Hepatitis B vs. Hepatitis C: What Are the Differences?
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Medically reviewed by Robert Burakoff, MD, MPH
A viral hepatitis infection is an inflammation of the liver, resulting in liver damage. There are different types of hepatitis viruses, including hepatitis B (HBV) and hepatitis C (HCV), which are distinct viruses that share some similarities.
Though both viral strains can be transmitted through contact with infected blood, HBV can also be spread through other bodily fluids. Either can cause an acute (short-term) or chronic (long-term) infection, and symptoms can present similarly.
Read on to learn more about the similarities and differences between hepatitis B and C, including causes, symptoms, diagnosis, treatment, and prevention strategies.
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Symptoms
HBV and HCV have similar symptoms. Acute infections may cause physical symptoms. However, some people may only have mild symptoms while others may be asymptomatic (have no symptoms).
Symptoms of an acute infection may include:
Loss of appetite
Nausea and vomiting
Pain in the abdomen and joints
Dark-colored urine
Light-colored stools (bowel movements)
People with chronic HBV and HCV infections often have no symptoms. Some people with chronic infections report vague symptoms such as chronic fatigue and depression.
Causes
A viral infection due to HBV or HCV can occur when you come into contact with infected blood. HBV, however, can also be caused by contact with fluids from mucous membranes such as semen and saliva.
If you become infected with either virus, inflammation and significant liver damage can occur. The damage may include cirrhosis (liver scarring) or even liver cancer. It impacts liver functioning, which includes fighting infections, processing nutrients, and removing toxins from the body.
Hepatitis Transmission
HBV and HCV can be transmitted through similar behaviors and activities. However, the prevalence of each virus and how long they take to show symptoms differ.
Hepatitis B
There are a number of ways you may come into contact with HBV-infected blood and bodily fluids, including:
Having unprotected sex with someone who has an HBV infection
Sharing needles or other items related to injection drug use
Coming into contact with an infected person's blood or open wounds
Getting accidental needle stick injuries
Sharing personal items that have the potential to cause breaks in the skin, such as razors, nail clippers, and toothbrushes
Pregnant people may pass on an HBV infection to their baby as well.
From the time you're exposed to HBV to the time you may experience symptoms (also known as the incubation period) is between 60 days and 150 days. On average, the incubation period is about 90 days.
In the United States, it's estimated that 850,000 people are living with hepatitis B. However, the numbers may be as high as 2.2 million.
Hepatitis C
The most common ways HCV is transmitted are through injection drug use and pregnancy.
Other possible, though less common, ways HCV may be transmitted include:
Tattoo procedures with non-sterile equipment
Unintentional needle sticks
Using shared personal items that may come into contact with infected blood, such as toothbrushes and razors
Undergoing invasive procedures or other injections in a healthcare setting
Transmitting the virus through sex is possible, though it's not common.
Coming into contact with donated blood or having a blood transfusion could possibly transmit HCV. However, the donated blood supply is now routinely tested for HCV, and people who have HBV or HCV infections can't donate blood.
If you do experience symptoms, it can take two to 12 weeks from when you're exposed to HCV to develop.
About 2.4 million people are estimated to be living with HCV in the United States.
Risk Factors
Many of the factors that increase the likelihood of an HBV and HCV infection are the same, though there are some specific differences.
HBV Risk Factors
Being a child born to a pregnant person with HBV
Having sex with a partner who has HBV
Using injectable drugs
Having prolonged contact with people who have chronic HBV
Getting accidental needle stick injuries or having contact with infected blood or body fluids (often healthcare workers)
Living with a health condition that requires hemodialysis (treatment that filters water and waste from blood)
HCV Risk Factors
Being a child born to a pregnant person with HCV
Using injectable drugs, even if it was some time ago
Getting accidental needle stick injuries or having contact with infected blood
Living with a health condition that requires hemodialysis
Receiving a blood transfusion or organ transplant before July 1992 (before HCV screenings were available)
Diagnosis
Healthcare providers will rely on blood tests to diagnose HBV or HCV infections. They will also ask about your medical history to determine any risk factors and perform a physical examination to look for signs of liver damage.
