Viral Hepatitis — Treatment and Surveillance

The answer first

This page takes the infectious-diseases view of chronic viral hepatitis: reading serology, deciding and monitoring hepatitis B treatment, preventing reactivation, curing hepatitis C, and knowing whose liver cancer surveillance outlives the virus. The hepatic companion topic covers all five hepatotropic viruses. Keep four rules in view: ^{[1] [2]}

1. Read hepatitis B serology as a pattern. HBsAg is present in acute or chronic infection, total anti-HBc marks previous or ongoing infection and is not produced by vaccination, and anti-HBs marks recovery or successful vaccination. ^[25]
2. Treat immune-active disease, not immune-tolerant disease. AASLD recommends antiviral therapy for adults with immune-active chronic hepatitis B and recommends against it in immune-tolerant adults. ^[1]
3. Screen before you suppress. AASLD recommends HBsAg and anti-HBc testing in everyone before immunosuppressive, cytotoxic or immunomodulatory therapy. ^[1]
4. Hepatitis C is curable. CDC states that an 8 to 12 week course of oral direct-acting antiviral therapy cures more than 95 percent of people with hepatitis C regardless of genotype. ^[26]

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References29ShowHide

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2. [2]Ghany MG, Morgan TR, AASLD-IDSA Hepatitis C Guidance Panel Hepatitis C Guidance 2019 Update: American Association for the Study of Liver Diseases-Infectious Diseases Society of America Recommendations for Testing, Managing, and Treating Hepatitis C Virus Infection. Hepatology (Baltimore, Md.), 2020.PMID 31816111
3. [3]Singal AG, Llovet JM, Yarchoan M, et al. AASLD Practice Guidance on prevention, diagnosis, and treatment of hepatocellular carcinoma. Hepatology (Baltimore, Md.), 2023.PMID 37199193
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9. [9]Pan CQ, Duan Z, Dai E, et al. Tenofovir to Prevent Hepatitis B Transmission in Mothers with High Viral Load. The New England journal of medicine, 2016.PMID 27305192
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11. [11]Zeuzem S, Foster GR, Wang S, et al. Glecaprevir-Pibrentasvir for 8 or 12 Weeks in HCV Genotype 1 or 3 Infection. The New England journal of medicine, 2018.PMID 29365309
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15. [15]Marcellin P, Gane E, Buti M, et al. Regression of cirrhosis during treatment with tenofovir disoproxil fumarate for chronic hepatitis B: a 5-year open-label follow-up study. Lancet (London, England), 2013.PMID 23234725
16. [16]Zhang BH, Yang BH, Tang ZY Randomized controlled trial of screening for hepatocellular carcinoma. Journal of cancer research and clinical oncology, 2004.PMID 15042359
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18. [18]Wedemeyer H, Yurdaydìn C, Dalekos GN, et al. Peginterferon plus adefovir versus either drug alone for hepatitis delta. The New England journal of medicine, 2011.PMID 21268724
19. [19]Schillie S, Vellozzi C, Reingold A, et al. Prevention of Hepatitis B Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices. MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports, 2018.PMID 29939980
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24. [24]Centers for Disease Control and Prevention Clinical Overview of Hepatitis B CDC, 2025.Source
25. [25]Centers for Disease Control and Prevention Screening and Testing for Hepatitis B CDC, 2026.Source
26. [26]Centers for Disease Control and Prevention Clinical Overview of Hepatitis C CDC, 2025.Source
27. [27]Centers for Disease Control and Prevention Testing for Hepatitis C CDC, 2025.Source
28. [28]World Health Organization Hepatitis D fact sheet WHO, 2026.Source
29. [29]World Health Organization Hepatitis E fact sheet WHO, 2026.Source