India's Silent Hepatitis Epidemic: A Looming Public Health Crisis
In India, a staggering number of individuals are living with hepatitis B or C infections without any awareness of their condition. You might feel perfectly healthy, maintain a regular routine of work, diet, and sleep, yet a virus could be silently wreaking havoc on your liver. By the time symptoms manifest, the damage is often severe, leading to conditions like cirrhosis, liver failure, or even liver cancer.
Expert Insights on the Hepatitis Burden
Dr. Souradeep Chowdhury from the Department of Internal Medicine at Medanta Hospital Noida highlighted the severity of the issue. "A high burden of hepatitis viruses is present in India. Approximately 3-4% of the population is infected with Hepatitis B virus (HBV) while 0.5-1% of people have Hepatitis C virus (HCV). As a result, there are probably more than 10 million people in India who are living with chronic HBV or HCV infections." He explained that many remain unaware because these viruses can lie dormant for years, allowing significant liver damage to occur before any signs appear.
The Scope of Hepatitis in India
Hepatitis continues to pose a major public health challenge across the nation, with viral types A, B, C, D, and E driving most cases and contributing to high rates of cirrhosis and liver cancer. India bears a heavy burden, with Hepatitis B surface antigen prevalence around 0.95% and HCV prevalence approximately 1% overall. A meta-analysis from Lucknow, via the National Viral Hepatitis Control Program (NVHCP), revealed wide regional spread linked to unsafe injections and transfusions. Half of the cases affect adults aged 30-54, with 12% occurring in children.
Hepatitis A (HAV) accounts for 10-30% of acute hepatitis cases, often in areas with poor sanitation. Hepatitis E virus (HEV) drives 10-40% of acute hepatitis and 15-45% of acute liver failure, particularly during pregnancy.
Low Awareness and Common Misconceptions
Despite the prevalence, awareness remains shockingly low. Many people mistakenly believe liver disease only affects heavy drinkers, while others incorrectly assume hepatitis spreads through casual contact. Since routine testing is not standard for most adults, the virus often goes undetected.
Dr. Chowdhury addressed key questions to dispel myths and provide clarity on hepatitis.
Long-Term Health Consequences
Untreated hepatitis B or C can lead to progressive liver fibrosis, resulting in cirrhosis and potentially liver cancer (hepatocellular carcinoma). Hepatitis C is curable, but early diagnosis is crucial. Delayed diagnosis can cause irreversible liver damage. Most hepatitis B cases require long-term therapy, as untreated infections can be fatal.
Transmission and Myths
Hepatitis B or C is typically contracted through:
- Exposure to contaminated needles
- Blood transfusions from unscreened donors
- Surgery or dental work with unsterilized equipment
- Tattoos or piercings with dirty objects
- Mother-to-child transmission during delivery
A common myth is that hepatitis spreads through sharing meals, hugging, or coughing, which is false and leads to unnecessary stigma.
Reasons for Low Awareness
Hepatitis lacks the visibility of diseases like TB or HIV. Factors include limited routine screening, insufficient public health messaging, and historical social stigma. Many assume only alcohol consumers develop liver disease, which is inaccurate.
Testing and Treatment Accessibility
Testing for hepatitis is now simple and affordable, typically involving a blood test. Treatment has become more accessible, with hepatitis C curable using oral medications taken for 8 to 12 weeks. However, awareness, referral pathways, and follow-up care are not uniformly distributed.
Impact of Lifestyle Choices
Lifestyle factors can exacerbate hepatitis-related liver damage. Alcohol consumption accelerates damage in those with hepatitis B or C. An unhealthy diet, obesity, and poorly controlled diabetes also contribute. Even moderate drinkers with chronic hepatitis are at risk.
Challenges in Diagnosis and Treatment
Doctors face obstacles such as late patient presentation, missed screening opportunities, poor access to specialist care, incomplete follow-up, and persistent misconceptions among patients and healthcare professionals.
Urgent Public Message
Dr. Chowdhury's urgent advice: "If you have received any type of injection, surgery, transfusion, or medical procedure, it is important that you get tested. While you can prevent hepatitis B by getting vaccinated and cure hepatitis C, early diagnosis can save your life and your liver."
This article incorporates expert inputs from Dr. Souradeep Chowdhury, used to explain the silent health crisis of hepatitis in India and emphasize preventive measures through symptom identification and proactive steps.