The Centers for Disease Control recommends both HBV and HCV screening for all adults at least once in their lifetime.
Treatment
Treating HBV and HCV infections isn't quite the same. Treatment can depend on whether the infection is acute or chronic, and if tests reveal any liver damage that may have been a result of the infection.
Hepatitis B
Treating HBV is uncommon unless the infection is considered chronic. However, not all chronic HBV infections require treatment.
If tests determine that liver damage has occurred from a chronic infection, treatment will involve antiviral medications. The treatment duration will vary from person to person. Regular monitoring of any liver damage or cancer is common as well.
Hepatitis C
Treatment with antiviral medications can cure acute and chronic HCV infections. Healthcare providers may wait for an acute HCV infection to turn into a chronic one (if it does) before prescribing medication. It is possible for an acute infection to go away on its own.
The length of time you may take the antiviral medications for an HCV infection can be between eight and 24 weeks. A healthcare provider may also recommend getting the hepatitis A and hepatitis B vaccines.
Prevention
Prevention strategies for HBV and HCV infections are similar. Avoiding contact with any bodily fluids that may transmit the virus is the primary mode of prevention. However, one major difference is that there is a vaccine to prevent HBV, but not HCV.
Hepatitis B
The primary way to prevent a hepatitis B infection is to get the hepatitis B vaccine. Experts recommend getting the vaccine before you may be exposed to the virus, typically as a baby, child, or teenager.
Other ways to prevent an HBV infection include:
Not sharing syringes if you use injectable drugs
Wearing gloves when in contact with another person's blood or open wounds
Using barrier methods during sex, such as condoms
Ensuring your tattoo artist uses sterile equipment
Not sharing personal items, such as a toothbrush or nail clippers
Hepatitis C
There is no vaccine for HCV. Prevention is associated with avoiding contact with infected blood, including not sharing needles, using sterile tattooing tools, and wearing gloves, which are similar to strategies for preventing an HBV infection.
Summary
There are many similarities between HBV and HCV but also some key differences. Both can be transmitted through infected blood. Other bodily fluids, like semen, may also transmit HBV and HCV. Many people with HBV or HCV have no symptoms. Those with symptoms may experience fever, fatigue, loss of appetite, light-colored stools, dark urine, and jaundice.
Blood tests, a physical exam, and a health history are used to diagnose HBV or HCV. HCV is treated with antiviral medication, but some acute infections may resolve on their own. Treatment may not be necessary for acute or chronic HBV infections unless there's liver damage.
Avoiding activities that may expose you to infected blood or bodily fluids can help prevent HBV and HCV. There is also a vaccine for HBV, but not for HCV.
A Word From Verywell
Since HBV and HCV can present similarly, it's encouraged that you speak with a healthcare provider if you suspect an infection. You can discuss behaviors and activities that increase your likelihood of infection, investigate any symptoms, and get the necessary treatment. Making sure you're also up-to-date on your vaccines, including the HBV vaccine, is also a key prevention strategy to keep you healthy.
Frequently Asked Questions
Which type of hepatitis is the most severe?
Having hepatitis B and D infection at the same time (coinfection) is considered the most severe form of chronic viral hepatitis. This coinfection can rapidly lead to hepatocellular carcinoma (a liver cancer) and liver death.
Are hepatitis B and C curable?
Hepatitis C infections can be cured with antiviral medications. While acute hepatitis B infections may go away on their own without treatment, chronic hepatitis B can be treated but not cured.
Which type of hepatitis is the most contagious?
Hepatitis A is considered to be highly contagious. It is spread through contact with infected blood and stool. People with a hepatitis A infection can spread it to someone else before they even begin to feel sick.
