Every year, 28 July is observed as World Hepatitis Day to raise awareness about viral hepatitis, a disease that continues to be one of the leading causes of chronic liver disease, liver cirrhosis and liver cancer across the world. This year's theme, "Hepatitis: Let's Break It Down," calls for removing the barriers that prevent people from accessing timely testing, treatment and preventive care.
Despite the availability of effective vaccines, reliable diagnostic tests and antiviral medicines, millions of people remain unaware that they are living with hepatitis. Many are diagnosed only after the disease has silently caused significant damage to the liver. According to the World Health Organization (WHO), 10 countries including India account for nearly 66% of the global burden of Hepatitis B and C. Worldwide, an estimated 254 million people are living with Hepatitis B, while 50 million people have Hepatitis C, yet a large proportion remain undiagnosed or untreated.
Adding to the concern, a study by the Department of Gastroenterology at AIIMS, New Delhi, has shown that Hepatitis A and Hepatitis E together account for nearly 30% of acute liver failure cases, a condition associated with a mortality rate of more than 50%. The researchers say that a large proportion of these infections can be prevented simply by ensuring access to safe and clean drinking water.
In India, the leading causes of liver cirrhosis are alcohol, viral hepatitis and non-alcoholic fatty liver disease (NAFLD), responsible for approximately 43%, 18% and 14% of cases, respectively. The proportion of alcohol and NAFLD-related cirrhosis is increasing in India. As per a recent study, the number of cases of liver cancer (hepatocellular carcinoma) occurring due to NAFLD are also increasing.
A recent study suggests that more than one-third (38%) of Indians have a “fatty liver” or “metabolic dysfunction associated steatotic liver disease”, previously called non-alcoholic fatty liver disease (NAFLD). This is not only restricted to adults but affects nearly 35% of children as well. It is often unrecognised in its early stages since it does not cause any symptoms, but can progress to severe liver disease in some patients. The rise in “fatty liver” or “steatohepatitis” is due to the adoption of Western diets- including an increase in fast food consumption and lack of fruits and vegetables, coupled with an unhealthy sedentary lifestyle. The way to conquer this new epidemic is to adopt a healthier lifestyle and achieve weight loss in obese individuals through an adequate diet, restricting junk and sugary food intake, and exercising regularly.
A recent study reported that alcohol is the most common cause of a severe form of liver injury known as acute on chronic liver failure, which is associated with a very high mortality. The preventive strategy must be adopted at the society and policy level.
What Is Hepatitis and Why Is It Dangerous?
Hepatitis refers to inflammation of the liver, an organ that performs more than 500 vital functions in the human body. The disease may be acute, lasting only a few weeks, or chronic, where the infection persists for more than six months. While many patients with acute hepatitis recover within four to six weeks, chronic infection can gradually progress to liver cirrhosis, liver failure or liver cancer. In some people, hepatitis causes no symptoms at all until advanced liver damage has already occurred.
Five Viruses, Five Different Diseases
There are five major hepatitis viruses A, B, C, D and E and each behaves differently.
Hepatitis A and E are usually spread through contaminated food and water and generally cause acute infections. In contrast, Hepatitis B and C spread through infected blood and body fluids, including unsafe blood transfusions, mother-to-child transmission at birth, unsafe sexual practices and injectable drug use. These two viruses are responsible for most cases of chronic liver disease, liver cirrhosis and liver cancer worldwide.
Treatment also differs depending on the virus. Hepatitis A and E generally do not require specific antiviral medicines. Hepatitis B usually requires long-term antiviral therapy to suppress the virus, while more than 95% of Hepatitis C infections can now be cured with about three months of antiviral treatment. Patients with advanced liver disease or liver cancer may eventually require a liver transplant.
Lifestyle Also Plays a Major Role
Viral hepatitis is not the only threat to liver health. According to the experts, excessive alcohol consumption, certain medicines, autoimmune diseases and unhealthy lifestyle habits can also damage the liver. Fat accumulation in the liver due to obesity, diabetes and physical inactivity may eventually progress to serious liver disease if left unchecked. Maintaining a healthy weight, exercising regularly, eating a balanced diet, avoiding alcohol and taking medicines only under medical supervision are essential for protecting the liver.
India Continues to Face a Heavy Burden
India remains among the countries with the highest burden of viral hepatitis, accounting for nearly 12% of global cases. Estimates suggest that around 40 million people in India are living with chronic Hepatitis B, while another 6–12 million are infected with Hepatitis C.
To address this challenge, the National Viral Hepatitis Control Programme is working towards the WHO's goal of eliminating viral hepatitis as a public health threat by 2030. The programme provides Hepatitis B vaccination for newborns, free testing facilities and medicines for Hepatitis B and C through government healthcare institutions. People at higher risk—including healthcare workers, pregnant women, those who have received blood transfusions, intravenous drug users and family members of Hepatitis B patients—are encouraged to undergo testing.
Fatty Liver and Alcohol Are Emerging Challenges
The experts also point out that liver disease in India is increasingly being driven by lifestyle-related conditions. Alcohol remains the leading cause of liver cirrhosis in the country, followed by viral hepatitis and non-alcoholic fatty liver disease (NAFLD). Recent studies suggest that more than one-third of Indians have fatty liver disease, with the condition also affecting nearly 35% of children. The growing consumption of processed foods, sugary drinks and increasingly sedentary lifestyles is believed to be contributing to this trend.
The Way Forward
Experts say that viral hepatitis is largely preventable and, in many cases, treatable. Increasing awareness, expanding vaccination, ensuring access to clean drinking water, promoting early testing and encouraging healthy lifestyle choices can significantly reduce the burden of liver disease. On this World Hepatitis Day, the message is clear: don't wait for symptoms protect your liver before it's too late.