living with chronic hepatitis b: how routine care is helping one man keep his diagnosis ‘in the background’
many people with chronic hepatitis b (chb) have no symptoms — but that doesn’t mean they’re not at risk of serious liver problems
published mar 05, 2026
last updated may 12, 2026
4 minute read
4 minute read
“it’s possible for people to have chb and not know it, until someone develops a complication like liver cancer or ascites (a build-up of fluid in the abdomen),” says dr. scott fung, a hepatologist at toronto general hospital, university health network. nick kozak
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when salahuddin found out he had chronic hepatitis b (chb) 25 years ago, it came as a shock — he felt perfectly healthy. “after the birth of my first child, my wife needed a blood transfusion, so i wanted to donate blood,” salahuddin recalls.
a few days later, salahuddin received a call from authorities in pakistan, where they were living. his blood sample had tested positive for chb, a condition that can cause serious liver problems if it goes untreated.
chb is a condition in which the hepatitis b virus attacks the liver over many years, often without obvious symptoms, explains dr. scott fung, a hepatologist at toronto general hospital, university health network and clinician investigator, toronto general hospital research institute. this condition can increase the risk of cancer and cause inflammation in the liver, which may lead to liver failure and cirrhosis (scarring of the liver). in the advanced stages of the disease, a liver transplant may be the only treatment option.
“it’s possible for people to have chb and not know it, until someone develops a complication like liver cancer or ascites (a build-up of fluid in the abdomen),” dr. fung explains.
salahuddin doesn’t know how he contracted the infection, but it’s possible he has had it since birth. due to historically low rates of vaccination, hepatitis b is more common among people who were born in parts of asia, africa, and the middle east. worldwide, mother-to-child transmission is the most common way for the disease to spread along with early childhood transmission.
“when i first heard about it, i felt a mix of fear and uncertainty about living with a disease i didn’t even know i had and what the future might hold,” recalls salahuddin. he and his family immigrated to canada in 2006. here, public health officials quickly connected him with a liver specialist. today, salahuddin must take daily medication to keep the hepatitis b viral load down, undergoes routine blood testing to check his virus levels and regularly monitors his liver function.
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the hepatitis b virus spreads through contact with blood or bodily fluids. the infection becomes chronic when the immune system cannot eliminate the virus, allowing it to persist in the blood and liver. chb is the leading cause of liver cancer worldwide, resulting in nearly 900,000 deaths annually.
the government of canada estimates that under 1 per cent of the canadian population lives with chb; however, around 40 per cent of them remain undiagnosed. this means thousands of people are unknowingly at risk of developing irreversible liver damage.
one of the challenges with diagnosis is that health-care providers may order a single hepatitis b test, instead of the gold-standard “triple screen” test, which looks for three biomarkers. “we commonly see patients coming into the hospital with severe complications of chb who say they had tested negative in the past. but if you look back, the wrong test was ordered. there’s confusion surrounding the testing,” explains dr. fung.
people who are most at risk of contracting chb include people born in countries and at times where hepatitis b was prevalent, those born to a mother who has chb and people who were not vaccinated against hepatitis b as infants.
because the condition can cause liver damage even if people don’t experience symptoms, dr. fung and his colleagues recommend all canadians be screened for chb at least once. the universal screening recommendations were published earlier this year, as part of the updated canadian association for the study of the liver (casl) and the association of medical microbiology and infectious disease (ammi) guidelines for the management of chb. (previous canadian guidelines only recommended pregnant people and those at risk for chb be routinely screened for hepatitis b in canada.) by catching chb early, people can help avoid liver damage and live long, full lives.
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still, there’s often a reluctance for people to get tested. “there can be shame and anxiety associated with the test,” says dr. fung. people may think that their past exposure to hepatitis b is somehow their own fault. they may also worry about what having a chronic liver condition means for their future. “people worry about discrimination in schools and in workplaces,” dr. fung explains.
to combat misinformation, dr. fung underscores an empowering message: hepatitis b is a highly treatable condition. “we are fortunate to have safe and very effective treatments that not only help patients feel better once their viral loads are reduced or suppressed but also lower their risk of developing cirrhosis and liver cancer,” he explains.
while chb remains incurable, for salahuddin, adhering to treatment has been key to managing the infection. “i feel like my diagnosis is in the background, but i am fully aware that managing it requires an ongoing commitment,” shares salahuddin. patients like salahuddin must remain on lifelong therapy and undergo routine blood testing along with frequent monitoring of their liver function to stay healthy.
while individual adherence to treatment remains essential, the broader goal of managing chb continues to evolve. reflecting this progress, the updated canadian guidelines have expanded the eligibility criteria for patients to access current treatments. dr. fung explains, “the goal is to control the virus to a level where it can no longer be detected, and liver enzymes return to normal, scarring in the liver reverses and complications are reduced.”
salahuddin’s story is an example of how proper care can help individuals live full lives with chb. but for every success story like his, there are countless others who lose their lives because their condition went undiagnosed and untreated.
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speak with your health-care professional to understand your risk of chb and how early intervention, along with regular monitoring, can help prevent complications. if you are already living with chb, regular reassessment is key. ask your provider whether the new canadian guidelines apply to your care.
this story was created by healthing content works, healthing.ca’s commercial content division, on behalf of gsk canada.
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