Health condition · Clinically reviewed
Hepatitis B and C, chronic viral hepatitis — cure is possible for most.
Modern direct-acting antivirals cure hepatitis C in almost all patients; hepatitis B is treatable and preventable. Screening, vaccination and specialist hepatology care are what change trajectories.
Why trust this guide
- 01
Clinically reviewed
Written by our editorial team and reviewed by a registered UK clinician before publication.
- 02
Sourced from guidance
Every claim is checked against NICE, BHIVA/BASHH and World Hepatitis Alliance sources you can see at the end.
- 03
Current for 2026
Reflects direct-acting antivirals for hepatitis C, modern tenofovir/entecavir suppression for hepatitis B, and universal infant HBV vaccination.
Key facts
Hepatitis B and C at a glance.
The essentials, in plain English — what chronic viral hepatitis is, how common it is, and what modern treatment can do.
-
Hepatitis B (global)
Hepatitis B (HBV) is chronic in around 250 million people globally; approximately 180,000 in the UK.
-
Hepatitis C (UK)
Hepatitis C (HCV) affects around 100,000 people in the UK — many undiagnosed.
-
HCV is curable
HCV is CURABLE with direct-acting antiviral (DAA) therapy in almost all patients.
-
HBV is preventable
HBV vaccination is universal in UK infants — a major reason new infections are declining.
-
Long-term concern
Cirrhosis and hepatocellular carcinoma (HCC) surveillance is the long-term concern in chronic viral hepatitis.
-
How it is transmitted
Perinatal, sexual and blood-borne transmission — screening at-risk groups changes trajectories.
Why this guide matters
A once-feared diagnosis, now largely treatable.
Viral hepatitis care in 2026 looks nothing like it did a decade ago. The three points below shape everything else on this page.
-
HCV is now curable
Direct-acting antivirals clear hepatitis C in almost all patients, in 8-12 weeks of tablets.
-
HBV is well-suppressed
Tenofovir and entecavir keep hepatitis B under control, dramatically lowering liver damage and cancer risk.
-
Screening changes outcomes
Finding infection early — before cirrhosis — is what determines whether treatment prevents complications.
How the diagnosis is made
From first screen to a clear plan.
The steps a UK GP and hepatology team will normally follow, in order — so you know what to expect and why.
Phase 1 · Screening
Hepatitis screen, viraemia and LFTs
Phase 2 · Staging
FibroScan and HCC surveillance
Phase 3 · Treating
Genotype and hepatology plan
- 01
Screening
Hepatitis screen
HBsAg, anti-HCV, anti-HBs and anti-HBc together map exposure, immunity and active infection.
- 02
Screening
Confirm active viraemia
HBV DNA and HCV RNA confirm whether the virus is actively replicating.
- 03
Screening
LFTs and FBC
Baseline liver function and blood count set the scene for staging and treatment.
- 04
Staging
FibroScan / elastography
Non-invasive liver stiffness measurement stages fibrosis without a biopsy.
- 05
Staging
Ultrasound + AFP
Six-monthly ultrasound with alpha-fetoprotein is the standard HCC surveillance in cirrhosis.
- 06
Treating
HCV genotype
Genotype guides which DAA regimen is used — most modern regimens are pan-genotypic.
- 07
Treating
Hepatology consultation
Specialist review sets the treatment plan, family screening and long-term surveillance.
Typical timeline: 4-8 weeks from first blood test to a settled plan.
Symptoms
What chronic viral hepatitis actually looks like.
Often silent — which is exactly why screening at-risk groups matters so much. Here is what to watch for.
-
Asymptomatic (often)
Chronic viral hepatitis is often silent for years — screening at-risk groups is how it is found.
-
Fatigue
A vague, persistent tiredness is the most common symptom people describe.
-
Jaundice
Yellowing of the skin or eyes suggests more advanced liver involvement — needs prompt review.
-
Dark urine
Tea-coloured urine can be an early clue to jaundice and hepatic dysfunction.
-
Weight loss
Unintentional weight loss deserves a hepatitis screen alongside other work-up.
-
Right upper quadrant discomfort
A dull ache under the right ribs can accompany hepatitis or its complications.
-
Pregnancy considerations
HBV in pregnancy needs specialist input to prevent perinatal transmission to the baby.
-
Red flag: decompensation
Variceal bleeding, encephalopathy or ascites — call 999.
Treatment
How hepatitis B and C are treated in the UK.
Antivirals do the heavy lifting — plus vaccination, surveillance and the wider steps that keep livers healthy.
-
DAA therapy for HCV
Glecaprevir/pibrentasvir or sofosbuvir/velpatasvir — pan-genotypic direct-acting antivirals cure HCV in almost all patients.
-
Tenofovir or entecavir for HBV
Long-term antiviral suppression controls HBV, reduces liver damage and lowers HCC risk.
