Hepatitis B and C Screening: What You Need to Know

Understanding Hepatitis B and C

Hepatitis B and C are viral infections affecting the liver. Many people are unaware they have chronic infection. Early detection through screening allows for treatment to prevent cirrhosis and liver cancer. Blood tests are the primary screening method.

Hepatitis B Screening Tests

1. HBsAg (Hepatitis B Surface Antigen)

Initial screening test for HBV infection. Positive result indicates active or chronic infection. Requires confirmatory testing with anti-HBc and HBeAg.

2. Anti-HBc (Hepatitis B Core Antibody)

Indicates past or current HBV infection. Present in acute infection, chronic infection, and resolved infection. Used to differentiate false-positive HBsAg results.

3. HBeAg (Hepatitis B E Antigen)

Indicates active viral replication and high infectivity. Useful for assessing disease stage and treatment response in chronic HBV.

Hepatitis C Screening Tests

1. Anti-HCV (Hepatitis C Antibody)

Screening test for HCV exposure. Positive result indicates past or current infection. Approximately 15-20% clear infection spontaneously; others develop chronic disease.

2. HCV RNA (Hepatitis C Viral Load)

Confirms active viral replication. Undetectable HCV RNA indicates viral suppression (cure or remission). Used to guide treatment decisions and monitor therapy response.

3. Genotyping

Identifies HCV genotype (1-6). Important for selecting antiviral treatment and predicting treatment response. Different genotypes require different therapy durations.

Risk Factors for Hepatitis B and C

Transmission Routes

• ✓ HBV: Bloodborne (shared needles, unsafe sexual practices, occupational exposure)
• ✓ HCV: Primarily bloodborne (IVDU, healthcare workers, transfusions pre-1992)
• ✓ Mother-to-child: Both viruses transmissible perinatally

Who Should Be Screened?

• ✓ All adults once in lifetime (CDC recommendation)
• ✓ People with HIV or other STIs
• ✓ Injection drug users and their partners
• ✓ Healthcare workers with occupational exposure
• ✓ Pregnant women
• ✓ Dialysis patients
• ✓ Incarcerated individuals

Treatment Options

Hepatitis C has highly effective direct-acting antiviral (DAA) therapies with cure rates exceeding 95%. Hepatitis B treatment focuses on viral suppression using antivirals. Early diagnosis dramatically improves outcomes.