Hepatitis B and C: Five Common Misconceptions Explained

Hepatitis B and hepatitis C are different viral infections, but both can affect the liver without causing obvious symptoms.

They are also widely misunderstood. Someone may assume hepatitis always causes jaundice, only affects certain people or would automatically be identified through a routine blood test.

World Hepatitis Day, held on 28 July each year, provides an opportunity to challenge these assumptions and reduce the stigma and practical barriers that can prevent people from accessing reliable information and appropriate medical care.

Here are five common misconceptions about hepatitis B and C—and what is useful to know instead.

What are hepatitis B and hepatitis C?

Hepatitis means inflammation of the liver. It can have several causes, including viral infections, alcohol, certain medicines and autoimmune conditions.

Hepatitis B and hepatitis C are caused by different viruses. Both can become long-term infections, but they do not spread in exactly the same way and require different laboratory tests and clinical follow-up.

Hepatitis B can be transmitted through infected blood and certain body fluids. Hepatitis C is transmitted mainly when infected blood enters another person’s bloodstream.

A vaccine is available against hepatitis B, although DocTap does not currently provide vaccinations. There is no vaccine against hepatitis C, but an active hepatitis C infection can usually be cured with antiviral treatment.

Misconception 1: hepatitis always causes noticeable symptoms

Many people expect a liver infection to cause obvious illness or visible yellowing of the skin and eyes.

In reality, hepatitis B and hepatitis C can both be present without causing noticeable symptoms. Someone may feel well and have no reason to suspect an infection.

When symptoms occur, they can be vague and may include:

• tiredness
• feeling or being sick
• reduced appetite
• upper abdominal discomfort
• itchy skin
• urine that is darker than usual
• pale stools
• yellowing of the skin or whites of the eyes

Yellowing of the skin or eyes is known as jaundice. It may be less noticeable on brown or black skin but easier to see in the whites of the eyes.

These symptoms can also be caused by many other conditions. Having them does not diagnose hepatitis, while having no symptoms does not rule it out.

The more useful question is whether there has been a possible exposure that makes testing or clinical advice appropriate.

For fuller information about the individual infections, read about private hepatitis B testing in London or private hepatitis C testing in London.

Misconception 2: hepatitis only affects certain people

Hepatitis is sometimes discussed in ways that associate infection with one lifestyle or a narrowly defined group.

This can create stigma and discourage people from discussing a possible exposure with a healthcare professional.

Hepatitis B and C can affect people with very different histories. Possible routes of exposure include:

• transmission during pregnancy or childbirth
• historic blood transfusions
• medical or dental procedures where equipment was not sterilised adequately
• needlestick or sharps injuries
• tattoos or piercings using unsterilised equipment
• sharing injecting or other drug-use equipment
• sharing personal items contaminated with blood
• sexual contact in some circumstances

Someone may have been exposed many years earlier. They may not remember a particular event or know exactly when an infection was acquired.

Requesting a hepatitis test is a healthcare decision. It is not a statement about someone’s identity, relationships, lifestyle or character.

Breaking down stigma starts with treating hepatitis testing in the same factual and non-judgemental way as any other medical investigation.

Misconception 3: hepatitis B and hepatitis C spread in the same way

Their names are similar, but hepatitis B and C are distinct infections.

How hepatitis B can spread

Hepatitis B can be transmitted through infected blood and certain body fluids.

Possible routes include sexual contact, sharing needles, needlestick injuries, unsterilised medical or cosmetic equipment and transmission during childbirth.

This means hepatitis B can be sexually transmitted, but it is not transmitted only through sex.

How hepatitis C can spread

Hepatitis C is transmitted primarily when infected blood enters another person’s bloodstream.

Possible routes include shared injecting equipment, needlestick injuries, unsterilised medical or cosmetic equipment, older unscreened blood transfusions and transmission during childbirth.

Sexual transmission can occur, particularly where blood exposure is involved, but hepatitis C is mainly considered a blood-borne infection.

Understanding the difference matters because the risk assessment for hepatitis B may not be identical to the assessment for hepatitis C.

People concerned about a sexual exposure can review DocTap’s wider private STI testing service. Anyone who is unsure which infections or samples are relevant should arrange a clinical assessment rather than selecting a package based only on its name.

