Many Indians Are Discovering Hepatitis Only During Routine Blood Tests

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India is home to an estimated 29 million people living with hepatitis B and another 5.5 million with hepatitis C, according to the World Health Organization's Global Hepatitis Report 2024, a burden second only to one other country in the world. Yet a large share of them have no idea the virus is there.

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That's the strange, unsettling thing about hepatitis. It rarely announces itself. People go to work, exercise, eat normally, and feel entirely well, while the infection quietly does its damage in the background - until a routine health check-up, a pre-surgical blood panel, an insurance screening, or a blood donation test brings it to light.

We spoke to Dr Rajeev Reddy, Consultant, Gastrointestinal and Minimal Access Surgeon, Arete Hospitals, who explained why hepatitis so often slips past unnoticed in India, what people get wrong about it, and why the outlook for patients today is far better than it used to be.

Why Hepatitis Often Goes Undetected

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Unlike many other illnesses, chronic hepatitis often produces very few symptoms initially. People may continue working, exercising, and functioning normally while low-grade liver damage quietly progresses in the background.

This is particularly important in India because hepatitis B remains fairly common, and a significant number of people may carry the infection without knowing it.

"Patients often assume liver disease always causes jaundice, abdominal swelling, or severe illness. But early hepatitis frequently causes none of these. Some individuals may only experience vague fatigue, reduced appetite, or mild weakness - symptoms that are easily ignored or attributed to stress and overwork," said Dr Reddy.

By the time obvious symptoms appear, liver damage may already be advanced.

How Hepatitis B and C Spread

"Both hepatitis B and hepatitis C are viral infections involving the liver. These infections may spread through contact with infected blood, unsafe injections, inadequately sterilised instruments used during medical or cosmetic procedures, sexual transmission, or from mother to baby during childbirth in hepatitis B infection," explained Dr Reddy.

Earlier, reuse of injections and inadequate sterilisation practices played a major role in the spread of hepatitis in certain areas. While healthcare safety measures are much better today than they were years ago, infections can still occasionally occur when proper sterilisation protocols are not followed consistently.

Common Misconceptions About Hepatitis

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Another misconception is that hepatitis only affects people who consume alcohol heavily. Alcohol-related liver disease is common, but viral hepatitis develops through entirely different mechanisms.

"Many patients are emotionally shocked by the diagnosis because they do not identify with the usual stereotypes associated with liver disease. Some become anxious about social judgement, while others worry unnecessarily that casual contact with family members may spread infection," shared Dr Reddy.

When Routine Tests Reveal Hepatitis

Doctors also see situations where hepatitis is discovered only after routine liver tests remain abnormal repeatedly. Sometimes liver abnormalities are picked up accidentally when scans are performed for completely different reasons, such as stomach discomfort or routine abdominal evaluation. Since many people do not feel noticeably unwell in the early stages, abnormal findings on reports are often ignored or not followed up immediately.

Why Follow-Up Matters Even Without Symptoms

Another challenge is that many individuals stop follow-up once they start feeling well again. Chronic hepatitis, however, usually requires periodic monitoring even when symptoms are absent.

Regular blood tests and medical review help doctors assess liver function and detect complications early.

Treatment Has Changed The Story

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The more hopeful part, Dr Reddy said, is how far treatment has come. Hepatitis C is now curable in most patients with antiviral medication - direct-acting antivirals have pushed cure rates in Indian studies above 90 per cent. Hepatitis B can't yet be cured, but modern antiviral therapy can suppress the virus to extremely low or undetectable levels in patients who need treatment, sharply cutting the risk of cirrhosis and liver cancer, provided they stay on medication and keep up with follow-up.

Vaccination remains one of the strongest tools against hepatitis B, Dr Reddy added, yet a large number of adults in India still haven't had it.

Who Should Get Screened

Dr Reddy recommends routine screening for anyone with a history of blood transfusion, dialysis, a family history of hepatitis, healthcare exposure, multiple medical or surgical procedures, or unexplained liver enzyme abnormalities. Fatty liver disease, he noted, is also increasingly picked up incidentally during health check-ups, and can coexist with hepatitis to raise liver risk further.

Bottomline

Dr Reddy concluded, "The liver is remarkably resilient, but it also tolerates damage silently for long periods. That silence is exactly why routine blood testing and timely evaluation matter. Many patients feel completely healthy until the diagnosis appears unexpectedly on paper."

Disclaimer: The information provided in this article is for general informational and educational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or a qualified healthcare provider with any questions you may have regarding a medical condition.