Medically reviewed by Dr Usman Naeem, 24 Oct 2026.
How do they spread?
Both viruses spread through blood. Hepatitis B can also spread through sexual contact and from a mother to her baby at birth. In Pakistan, common routes include:
- Reused or poorly sterilised needles, syringes and drips
- Unscreened blood transfusions
- Shared razors at barbers or at home, and shared toothbrushes
- Dental, surgical, tattoo, ear-piercing or cupping (hijama) procedures with unsterile instruments
- From mother to baby (mainly hepatitis B)
- They do not spread by sharing food, plates or water, hugging, shaking hands or breastfeeding (unless nipples are cracked and bleeding)
Which tests should you ask for?
Screening is a simple blood test. It is sensible for most adults in Pakistan, and especially for pregnant women, family members of a patient, people who have had transfusions, dialysis or many injections, and anyone with raised liver tests.
- HBsAg (hepatitis B surface antigen): a positive result means hepatitis B infection
- Anti-HCV (hepatitis C antibody): a positive result means you have been exposed to hepatitis C at some point, but not necessarily that it is still active
- HCV RNA (PCR): needed after a positive anti-HCV, to see whether the virus is still present
- If hepatitis B is positive, further tests usually include HBV DNA (viral load), HBeAg and liver function tests
- For both, a check for liver scarring, such as an ultrasound, a FIB-4 score or FibroScan
Hepatitis C treatment
Hepatitis C is now treated with tablets called direct-acting antivirals, usually taken for 8 to 12 weeks. In guideline studies, these cure more than 95% of people. Cure is confirmed by a PCR test about 12 weeks after the course ends.
Cure does not protect you from catching hepatitis C again, so avoiding the routes above still matters. People who already had cirrhosis before treatment still need regular follow-up, including liver cancer surveillance, even after cure.
Hepatitis B treatment
Not everyone with hepatitis B needs medicine straight away. The decision depends on the viral load, liver tests, scarring and family history. When treatment is needed, tablets such as tenofovir or entecavir keep the virus suppressed and lower the risk of cirrhosis and liver cancer.
These tablets rarely clear the virus completely, so treatment is usually long term and should not be stopped without your doctor’s advice, because stopping suddenly can cause a dangerous flare. People not on treatment still need regular check-ups.
Protecting your family
- Hepatitis B vaccine is safe and effective. Family members and close contacts of a person with hepatitis B should be tested and vaccinated if they are not immune
- Every newborn should receive the hepatitis B vaccine, ideally within 24 hours of birth. Babies of mothers with hepatitis B may also need immunoglobulin, and some mothers are given tablets in late pregnancy
- There is no vaccine for hepatitis C, so prevention depends on safe injections and instruments
- Use your own razor and toothbrush, and ask for a new disposable blade at the barber
- Avoid alcohol and tell your doctor before taking herbal or other new medicines
When to seek medical help urgently
- Yellow eyes or skin, dark urine or pale stools
- Vomiting blood or black, tarry stools
- Swelling of the belly or legs
- Confusion or unusual drowsiness
- Severe tiredness, vomiting or abdominal pain with jaundice
In an emergency go to the nearest emergency department or call Rescue 1122. Do not wait for a WhatsApp reply.
Common questions
If my anti-HCV is positive, do I definitely have hepatitis C?
Not necessarily. About a quarter of people clear the virus on their own, and a cured person stays antibody positive. An HCV RNA (PCR) test shows whether the virus is still active.
Can hepatitis B be cured?
Complete cure is uncommon with current tablets, but they control the virus very well and lower the risk of serious liver damage. Some people never need tablets but do need regular monitoring.
Can a woman with hepatitis B or C have children?
Yes. With testing in pregnancy, the birth-dose vaccine and, when needed, immunoglobulin or tablets, most babies of mothers with hepatitis B are protected. Discuss hepatitis C treatment with your doctor before or after pregnancy.
Can I marry or work normally?
Yes. People with hepatitis B or C can marry, work and live normally. A partner should be tested and, for hepatitis B, vaccinated if not immune.
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Watch on YouTubeRelated condition guides
More articles
- High SGPT (ALT) in Your Blood Test: What It Means and What to Do Next
- Fatty Liver Diet: A Practical Guide with Everyday Pakistani Food
- Blood in Stool: Common Causes, When to Worry and When a Colonoscopy Is Needed
- Acidity and H. pylori: Symptoms, Testing and When to See a Doctor
- When Do You Need an Endoscopy? Reasons, Preparation and What to Expect
- Cirrhosis Diet: What to Eat and What to Avoid
- Water in the Belly (Ascites): Causes, Tests and Care
- Yellow Eyes (Jaundice): Causes, Tests and When to Worry
Sources and further reading
- World Health Organization. Hepatitis C fact sheet. Link
- World Health Organization. Hepatitis B fact sheet. Link
- European Association for the Study of the Liver. EASL recommendations on treatment of hepatitis C: Final update of the series. J Hepatol 2020;73:1170–1218. Link
- European Association for the Study of the Liver. EASL 2017 Clinical Practice Guidelines on the management of hepatitis B virus infection. J Hepatol 2017;67:370–398. Link
General information only, not personal medical advice. Do not start or stop medicines because of this article. See the medical disclaimer.