Hepatitis

Also called Hepatitis B, Hepatitis C, Liver inflammation

Inflammation of the liver. Hepatitis C is now curable in most people, and thousands in the UK do not know they have it.

What it is

Hepatitis means inflammation of the liver. The viral forms matter most here.

Hepatitis C is the headline. It used to mean decades of treatment with poor results. Direct-acting antivirals now cure it in more than 95% of people, with a course of tablets lasting 8 to 12 weeks and few side effects. England is working towards elimination.

The obstacle is that it is silent. Thousands of people in the UK have hepatitis C and do not know, often from an exposure decades ago.

Hepatitis B is vaccine-preventable and manageable, though usually not curable. Hepatitis A is usually a short illness and is vaccine-preventable.

Alcohol and fatty liver disease cause non-viral hepatitis, and are commoner still.

Signs you might notice

Frequently nothing for years, which is the whole problem.

Fatigue, which is the commonest symptom and the least specific.

Jaundice, dark urine, pale stools.

Abdominal pain, nausea, loss of appetite.

Later, from cirrhosis: swollen abdomen, easy bruising, confusion, and vomiting blood, which is an emergency.

Anybody who has ever injected drugs, had a blood transfusion before 1991, had a tattoo abroad, or received medical care in a country with poor infection control should be tested.

How it can affect day-to-day life

The stigma attached to hepatitis C keeps people from testing, and it is misplaced: exposure routes include medical care decades ago and shared razors, not only injecting.

For a curable disease, not knowing is the only real risk factor left.

In hepatitis B, the practical issues are avoiding drugs that harm the liver, monitoring for liver cancer, and vaccinating close contacts.

Alcohol accelerates liver damage in every form of hepatitis, so reducing it matters more here than almost anywhere.

Supporting someone well

Get tested if there is any risk factor, ever. Testing is free, quick, and available by post.

Take the antiviral course exactly as prescribed. Cure rates depend on completing it.

Avoid alcohol, and check every medicine including over-the-counter ones with a pharmacist.

Vaccinate against hepatitis A and B where indicated, and vaccinate household contacts in hepatitis B.

Attend liver monitoring, including scans for liver cancer where advised.

Treat the stigma directly. People do not test because of what they expect to be thought.

Where to get help

A GP, sexual health clinic or drug service can test. Postal testing is available free in England.

The Hepatitis C Trust run a helpline staffed by people who have had the virus: 020 7089 6221.

Vomiting blood, confusion or severe abdominal swelling needs emergency assessment.