World Hepatitis Day 2026: Why Hepatitis B remains India’s silent public health crisis

New Delhi: India has the second-highest hepatitis B burden globally, with an estimated 40–50 million chronic carriers. Hepatitis B is one of the viruses causing chronic hepatitis, and in the long run, it can lead to end-stage liver disease, cirrhosis, and liver cancer.

As a liver transplant surgeon who deals with the end stages of this virus, we see the devastating results – cirrhosis, liver failure, and liver cancer (hepatocellular carcinoma).

What this massive burden means to you and your loved ones

1. The Silent Carrier – Why it often goes undetected

Hepatitis B is often in a silent carrier state and does not lead to any clinical symptoms or concerns for years or decades. The virus causes slow, silent chronic inflammation in the liver. By the time symptoms occur -in the form of jaundice, fatigue, lethargy, or abdominal swelling -the liver is heavily scarred (cirrhosis). This is the point at which surgeons often meet such patients for the first time, and it becomes shocking for the patient and family to hear that a liver transplant is now the only option.

2. It is frequently passed down in families

It spreads and bodily fluids. The most common form of transmission is either mother to child (vertical transmission) -this being the most common route in India, when a pregnant mother passes the virus to her newborn -or household spread (horizontal transmission).
The virus can survive outside the body for up to a week. Sharing razors, toothbrushes, nail clippers, or even minor cuts and scrapes within the household can easily transmit the virus to another family member.

It is preventable and highly treatable but rarely curable

Vaccination has a very good bearing 100 per cent protection. India introduced vaccination against hepatitis B in universal immunisation in year 2002. However, millions born before 2002 are often not vaccinated.
If someone tests positive, just taking one pill a day -for example, entecavir or tenofovir -will keep the virus silent for more than 99 per cent of cases. However, resistant cases do exist which do not respond to medicines. These medicines will not cure the virus, only keep it suppressed.

What you should do

Because of India’s high burden, transplant surgeons and hepatologists recommend a simple, proactive rule of thumb:
Get a simple HBsAg blood test once.

If you are negative, ensure you are vaccinated. If you are positive, don’t panic -regular monitoring with a doctor can ensure you stay perfectly healthy and never have to see a transplant surgeon in an operating room.

Article curated by: Dr. Ankur Garg, Group Director Liver Transplant & GI Surgery, Paras Health Hospital, Gurgaon