Hepatitis B and C Compared to HIV

Start with the viruses. Then see why they are often grouped together.

1. What are hepatitis B, hepatitis C and HIV?

Hepatitis B and hepatitis C are viral infections of the liver. Each can be acute, which is short and severe. Each can also turn chronic, which means long term.

HIV is a different kind of virus. It attacks the body’s immune system and targets white blood cells. Untreated HIV can progress to AIDS, often after many years.

All three can spread through blood. That is why exam questions place them side by side.

2. How does hepatitis B spread, and why is it called "much like HIV"?

Hepatitis B spreads through infected blood and body fluids. WHO lists blood, semen, vaginal fluids and saliva in the presence of open cuts and sores. It also passes from a mother to her baby.

In highly endemic areas, the most common route is mother to child at birth. Other routes include unsafe injections, needlestick injuries, tattooing and piercing.

HIV spreads through blood, breast milk, semen and vaginal fluids. It also passes from mother to baby. So the two viruses share the same main routes. This is why the UPSC statement “Hepatitis B is transmitted much like HIV” is correct.

HIV does not spread by kisses, hugs or sharing food.

3. How does hepatitis C spread?

Hepatitis C is a bloodborne virus. WHO names three common routes:

• Reuse or poor sterilisation of syringes and needles in health care.
• Transfusion of unscreened blood and blood products.
• Sharing injection equipment among people who inject drugs.

Sexual spread and mother-to-baby spread are less common. Hepatitis C does not spread through breast milk, food, water or casual contact such as hugging.

4. Why can these infections stay silent for years?

Most people with a new hepatitis B infection have no symptoms. Acute hepatitis C is also usually without symptoms. A person can carry the virus and not know it.

Meanwhile the liver may be damaged. Among people with chronic hepatitis C, the risk of cirrhosis is 15 to 30 per cent within 20 years. WHO notes that hepatitis C symptoms may not appear until decades after infection.

HIV can also stay quiet. Many people are unaware of their status until the later stages.

This silent course is why UPSC statement (d), about symptoms not showing for many years, is correct.

This is the part UPSC flipped. Read it slowly.

5. Does hepatitis B have a vaccine?

Yes. Hepatitis B can be prevented by a safe and effective vaccine. WHO says babies should get the first dose within 24 hours of birth.

Two or three more doses follow, at least four weeks apart. The vaccine gives nearly 100 per cent protection. It protects for at least 20 years and probably for life.

In India, hepatitis B is one of the diseases covered by the Universal Immunisation Programme.

6. How is the hepatitis B vaccine made?

The first vaccine used blood plasma from people carrying the virus. The plasma was purified and inactivated. The US regulator licensed this plasma-derived vaccine in late 1981.

Some people feared contamination with other blood viruses, including HIV. Later tests showed the inactivation steps destroyed such viruses.

Newer vaccines use yeast cells that carry the gene for the virus surface protein. These recombinant vaccines were developed and licensed in the 1980s.

7. Does hepatitis C have a vaccine or a cure?

WHO says there is no effective vaccine against hepatitis C. Prevention depends on avoiding contact with infected blood.

But hepatitis C can be cured. Direct-acting antiviral medicines, called DAAs, cure more than 95 per cent of people. A short oral course of 8 to 12 weeks is enough in nearly all patients.

So the right memory line is: hepatitis C has a cure but no vaccine. Hepatitis B has a vaccine, and its medicines control the infection.

8. What about treatment for hepatitis B and HIV?

Chronic hepatitis B can be treated with oral medicines such as tenofovir or entecavir. They slow cirrhosis and reduce liver cancer. Most people must continue treatment for life.

HIV has no cure. Yet antiretroviral therapy, called ART, makes it a manageable chronic condition. People on ART with no virus in the blood do not pass HIV to sexual partners.

Use WHO numbers. Remember that each year brings new estimates.

9. How many people live with hepatitis B?

WHO estimates that 240 million people lived with chronic hepatitis B in 2024. About 0.9 million new infections occur each year.

Hepatitis B caused about 1.1 million deaths in 2024. Most deaths came from cirrhosis and liver cancer.

The burden is highest in the Western Pacific Region and the African Region. They hold 102 million and 64 million chronic infections. South-East Asia has 43 million.

10. How many people live with hepatitis C?

An estimated 47 million people have chronic hepatitis C. Another 0.9 million people are newly infected each year. Around 239 000 people died from it in 2024.

The highest burden is in the Eastern Mediterranean Region, with 12 million chronic infections. The South-East Asia Region has 9 million.

Access to testing and treatment is low, even though a cure exists.

11. How many people live with HIV?

WHO estimates 41.0 million people were living with HIV at the end of 2025. About 64 per cent of them live in the African Region.

In 2025, around 570 000 people died of HIV-related causes. About 1.2 million people acquired HIV.

The 95-95-95 targets guide the response. In 2025, 88 per cent of people with HIV knew their status. Of those, 89 per cent were on ART.

12. Do hepatitis B and C really infect several times more people than HIV?

Yes. Add the WHO figures: 240 million with chronic hepatitis B plus 47 million with chronic hepatitis C. That is about 287 million. HIV has 41.0 million. The ratio is about seven to one.

The UPSC statement “several times more” is therefore correct. Deaths tell the same story. Hepatitis B and C together caused about 1.3 million deaths. HIV caused about 570 000.

Note the dates. The hepatitis numbers are for 2024. The HIV numbers are for 2025. The comparison still holds.

India has a national programme. It also overlaps with HIV care.

13. What is the National Viral Hepatitis Control Programme?

The Union Health Minister launched the National Viral Hepatitis Control Programme, or NVHCP, on 28 July 2018. That date is World Hepatitis Day.

Its aims are two. First, achieve countrywide elimination of hepatitis C by 2030. Second, bring a significant fall in infections, illness and deaths from hepatitis A, B, C and E.

The programme site also lists a protocol for the birth dose of the hepatitis B vaccine.

14. What happens when a person has both HIV and hepatitis B?

This is called co-infection. WHO estimates that 7.4 per cent of people with HIV also have hepatitis B.

There is a helpful link in treatment. Tenofovir is part of the first-line HIV treatment. It is also active against the hepatitis B virus. One medicine can therefore act on both infections.

HIV can also make hepatitis B and hepatitis C worse.

One question in 2019 covered the whole comparison.

15. What did UPSC ask in the Civil Services Preliminary Examination 2019?

UPSC CSP 2019, General Studies Paper I, Q100 (Series A). The question asked for the statement that is not correct.

The correct answer is (b). The official key marks (b) for Series A. Hepatitis B does have a vaccine. Hepatitis C is the one without a vaccine. The other three statements are true, as items 2, 4 and 12 show.

16. What should I revise at a glance?

Use this list before the exam:

• Hepatitis B: vaccine exists, first dose within 24 hours of birth. Spreads like HIV.
• Hepatitis C: no vaccine, but DAAs cure more than 95 per cent.
• HIV: no cure, but ART controls it.
• Silent course: hepatitis B and C may show no symptoms for years.
• Numbers: about 240 million with hepatitis B and 47 million with hepatitis C, against 41 million with HIV.
• India: NVHCP launched on 28 July 2018, aiming to eliminate hepatitis C by 2030.

Revise the list line by line.