“Hepatitis often progresses silently and may only be detected once severe damage like cirrhosis or liver failure sets in. Timely testing is critical to prevent long-term complications,” Dr Rakesh Kochhar, former head, Gastroenterology Department, PGIMER, said.
Ahead of the World Hepatitis Day on Monday, Kochhar said that the condition is caused by viruses such as hepatitis B and C, alcohol use, long-term medication, or metabolic disorders, and is increasingly becoming a public health concern in India. The expert cautioned against the rising number of cases linked to some herbal and ayurvedic supplements.
According to the World Health Organisation’s (WHO’s) 2024 report, India has the highest global burden of viral hepatitis, with nearly 40 million people living with chronic hepatitis B and 6–12 million with hepatitis C, yet testing and treatment remain limited.
Dr Sumeet Kainth, senior consultant, gastroenterology and hepatology, at Livasa Hospital Mohali said that Hepatitis B and C continue to silently damage the liver in many individuals, often without noticeable symptoms until the disease has significantly progressed. In addition, alcohol consumption and non-alcoholic fatty liver disease remain the major contributors to liver damage in India.
Without diagnosis and treatment, individuals remain unaware and continue to progress towards severe liver disease or cancerand so testing, treating, vaccinating, and integrating services into primary health systems are essential. This includes ensuring birth‑dose vaccination for hepatitis B, expanding screening for high‑risk groups, providing affordable curative treatment for hepatitis C virus (HCV), and offering antivirals and prophylaxis to prevent hepatitis C virus (HBV) transmission.
Dr Sunil Tanjea, associate professor, Department of Hepatology, PGIMER, Chandigarhsaid that a person who has acute or chronic hepatitis B can spread the infection to other people through his/her blood and other body fluids or by sexual contact.
“The risk of exposure to hepatitis B is through unprotected sex, tattoos, piercings, pedicures, manicures or medical procedures with improperly sterilised equipment, sharing personal hygiene items with an infected person e.g. razors, toothbrushes, nail clippers. For chronic hepatitis B, antiviral medicines have been approved for treatment. These treatments do not provide a complete cure, but they offer control of the virus so that further damage to your liver can be prevented. There is a safe and effective vaccine that can protect against hepatitis B. The vaccine is usually given in three doses over six months. It gives long-lasting protection and can be given at birth,” Taneja added.
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Dr Arvind Sahni, director, gastroenterology and hepatology, Fortis Hospital, Mohali, said, unlike viral hepatitis, autoimmune hepatitis (AIH) is caused by the body’s immune system attacking liver cells. The disease is more common in women, though it affects males too, with peak incidence seen in childhood, adolescence, and adults aged 40-60.
“AIH often goes undetected, and nearly one-third of patients are already in advanced stages of liver disease at diagnosis. Patients may experience fatigue, jaundice, swelling of the legs, abdominal fluid build-up, gastrointestinal bleeding, menstrual irregularities, and neurological symptoms. Enlarged liver is also common,” said Sahni.
Autoimmune hepatitis, he added, needs lifelong immunosuppressive treatment, which includes steroids and azathioprine. “Recently, Mycophenolate Mofetil (MMF), a new drug, has been approved as a first-line treatment for autoimmune hepatitis. MMF is more effective and better tolerated than traditional drugs, though it is contraindicated during pregnancy,” the doctor said.
“Among the five types of hepatitis B and C pose the highest risk of cirrhosis and liver cancer if not diagnosed and treated early,” Dr Mukesh K Rathore, principal consultant gastroenterology at Max Hospital, Mohali, said.
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In addition, alcohol consumption and non-alcoholic fatty liver disease remain the major contributors to liver damage. Vaccination remains our strongest defence against hepatitis A and B, Rathore stressed.
With the availability of highly effective antiviral medications, hepatitis C is now curable in most cases. Unfortunately, many individuals remain unaware that they may be living with chronic hepatitis.
“Early detection and timely treatment can prevent complications like liver failure and cancer. Adopting a balanced diet, staying physically active, and avoiding alcohol and tobacco are crucial to preventing liver-related complications,” Rathore suggested.
