New Delhi: Liver disease often progresses silently with many patients experiencing no symptoms until irreversible damage such as cirrhosis or liver cancer has developed, experts from the AllMS, Delhi warned on World Hepatitis Day, urging wider screening and early diagnosis to curb India’s heavy burden of viral hepatitis.
India accounts for nearly 12 per cent of the global burden of viral hepatitis, with an estimated 40 million people living with chronic hepatitis B infection and another six to twelve million chronically infected with hepatitis C, making it one of the countries with the highest disease burden worldwide, they said.
According to the World Health Organization (WHO), 10 countries, including India, account for nearly 66 per cent of the global burden of hepatitis B and C. Globally, about 254 million people are living with hepatitis B and 50 million with hepatitis C.
Speaking on the occasion of World Hepatitis Day, observed every year on July 28, AIIMS experts said the biggest challenge is that chronic viral hepatitis and other liver diseases frequently remain undiagnosed because they do not produce symptoms in their early stages.
“Liver disease is often called a silent disease because many patients remain completely asymptomatic until advanced liver damage has already occurred. By the time jaundice, abdominal swelling or liver failure develops, treatment becomes far more difficult,” Dr Pramod Garg, Head of Department of Gastroenterology at AIIMS, Delhi, said.
Inflammation of the liver, or hepatitis, may be caused by viruses, alcohol, drugs or autoimmune disorders, Dr Shalimar, Professor in the Department of Gastroenterology, said.
While hepatitis A and E usually cause acute illness and are transmitted through contaminated food and water, hepatitis B and C spread through infected blood, unsafe injections, unscreened blood transfusions, mother-to-child transmission and unsafe sexual practices, and can progress to chronic liver disease, cirrhosis and liver cancer.
Experts said hepatitis C can now be cured in more than 95 per cent of patients with a three-month course of antiviral medicines, while hepatitis B can be effectively controlled with long-term treatment. They stressed that early testing remains the key to preventing complications.
This year’s World Hepatitis Day theme, “Hepatitis: Let’s Break It Down”, calls for removing stigma, misinformation and barriers that prevent people from accessing testing and treatment.
Dr Garg also highlighted the growing burden of non-viral liver diseases in India. Excessive alcohol consumption, obesity, diabetes and sedentary lifestyles are driving a sharp rise in metabolic dysfunction-associated steatotic liver disease (MASLD), previously known as non-alcoholic fatty liver disease (NAFLD), he said.
Recent studies suggest nearly 38 per cent of Indians have fatty liver disease, while the condition also affects around 35 per cent of children, largely because of unhealthy diets, increasing consumption of processed foods and physical inactivity.
Citing findings from the Department of Gastroenterology at AIIMS, Delhi, the experts said hepatitis A and E together account for nearly 30 per cent of acute liver failure cases in India, a condition associated with mortality exceeding 50 per cent. Ensuring access to safe drinking water and proper sanitation can prevent a large proportion of these infections, they said.
Dr Shalimar noted that alcohol, viral hepatitis and fatty liver disease account for about 43 per cent, 18 per cent and 14 per cent of liver cirrhosis cases in India respectively, with alcohol-related liver injury and fatty liver disease showing an increasing trend.
The experts said people at high risk including healthcare workers, pregnant women, people who received blood transfusions, injectable drug users, family members of hepatitis B patients and other vulnerable groups should undergo hepatitis screening.
Experts also emphasised that all newborns should receive the hepatitis B vaccine at birth, while eligible patients can access free diagnosis and treatment under the National Viral Hepatitis Control Programme.
“Protecting the liver begins with prevention,” Dr Garg said, advising people to avoid alcohol, maintain a healthy weight, exercise regularly, eat a balanced diet, ensure safe drinking water, avoid self-medication with potentially liver-toxic drugs and undergo timely hepatitis testing if they have risk factors.
