In recent years, hepatitis has taken on new and often silent forms, emerging not only from viral infections but also from the changing contours of urban life. It’s important to shift public focus back to this often-overlooked disease, which remains one of the leading causes of liver failure and liver cancer in India.
Hepatitis refers to inflammation of the liver, a condition that can range from mild and self-limiting to severe and life-threatening. It is most commonly caused by viral infections — hepatitis A, B, C, D, and E viruses. However, this condition can also result from alcohol misuse, certain
medications, autoimmune disorders, or metabolic conditions.
Hepatitis A and E are typically short-term infections spread through contaminated food or water, while hepatitis B and C can become chronic, silently damaging the liver over years and leading to fibrosis (scarring of the liver), cirrhosis (permanent scarring), liver failure, or liver cancer if untreated. Globally, hepatitis B and C account for a majority of chronic liver disease and liver-related deaths.
Despite the availability of vaccines (Hepatitis A and B have vaccines) and highly effective treatments, a large proportion of those infected remain unaware of their condition due to the absence of symptoms in the early stages and lack of awareness about preventive measures.
India is now facing a silent liver health crisis driven by a convergence of metabolic, viral, and alcohol-related causes; many of which remain undiscovered until advanced stages. A growing number of hepatitis cases are being diagnosed with Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD). This condition is largely driven by sedentary lifestyles, poor diets, obesity, and type 2 diabetes — all hallmarks of modern urban living. MASLD represents a spectrum — from simple fat accumulation in the liver to more advanced inflammation and scarring, and eventually liver cancer.
At the same time, viral hepatitis (especially Hepatitis B and C) continues to fly under the radar. India holds a substantial share of the global hepatitis burden, but detection rates remain low. Because it often causes no symptoms in its early stages, many people are diagnosed only after significant liver damage has occurred. In some cases, people present with complications like jaundice, abdominal fluid buildup, or gastrointestinal bleeding, by which point the liver is already severely affected.
Despite the challenges, there is good news. Advancements in diagnostics now make it easier to detect liver disease early, and often without invasive procedures. Tools like FibroScan, which measures liver stiffness, and liver MRI, which identifies early inflammation or fibrosis, allow for early diagnosis and monitoring of conditions like hepatitis B and C without the need for biopsy.
Newer tests like quantitative HBsAg and HBV DNA testing for hepatitis B, or HCV RNA PCR for hepatitis C help assess viral load and guide treatment decisions. Genomic testing and pharmacogenomic profiling further enhance treatment precision by helping doctors select the right antiviral medications and predict potential side effects. In cases of hepatitis C, modern direct-acting antivirals have transformed treatment, offering complete cures in more than 95% of cases — often within just 8 to 12 weeks.
Early detection is particularly critical in high-risk populations. Patients undergoing dialysis, pregnant women, healthcare workers, individuals with a history of IV drug use, and those who received blood transfusions before the year 2002 should be routinely screened.
Many forms of hepatitis silently damage the liver for years before symptoms appear. That’s where preventive health checks come in. By including liver function tests and hepatitis screening in routine evaluations, it is possible to catch disease early, often before irreversible damage occurs.
At Apollo Hospitals, liver care and hepatitis treatment are not just reactive; it is strategic, personalised, and future-ready. Our dedicated multidisciplinary liver clinics bring together hepatologists, infectious disease specialists, interventional radiologists, transplant surgeons, genetic counsellors, and nutrition experts.
We are actively involved in multi-centre trials investigating novel antivirals, immunomodulators, and long-acting injectable therapies. Our teams are also studying the role of stem cell-based regenerative treatments, exploring how damaged liver tissue can be repaired without surgery. Collaborative efforts with academic institutions are helping us bridge the gap between laboratory science and bedside care through translational research initiatives.
This integrated, research-backed model aligns closely with the World Health Organization’s goal to eliminate viral hepatitis as a public health threat by 2030.
Dr Ilankumaran Kaliamoorthy, Senior Consultant - Liver Anesthetist & Intensivist at Apollo Hospitals.