-
HBV vaccination
Universal in UK infants and offered to at-risk adults — the single best prevention tool for hepatitis B.
-
Post-exposure prophylaxis
Rapid HBV vaccination (with immunoglobulin where indicated) after needlestick or sexual exposure.
-
HCC surveillance in cirrhosis
Six-monthly ultrasound plus AFP catches hepatocellular carcinoma early enough to treat.
-
Alcohol cessation
Alcohol accelerates fibrosis on top of viral hepatitis — abstinence is the safest position.
-
Family / partner screening
Household and sexual contacts are screened and vaccinated — a core public-health step.
-
Liver transplant
Reserved for decompensated cirrhosis or HCC meeting transplant criteria — a life-changing option in the right patient.
What this guide is based on
The sources behind every number on this page.
UK national guidance and specialist society standards, current at the time of last review.
Key references
Guidelines and standards we relied on.
A quiet reminder
This guide is for information, not medical advice.
Your GP or hepatology team knows your history and can tell you which parts apply to you. If in doubt, ask them.
-
NICE. Hepatitis B (chronic): diagnosis and management (CG165).
-
NICE. Hepatitis C — diagnosis and treatment guidance.
-
British HIV Association (BHIVA) / British Association for Sexual Health and HIV (BASHH). Testing and management guidelines.
-
World Hepatitis Alliance. Global patient information on viral hepatitis.
Red flags
When viral hepatitis becomes an emergency.
Most of the time chronic hepatitis is a slow burn. These are the situations where it stops being slow — and you should act today.
-
Cirrhosis with decompensation
Jaundice, ascites, encephalopathy or variceal bleeding in known viral hepatitis — urgent.
-
Hepatocellular carcinoma
A new liver lesion on surveillance scans needs prompt specialist assessment.
-
Variceal bleeding
Vomiting blood or black stools in someone with chronic hepatitis — call 999.
-
Ascites
Rapidly enlarging abdomen with liver disease — same-day review.
-
Encephalopathy
New confusion or drowsiness in a person with liver disease — urgent.
-
Post-treatment relapse
Rising HCV RNA after completing DAA therapy — needs re-testing and hepatology review.
-
Perinatal transmission risk
HBV-positive pregnancy — needs joint hepatology and obstetric management before delivery.
-
Post-transplant complications
Anyone on immunosuppression with viral hepatitis needs close specialist follow-up.
-
Coinfection HIV / HDV
HIV or hepatitis D coinfection changes prognosis and treatment — requires specialist input.
Living with it
A long-term condition, but a very treatable one.
Four things that make the biggest difference day to day — adherence, alcohol, reviews and mental health.
A quiet reminder
Consistency beats intensity, every time.
Taking every tablet and attending every surveillance appointment — over months and years — does more than any single heroic week.
- 01 Adherence
Take every dose
DAA cure rates and long-term HBV suppression depend on taking every tablet on time — set reminders and keep supply ahead.
- 02 Alcohol
Kind to your liver
Alcohol compounds viral liver damage. If you have fibrosis, abstinence is the safest position.
- 03 Reviews
Stay on surveillance
Six-monthly ultrasound and AFP in cirrhosis is what catches HCC early enough to treat.
- 04 Mental health
Stigma is not the whole story
A diagnosis of viral hepatitis carries stigma that is not deserved. Support is available — ask.
Frequently asked
Everything we get asked about hepatitis B and C.
Quick answers on DAA cure, HBV suppression, vaccination and when to worry.
-
Is hepatitis C really curable?
Yes — modern direct-acting antiviral (DAA) tablets clear the virus in almost all patients, usually with an 8-12 week course. Cure is confirmed by an undetectable HCV RNA test 12 weeks after finishing treatment.
-
Can hepatitis B be cured?
A functional cure is uncommon, but hepatitis B can be very effectively suppressed with long-term tenofovir or entecavir. This dramatically lowers liver damage and the risk of liver cancer.
-
Do I need vaccination against hepatitis B?
In the UK, hepatitis B vaccination is universal in infants. Adults at higher risk — healthcare workers, household contacts of a person with HBV, people who inject drugs, and people with multiple sexual partners — should be vaccinated too.
-
How is chronic viral hepatitis monitored?
With regular LFTs, viral load testing (HBV DNA or HCV RNA), and FibroScan to stage fibrosis. Anyone with cirrhosis needs six-monthly ultrasound and AFP to screen for hepatocellular carcinoma.
-
Can I pass hepatitis on to my family?
HBV and HCV are blood-borne; HBV is also transmitted sexually and perinatally. Household and sexual contacts should be screened, and vaccinated against HBV where appropriate. Everyday contact — sharing meals, hugs — does not spread the virus.
-
When should I be worried?
Any sign of decompensated liver disease — jaundice, confusion, a rapidly swelling abdomen, or vomiting blood — needs urgent assessment. A rising viral load after treatment also warrants same-week review.