World Hepatitis Day 2025: Strategies for prevention, screening, and treatment
Hepatitis is an inflammation of the liver. However, it is not only a liver disease. Its impact can extend to the kidneys, blood vessels, nervous system, and even mental health.
Dr Randhir Sud, Chairman, Gastroenterology, Gastrosciences, Medanta, Gurugram, said that untreated, chronic hepatitis – particularly Hepatitis B (HBV) and C (HCV) – can unleash multiple and devastating effects that significantly impact overall health.
In India, as per the latest estimates by the World Health Organisation, 40 million people are chronically infected with hepatitis B, and six to 12 million people are chronically infected with hepatitis C. This is a huge burden that is inexplicable given that hepatitis is largely preventable.
What is the role of the liver?
The liver is the central processing unit of the digestive system. It produces bile essential for fat digestion, metabolises nutrients absorbed from the gut, detoxifies harmful substances, and plays a key role in blood clotting and immune function. When hepatitis inflames and damages liver cells, these critical functions begin to falter.
Initially, the impact might manifest as non-specific digestive issues. Chronic inflammation can lead to impaired bile production, affecting the digestion and absorption of fats and fat-soluble vitamins. This can result in symptoms like indigestion, bloating, and nutrient deficiencies.
Liver damage progresses to fibrosis and cirrhosis- both conditions which involve scarring of the liver, though cirrhosis is far more dangerous and significantly impacts liver function.
As the flow of blood through the liver is obstructed, it leads to portal hypertension- increased pressure on the portal vein, which carries blood from the digestive organs to the liver.
The consequences include esophageal varices. This is a condition where the veins in the esophagus are swollen and fragile, and are prone to rupture, leading to life-threatening internal bleeding. It can also cause gastropathy and enteropathy, wherein the lining of the stomach and intestines becomes congested and damaged, leading to chronic bleeding, anemia, and impaired nutrient absorption. The spleen, also connected to the portal system, can enlarge (splenomegaly), further complicating blood cell counts.
A compromised liver struggles to detoxify the blood, allowing toxins, particularly ammonia, to accumulate. These toxins can then cross the blood-brain barrier, leading to hepatic encephalopathy, a severe neurological complication that affects cognitive function, mood, and motor skills. This highlights how liver damage can even impact organs seemingly unrelated to the digestive tract.
Factors that contribute to the huge disease burden in India include unsafe injection practices, unsterilized medical equipment, and mother-to-child transmission.
Despite the availability of effective vaccines for Hepatitis B and increasingly accessible treatments for Hepatitis C, the disease continues to be a silent epidemic, Dr Sud said.
Forget treatment, many individuals remain undiagnosed until the disease has progressed to advanced stages, when the broader digestive and systemic complications are already well underway.
Way forward:
Addressing hepatitis in India requires a multi-pronged approach that includes robust vaccination programs, improved sanitation and safe injection practices, widespread screening, and ensuring access to affordable diagnostics and treatment.
Recognising that hepatitis is not just a liver problem is a crucial first step in this direction.
Health