Millions of people may have Hepatitis and not know it. How did this happen?

Key points:

• Millions of Europeans live with Hepatitis and don’t know it
• Stigma remains a crucial barrier to treating Hepatitis, as half of all people who have Hepatitis C report not being treated well in healthcare settings
• Vaccination and awareness campaigns are crucial for prevention, health authorities advise

One thing most people don’t know about STIs is that they often go undetected. Whether you’re dealing with HIV or Chlamydia, many STIs have an uncanny ability to go unnoticed by most of the people who have them.

But new data has shown that millions more people may have a particular infection than previously thought.

What’s happening, and how did we get here?

Keep reading to find out.

It’s always better to know your sexual health status.

What’s going on?

European health authorities have warned that millions of people are unknowingly living with Hepatitis B and Hepatitis C, according to the European Centre for Disease Prevention and Control (ECDC).

A recent report released by the institution gathered data from countries around the European Union, including Iceland, Liechtenstein, and Norway, stated that around five million people are living with chronic Hepatitis B or C. The majority of these infections are undiagnosed and will be left untreated, which puts people at risk of liver disease and cancer.

The report estimates that 3.2 million people in the region are infected with Hepatitis B, and 1.8 million have Hepatitis C. Together, these infections are connected to around 50,000 deaths every year.

The ECDC estimates that 65% of people infected with Hepatitis B and 62% of people with Hepatitis C remain undiagnosed.

What are Hepatitis B and C?

If you’ve ever heard of Hepatitis B or C and thought, “That sounds serious, but I’m not really sure what it is,” you’re not alone. These two viruses can quietly affect your liver and cause long-term health problems if left untreated—but the good news is, they’re both preventable and treatable.

Hepatitis B is a virus that attacks your liver. About 90% of people people who get it will recover quickly, going through jaundice (the skin turning yellow) , but for others (especially those who do not develop jaundice), it sticks around and becomes chronic. That’s when things can get more serious—think liver damage, cirrhosis, or even liver cancer.

Symptoms of an acute infection can include:

• Yellowing of the skin and eyes
• Fatigue
• Nausea
• Vomiting
• Abdominal pain
• Dark urine

But about 10% of people will never go through this process of symptoms and so will be unaware that they are infected.

Hepatitis C is also an infection that attacks the liver. If the infection becomes chronic (which occurs in 75% of cases), it can quietly damage the liver over many years without showing any obvious symptoms.

Symptoms of Hepatitis Care not common at first, and if they appear, it is later on when the infection has become chronic. They include:

• Flu-like symptoms, like muscle aches and fever
• Fatigue
• Loss of appetite
• Abdominal pain
• Nausea

How do people get these infections?

Here’s how these viruses typically spread:

Hepatitis B

• Through unprotected sex
• Sharing needles or razors
• From mother to baby during childbirth
• Tattooing or piercing with equipment that hasn’t been properly sterilised

This infection is much more common in unhygienic home environments.

Hepatitis C

• Mainly through sharing needles
• Blood transfusions (especially before the early ’90s)
• Unsterilised tattoo or piercing tools
• Occasionally through sex, especially if there’s blood involved

The profile of a person with chronic Hepatitis B is very different from the typical person with Hepatitis C, with the latter being typically seen in older people who have been infected for decades, maybe following a routine blood transfusion for a long forgotten operation in the 1980s.

What happens when they’re left untreated?

The tricky part is that both Hepatitis B and C often don’t cause symptoms right away. There is an incubation period at first in which you feel perfectly well.

Most people with Hepatitis B will become unwell and will go yellow – a clear indicator of something being very wrong, but in the other 10% and in most patients with Hepatitis C you might feel a bit tired or unwell, but these people don’t realise they’re infected until their liver has already taken a hit.

If left untreated, these viruses can lead to serious health issues like:

• Chronic liver disease
• Cirrhosis (scarring of the liver)
• Liver cancer
• Liver failure

Around 1% of people living with a Hepatitis B infection are also infected with HIV.

Globally, chronic viral Hepatitis causes around 1.3 million deaths each year – around 3,500 deaths a day. This is around the same number of deaths per year as Tuberculosis. In Europe, however, there are treatment options for these people.

Dealing with Hepatitis can be a struggle physically, mentally, and emotionally. According to a survey conducted by the World Hepatitis Alliance (WHA) and the ECDC, half of Europeans living with Hepatitis B or C (including people living in the UK) struggled with sharing their diagnoses with other people due to the stigma around the virus.

The survey also found that a quarter of the participants in seven European countries had not told their friends about living with these infections. Almost the same number had not told their families.

Nearly half of the people living with Hepatitis C and more than a quarter of the people living with Hepatitis B reported not being treated well in healthcare settings.

These infections can also have a massively negative effect on mental health. According to the survey, over a third of participants reported moderate to severe emotional distress because of their condition, often leading to anxiety and depression. The mental toll is great, but as is seen with other liver diseases, there is direct and negative effects on the brain.

What can be done?

The ECDC recommended that access to vaccination, testing, and medical care be provided for people already infected.

Like most STIs, Hepatitis B can be prevented by practising safe sex. Doing this can massively reduce your chances of getting most infections that are transmitted via infected bodily fluids like semen, vaginal secretions, mucus in the rectum, and blood-to-blood contact.

Sharing sex toys is also a mode of transmission of Hepatitis C that we sometimes see, since infected blood can remain on the toy after use.

Can either of these infections be cured?

Most people who contract Hepatitis B will not need treatment. This is because they develop symptoms, like jaundice which shows the liver is being inflamed correctly by the patients immunity and the virus is going to be kicked out. In most cases, these infections are cleared by the immune system. Around 10% of people infected with Hepatitis B will develop a chronic condition and they are very unlikely to be able to eliminate the virus on their own. 

However, it’s a different story for Hepatitis C. Around 75% of people who catch Hepatitis C will develop a long-term infection with no symptoms to warn them.

In Europe, if you have Hepatitis C, medication can usually clear the infection in more than 90% of cases. In cases of chronic Hepatitis B, most symptoms can be managed with antivirals.

If either infection becomes significantly advanced, specialised treatment will be needed.  

Final thoughts

Both Hepatitis B and C may be much more common than initially thought. If you’re sexually active or are having symptoms of an acute infection, you should get tested. If you turn yellow, you must get emergency medical attention right away.

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This article has been medically reviewed by Dr. Steve Chapman, 29/10/2025.