Viral Hepatitis — Hepatitis B & C

Hepatitis B & C

Modern antiviral treatments can suppress Hepatitis B for life and cure Hepatitis C in 8–12 weeks. Early treatment prevents cirrhosis and liver cancer.

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Hepatitis B

Hepatitis B is a DNA virus transmitted through blood, sexual contact, and mother-to-child during birth. India has over 40 million chronic carriers.

Who Needs Treatment?

  • HBV DNA > 2,000 IU/mL with elevated ALT
  • Any HBV DNA level with significant fibrosis (F2+)
  • HBeAg positive with active viral replication
  • Cirrhosis with any detectable HBV DNA
  • Before immunosuppression or chemotherapy

Treatment Options

  • Tenofovir (TDF/TAF) — first-line, once daily tablet. Powerful suppression with low resistance. Safe long-term.
  • Entecavir — alternative first-line agent. High barrier to resistance.
  • Treatment is usually lifelong — suppresses virus to undetectable but rarely cures HBV.
Goal: HBV DNA undetectable → prevents cirrhosis progression, reduces HCC risk by 70–80%
Hepatitis C

Hepatitis C is an RNA virus, transmitted primarily through blood. Unlike Hepatitis B, Hepatitis C can be completely cured with modern Direct Acting Antivirals (DAAs).

Who Needs Treatment?

  • All patients with confirmed HCV RNA positive
  • Treatment is recommended for all chronic HCV patients regardless of fibrosis stage
  • Post-liver transplant HCV recurrence

Treatment — DAA Regimens

  • Sofosbuvir/Velpatasvir (Epclusa) — pan-genotypic, 12 weeks, >95% SVR
  • Glecaprevir/Pibrentasvir (Mavyret) — 8 weeks for non-cirrhotic
  • Sofosbuvir/Daclatasvir — widely available in India at low cost
Goal: SVR12 (cure) → reduces cirrhosis risk by 90%, HCC risk by 75%

Ongoing Monitoring After Diagnosis

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Fibrosis Assessment

Fibroscan elastography or liver biopsy to stage fibrosis (F0–F4). Determines urgency of treatment and guides monitoring intensity.

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Viral Load Monitoring

HBV DNA and HCV RNA quantification to confirm treatment response and detect breakthrough at 3, 6, 12 months.

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HCC Surveillance

6-monthly ultrasound abdomen + AFP for all cirrhotic patients and high-risk non-cirrhotics (HBV with family history, older age).

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Treatment Response

HBsAg quantification for HBV. SVR12 testing at 12 weeks post-treatment for HCV to confirm cure. Resistance testing when needed.

HBsAg or Anti-HCV Positive?

Do not delay treatment. Send your viral load report on WhatsApp for an urgent review. Hepatitis C can be cured in 8 weeks.

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