"Hepatitis" sounds like one disease, but it is actually several that happen to share the same surname: they all inflame the liver. That is largely where the similarity ends. Hepatitis A, B and C differ a lot in how you catch them, whether there is a vaccine, and what they do in the long run. Anyone who understands that difference also understands why one falls under an STI screening and another does not.
What we most want to set straight: most people only know hepatitis B as "the STI", but hepatitis C in particular can quietly damage the liver for years, and is nowadays treatable in most cases. Not knowing you have it is the biggest risk there.
Hepatitis A, B and C side by side
| Hepatitis A | Hepatitis B | Hepatitis C | |
|---|---|---|---|
| Main transmission | Contaminated food/water, sometimes via sex (oral-anal contact) | Blood, semen and vaginal fluid; sexually transmissible | Mainly blood-to-blood contact; less often sexual |
| Vaccine available? | Yes | Yes | No |
| Course | Usually short, clears on its own | Can become chronic | Often becomes chronic, frequently without symptoms |
| Treatment | Mainly rest; no specific course | Medication for the chronic form | Often curable with medication |
A high-level comparison, based on information from RIVM and Thuisarts.nl. For your situation a doctor or the GGD can assess it more precisely.
Hepatitis A: usually short-lived
Hepatitis A mainly spreads through contaminated food or water, and sometimes through sexual contact where oral-anal contact plays a role. According to RIVM, hepatitis A usually clears on its own and does not become chronic. There is a vaccine, advised among other things for travel to certain regions. As an STI, hepatitis A plays a smaller role than B and C, but outbreaks do occur.
Hepatitis B: the classic sexually transmissible variant
Hepatitis B is the variant most clearly seen as an STI. The virus is present in blood, semen and vaginal fluid and can be passed through unprotected sex. Some infections run without symptoms, while in some people the infection becomes chronic and can damage the liver over time. The good news: there is an effective vaccine. In the Netherlands children receive the hepatitis B vaccination through the national immunisation programme, and certain risk groups are eligible too.
Hepatitis C: the quiet long-term damage
Hepatitis C is mainly passed through blood-to-blood contact and less often through sex, although that risk is higher in certain groups. The sting is in the silence: hepatitis C often becomes chronic and causes few symptoms for years, while it can damage the liver in the meantime. There is no vaccine, but there is good news on the treatment side. Current medication cures hepatitis C in many cases. That is why finding it matters so much: you can treat something you would otherwise never have noticed.
When does a hepatitis screening make sense?
A hepatitis screening can make sense after unprotected sexual contact with an unknown risk, after blood contact (for example through needlestick incidents or sharing needles), or if you belong to a higher-risk group. If you are unsure whether it fits you, you can discuss it with your GP or the GGD. If you want a targeted check, you could look at a hepatitis test or a broader hepatitis screening. If you want a complete picture of several STIs at once, a chlamydia, gonorrhoea and trichomonas test may fit. For choosing between tests, our guide which STI test you need and when helps.
Which symptoms can point to hepatitis?
A tricky point is that hepatitis often causes no or few symptoms, especially early on. When there are symptoms, according to Thuisarts.nl they can include fatigue, poor appetite, nausea, pain in the upper right of the abdomen and sometimes jaundice (a yellow colour of the skin or the whites of the eyes) or dark urine. These symptoms are not very specific and resemble those of many other conditions, so they prove nothing on their own. Conversely, the absence of symptoms also does not mean nothing is going on, and that is precisely why a test can be useful when there is a possible risk.
What does a positive result mean?
A positive hepatitis test is not an end point, but a starting point for further investigation. A first test may, for example, show that you have been in contact with the virus at some point, while follow-up testing has to determine whether there is an active or a past infection. That distinction decides whether, and which, treatment is needed. Those follow-up steps always run through a doctor. A home test or screening gives you a signal and a reason to follow up, but the interpretation and treatment belong with your GP, the GGD or a specialist.
The difference is in the details
Hepatitis is not one thing. A usually clears on its own, B is well prevented with a vaccine, and C can quietly do damage for years but is often very treatable if you find it in time. That is why hepatitis is mostly about knowing where you stand. With symptoms, a possible risk moment, or a positive result, you can always consult your GP or the GGD.
Sources
- RIVM, hepatitis A, B and C: rivm.nl/hepatitis
- Thuisarts.nl, hepatitis: thuisarts.nl/hepatitis
- Soa Aids Nederland, hepatitis B: soaaids.nl/nl/hepatitis-b
Every blood test result includes a professional assessment from a BIG-registered doctor. Discuss treatment decisions with your GP.
Autor
Discreettest
Dr. Naimi, lekarz wpisany do holenderskiego rejestru BIG, nadzoruje standardy medyczne naszych treści i ocen. Przeczytaj naszą politykę medyczną
