Hepatitis is a virus that affects the liver, which filters our blood. Many people in Canada are vaccinated for both Hep A and Hep B (Twinrix) together. Hepatitis B can (but does not always) clear up on its own. While there is no vaccine to prevent Hepatitis C, there is treatment that can cure it.
This website focuses on Hepatitis B and C as they are primarily transmitted sexually and by blood. Hepatitis A is usually passed by eating or drinking contaminated food or liquids. Visit the Public Health Agency of Canada for information about Hepatitis A.
Symptoms
*Not everyone will experience symptoms
Hepatitis B
When there are symptoms, they can range from mild to severe. They usually appear about one to four months after the infection, although sometimes, they can appear as early as two weeks post-infection. Some people experience flu-like symptoms, dark urine, fever, nausea and vomiting, abdominal pain, a rash, joint pain, or in rare cases, jaundice (yellowing of the skin and eyes).
Acute vs Chronic Hepatitis B
Hepatitis B infection may be either short-lived (acute) or long lasting (chronic).
Acute hepatitis B infection lasts less than six months. Our immune system can often clear acute hepatitis B from our body and we can recover completely within a few months. Most people who get hepatitis B as adults have an acute infection but it can lead to chronic infection if left untreated.
Chronic hepatitis B infection will last at least six months. It lingers because your immune system cannot fight off the infection. Chronic hepatitis B infection may last a lifetime, possibly leading to serious illnesses such as cirrhosis and liver cancer.
Hepatitis C
Hepatitis C infection may be either short-lived (acute) or long lasting (chronic).
Every hepatitis infection starts with an acute phase and for many people, there are no symptoms during that period. If there are symptoms, these are typically fatigue, weight loss and decreased appetite, flu-like symptoms, jaundice (yellowing of the skin and eyes), dark urine, or light stools. Acute hepatitis infections don’t always become chronic. Some of us can clear the virus spontaneously.
Long-term infection with the hepatitis C virus is known as chronic hepatitis C. It is usually a "silent infection” for many years, sometimes decades, until the virus damages the liver enough to cause the signs and symptoms of liver disease. Symptoms of chronic hepatitis C infection include abdominal swelling, bloody stools, jaundice, trouble sleeping, depression, blood in vomit, itchiness, and possible symptoms affecting the brain.
Transmission and Prevention
Hepatitis B
Hepatitis B is transmitted through oral, vaginal, or anal sex with someone with hepatitis B, as well as through exposure to hepatitis B-infected blood (e.g., through shared needles). In rare instances, transmission can occur through toothbrushes or razors. It can also be transmitted from a pregnant individual to their baby during childbirth. Where possible, those with acute hepatitis B infections should refrain from having unprotected sex until partner(s) are screened and/or immunized.
Condoms and dental dams for oral, anal, and vaginal sex can help prevent transmission.
All provinces and territories in Canada have school or infant-based hepatitis B vaccination programs. Clean needle exchange programs and other harm reduction programs are important public health initiatives to prevent the transmission of hepatitis B.
If someone is exposed to hepatitis B, they can receive an injection of antibodies (up to seven days after needlestick injury and 14 days after sexual contact) followed by vaccination to help avoid infection.
Hepatitis C
Hepatitis C is transmitted through unprotected sex with someone with Hepatitis C, or where blood infected with hepatitis C is present. It can also be transmitted through shared needles, as well as equipment used to snort or inhale drugs. Hepatitis C can also be transmitted from a pregnant individual to their baby during childbirth.
Condoms, when used consistently and correctly, are highly effective in reducing the risk of sexual transmission of Hepatitis.
To prevent transmission when using needles to inject drugs or for DIY tattooing, it’s important to make sure that everyone has their own equipment. Needle exchange programs and safe injection/consumption sites are extremely important resources in our communities to reduce the sharing of needles and other drug equipment, and by extension, the likelihood of transmitting STBBIs such as hepatitis C.
Treatment
Hepatitis B
There is no cure for hepatitis B; however, most individuals recover fully from the infection in approximately six months. Antiviral medications can also be used to manage hepatitis B symptoms.
Hepatitis C
Chronic hepatitis C is usually curable with oral medications taken every day for two to six months. Speak with your health care provider about the best regimen for you.
Testing
Testing for both hepatitis B and C is done through bloodwork.