Misconception 4: a normal liver blood test rules out hepatitis

Liver function blood tests measure enzymes, proteins and other substances associated with the liver and bile ducts.

They can provide useful information about possible liver irritation or dysfunction. However, they do not directly test for hepatitis B or hepatitis C.

A person can have viral hepatitis while some liver markers remain within the laboratory reference range. A normal liver-function result does not therefore rule out hepatitis following a relevant exposure.

Specific viral markers are needed to screen for the infections.

A hepatitis B screen may check for hepatitis B surface antigen. A hepatitis C screen commonly checks for hepatitis C antibodies.

These markers also answer different questions. A hepatitis C antibody result, for example, shows that the immune system has responded to the virus at some point. It does not always establish whether an active infection remains present.

The dedicated hepatitis B and C pages explain the respective tests in more detail. A GP can also decide which private blood tests are clinically appropriate based on symptoms, exposure history and previous results.

Misconception 5: every STI screen includes hepatitis

The phrase “full STI test” does not have one universal definition.

Some screens check for chlamydia and gonorrhoea. Others add HIV and syphilis. Hepatitis B and C may only be included in a broader screen or requested separately.

DocTap’s STI tests and prices page shows exactly which infections and laboratory markers are included in each option.

The six-infection screen includes:

• chlamydia
• gonorrhoea
• HIV
• syphilis
• hepatitis B surface antigen
• hepatitis C antibodies

Other screening options may not include hepatitis.

The same principle applies to routine blood tests. A full blood count, kidney-function test or liver-function test does not automatically screen for hepatitis B or hepatitis C.

Check the individual markers rather than relying on words such as “routine”, “comprehensive” or “full”.

What should you do if you are concerned about hepatitis?

The most appropriate next step depends on what happened, when it occurred and whether you have symptoms.

A test-only appointment may be suitable when you have no symptoms, already know which test you need and are testing at an appropriate time.

A private GP appointment is more appropriate if:

• you have symptoms
• the possible exposure was recent
• you are uncertain whether hepatitis B, hepatitis C or another test is needed
• you have received a previous reactive result
• you have unexplained abnormal liver results
• you need your results interpreted
• you may require onward specialist referral

Testing too early can sometimes produce a negative result before the relevant marker is detectable. The hepatitis B and C service pages contain the detailed test information, while a GP can assess circumstances that do not fit a standard screening pathway.

A recent needlestick injury or significant contact with another person’s blood may require prompt medical assessment rather than waiting for a routine private test.

What happens after a reactive screening result?

A reactive screening result is not always the final diagnosis.

Further assessment may involve:

• a repeat sample
• confirmatory testing
• additional hepatitis markers
• viral DNA or RNA testing
• further liver-related blood tests
• specialist assessment

The next steps differ between hepatitis B and hepatitis C.

A reactive hepatitis B surface-antigen result may require further tests to understand whether an infection is present and whether it appears recent or long term.

A reactive hepatitis C antibody result does not automatically confirm an active infection. A further test is normally needed to check whether the virus is currently present.

DocTap can provide initial testing, GP interpretation and appropriate onward referral.

Ongoing hepatitis treatment and monitoring are normally provided through an NHS or specialist service.

Replacing assumptions with more useful questions

World Hepatitis Day is not a reason for everyone to arrange testing regardless of their circumstances.

It is an opportunity to ask better questions:

• Have I had a possible exposure to infected blood or body fluids?
• Does the screen I am considering include hepatitis B or C?
• Am I testing at an appropriate time?
• Does the test check for current infection, previous exposure or immunity?
• Could I need a confirmatory test?
• Should a clinician review the result?

Clear answers are more useful than assumptions based on symptoms, stigma or the name of a testing package.

Confidential hepatitis testing in London

DocTap provides confidential hepatitis B and C blood testing at 11 London clinics.

Four-hour results are available for eligible tests at selected clinics with on-site laboratories. Testing is also available through the wider clinic network, with turnaround depending on the test and laboratory route.

Detailed test information is available on the individual service pages:

• Hepatitis B symptoms, testing and results
• Hepatitis C symptoms, testing and results

People who know which test they require and have no symptoms may be able to book a test-only appointment.

Book with a GP if you have symptoms, the possible exposure was recent or you are uncertain which test is appropriate.

Book a hepatitis test or GP appointment.