Hepatitis B: Silent Killer Demands New Treatment Approach

Hepatitis B, a silent viral infection, can lead to cirrhosis, liver failure, and cancer in up to 10% of infected individuals. Globally, 1.1 million lives were lost to hepatitis B in 2024, an increase from 2015. In India, approximately 29 million people live with the infection, with a significant percentage facing delayed diagnosis and treatment restrictions. Historically, treatment was limited to patients with high viral loads or significant liver damage, leaving many untreated.

Recent advancements, including new Asian guidelines released in June 2026, propose a 'Treat All' policy, recommending treatment for any detectable hepatitis B DNA or elevated liver enzymes, regardless of scarring. This aligns with India's successful AIDS control program. The availability of low-cost generic antivirals like tenofovir and entecavir makes this approach feasible.

Social stigma surrounding hepatitis B, often conflated with HIV, remains a significant barrier. This stigma leads to discrimination in employment, social exclusion, and reluctance among families to get tested. Prevention of mother-to-child transmission through screening pregnant women and vaccinating newborns within 24 hours is crucial. Overcoming stigma and implementing early viral suppression through accessible treatment are vital steps for eliminating hepatitis B.