no vaccine for HCV, making prevention through risk-reduction practices essential.

Prevention and Treatment Strategies

The prevention measures include vaccination, particularly for hepatitis A and B. Ensuring the safety of blood and blood products, injections, and drinking water is crucial. Maintaining good hygiene and sanitation, such as having clean toilets, is essential in preventing hepatitis. In 2018, India launched the ‘National Viral Hepatitis Control Program’ to combat and eradicate hepatitis C by 2030. The program encompasses immunization, promoting safe practices, providing free screening, diagnosis, and treatment, establishing surveillance systems, and ongoing training of healthcare workers.

Hepatitis continues to pose a substantial public health issue, especially in our nation. Recognizing the various forms of hepatitis, their effects on liver well-being, and the significance of routine check-ups can aid in managing and alleviating the illness. With the adoption of preventive measures, vaccination, and regular medical guidance, individuals can safeguard their liver health and contribute to the overarching objective of reducing morbidity and mortality associated with hepatitis.