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What viral hepatitis is

Hepatitis means inflammation of the liver. Viral hepatitis is that inflammation caused by a virus, and the two that matter most for sexual health are hepatitis B and hepatitis C.

Both can be silent for years or decades while damage accumulates, and both are worth knowing about for reasons that go well beyond sexual health: hepatitis B is vaccine preventable, and hepatitis C is now curable in the large majority of cases.

Hepatitis B and hepatitis C are different problems

• Hepatitis B transmits efficiently through blood and sexual contact, and from mother to baby at birth. It is common in South Africa. There is a vaccine, it is part of the childhood immunisation schedule, and it works. Most adults who are infected clear it; a minority develop chronic infection, which is the group at risk of cirrhosis and liver cancer.
• Hepatitis C transmits mainly through blood rather than sex, most often through shared needles or unsterile medical or tattooing equipment. Sexual transmission happens but is much less efficient. There is no vaccine. There is, however, direct-acting antiviral treatment that cures the large majority of cases.

How hepatitis is tested at Epicentre

If you are asking whether you have hepatitis B, the R269 Surface Antigen test is the one. The viral load test at R2,234 is a monitoring test for someone who already has a diagnosis, and ordering it to find out whether you are infected is an expensive way to answer the wrong question.

If you are having a PCR sexual health panel done anyway, the R524 combined add-on is almost always the better buy than a standalone hepatitis B test, because it covers HIV and syphilis in the same draw.

When to test after exposure

Hepatitis B surface antigen generally becomes detectable from around 4 weeks after exposure, and antibody responses take longer still. A test in the first days afterwards is likely to be negative regardless.

If you have had a high-risk exposure to hepatitis B, particularly a needlestick, see a doctor rather than waiting, because there is preventive action that is time sensitive. Epicentre does not prescribe.

The hepatitis B vaccine

Hepatitis B is one of the few sexually transmissible infections with a vaccine, and it is effective. It is part of the childhood immunisation schedule in South Africa, so many younger adults are already covered. If you are not sure whether you are, the Past Exposure test at R269 is what tells you.

Epicentre does not vaccinate. We test; a doctor or clinic vaccinates.

Your result, and what happens next

You get one report, emailed to you and to nobody else. It is the YourGenes patient report: colour coded, in plain language, with a line for every organism on your panel saying whether it was detected. There is no second document, and no separate practitioner version. This report is what your doctor reads too.

If hepatitis B or hepatitis C is detected, Epicentre does not treat it. We are a diagnostic laboratory. We collect samples, run tests and report results. We do not diagnose, prescribe medication or provide treatment, anywhere, including on WhatsApp. You have two equally good routes from here:

• Your own doctor, clinic or pharmacy clinic. Take the report. It names the organism, which is exactly what they need.
• An independent doctor we work with, who consults online or in person on sexual health results. She prescribes on her own responsibility, not as an Epicentre service.

For hepatitis specifically: a positive result is not the end of the story, it is the beginning of an assessment. Chronic hepatitis B is managed rather than cured, and managed well it does not shorten life. Hepatitis C is curable in most cases with direct-acting antivirals. Both need a doctor to work out which category you fall into.

Where to test

Walk in during those hours, no appointment and no doctor's referral. All three branches are closed on South African public holidays. If you would rather not come in, a home kit is couriered to you in discreet packaging and a free courier collects the sample.

Common questions