World Hepatitis Day 2026: Hidden Hepatitis C risks among young adults

For many young adults Hepatitis C feels like a disease from another era or one associated only with extreme risk factors and older generations It is rarely part of everyday health conversations Unlike illnesses that announce themselves through visible symptoms Hepatitis C often stays silent for years quietly progressing in the backgroundThat silence is precisely what makes it dangerous Medical experts warn that many people continue to think Hepatitis C affects only injection drug users or individuals with obvious medical vulnerabilities In reality exposure can happen in ways that feel surprisingly ordinary through unregulated tattoo studios improperly sterilised cosmetic procedures shared grooming tools unsafe injections or healthcare exposures that may have happened years earlierBecause symptoms may not appear until liver damage has already developed awareness and early testing remain the most powerful tools As the world observed Hepatitis Day on July 28 health experts explain why Hepatitis C deserves more attention from younger adults the everyday exposures people overlook and how modern treatment has transformed one of the worldrsquos most feared liver infections into a disease that can now be cured in the vast majority of casesWhy Hepatitis C can stay hidden for decadesOne of the most misunderstood aspects of Hepatitis C is how quietly it behaves According to Dr Vibhor Borkar director of paediatric hepatology gastroenterology and transplant medicine at Gleneagles Hospital in Parel in Mumbai the virus often escapes attention because it replicates within liver cells without triggering a strong immediate immune responseHe explains ldquoHepatitis C often remains undetected because the virus replicates quietly within liver cells without triggering a strong immune response leading to chronic infection in nearly 80 per cent of casesrdquo The infection usually begins with an acute phase lasting up to six months During this period most people experience few symptoms or none at allEverything that follows is the more concerning stage chronic infection Persistent inflammation can continue for years and gradually lead to fibrosis the process of scarring inside the liver This damage accumulates slowly often over two to three decades Over time fibrosis may progress to cirrhosis where permanent structural damage limits liver function In some patients this eventually increases the risk of hepatocellular carcinoma a form of liver cancerDr Borkar notes that this progression may be particularly significant in India because genotype 3 remains the most common strain and is associated with faster disease progression and higher rates of liverrelated complicationsThe challenge is that early warning signs are often vague People may experience mild fatigue episodes of brain fog or occasional abdominal discomfort and dismiss them as stress or poor sleep Symptoms such as jaundice swelling of the legs or fluid accumulation in the abdomen often appear only after substantial liver damage has already occurred India continues to carry a considerable Hepatitis C burden with an estimated 55 million people living with chronic infectionThe myth that Hepatitis C only affects ldquohighriskrdquo groupsOne of the biggest barriers to prevention is perception Dr Deepak Kulkarni consultant laparoscopic surgeon and coloproctologist at Apollo Clinic says misconceptions continue to stop people from taking Hepatitis C seriously He shares ldquoThere are many people with the false idea that only the elderly or those with serious problems can get infected by the Hepatitis C virusrdquo That assumption can create a dangerous sense of immunity among younger adultsKulkarni stresses that age itself offers no protection ldquoA person may feel completely healthy and still carry the virusrdquo Another common misunderstanding is the belief that symptoms would automatically appear if infection were present ldquoThatrsquos not true either a lot of people go for years with Hepatitis C and arenrsquot sick at allrdquoDuring those silent years liver injury continues Many people also remain unaware that treatment has changed dramatically Some continue to assume Hepatitis C cannot be cured a belief rooted in older treatment experiences rather than current medicineDr Kulkarni says that outdated perception no longer reflects reality The everyday exposures younger adults often overlook When people think about Hepatitis C transmission they often imagine only injection drug use or highrisk sexual behaviour Experts say this narrow understanding misses many realworld situationsAccording to Dr Borkar Hepatitis C spreads strictly through bloodtoblood contact It is not transmitted through food water hugging coughing or casual social interaction But blood exposure can occur in unexpected waysPotential sources include reused razors at barber shops where microscopic cuts may introduce infected blood Unsafe injection practices continue to remain a concern in some settings People who received blood transfusions before June 2001 prior to mandatory blood screening may also carry riskDental procedures performed with inadequate sterilisation deserve attention as well Borkar highlights the growing popularity of tattoos and piercings among younger populations Unregulated tattoo studios may appear hygienic while still failing critical sterilisation standardsSharing personal grooming items such as razors toothbrushes and nail clippers can also become problematic because microscopic traces of blood may remain unnoticedEven though sexual transmission is possible Dr Borkar notes that it remains relatively uncommon and usually requires situations involving blood exposureTattoos cosmetic procedures and the hidden hygiene gap Body art and cosmetic procedures have become increasingly mainstream but experts caution that aesthetics should never come before safety Borkar says concerns around unregulated tattoo studios microblading services and cosmetic procedures are legitimateWhen procedures are performed in regulated environments using disposable needles autoclave sterilisation and singleuse materials infection risk remains extremely lowThe problem begins when shortcuts are taken even if equipment appears visually clean Hepatitis C may survive outside the body for up to sixteen hours That means inadequate sterilisation can still create transmission risk The same concerns extend beyond tattooing Permanent makeup procedures manicures pedicures and cosmetic treatments involving skin penetration require proper hygiene standardsConsumers should expect sealed needles to be opened in front of them Facilities should use disposable supplies wherever possible and maintain visible sterilisation practices Staff should wear fresh gloves Dr Borkar advises avoiding any establishment that relies only on rinsing instruments or wiping them with alcoholDr Kulkarni echoes this message Before undergoing any tattoo piercing or cosmetic treatment he recommends choosing licensed facilities confirming that needles are new and singleuse and asking questions about infection control practices Roadside stalls or informal providers should be avoided regardless of cost advantagesWho should consider getting testedExperts increasingly argue that Hepatitis C testing should move beyond narrow definitions of risk Borkar puts it bluntly ldquoThe question today is no longer Who should get screened but rather Who shouldnrsquotrdquoPriority groups includebull People who received blood transfusions before 2001bull Individuals with a history of injection drug use even oncebull Patients receiving haemodialysisbull People living with HIV or Hepatitis Bbull Healthcare workers exposed through needlestick injuriesbull Individuals with unexplained liver enzyme abnormalitiesbull People with tattoos or cosmetic procedures performed in questionable settingsbull Individuals exposed to unsafe injection practicesbull Family members where bloodsharing exposures may occurDr Borkar also highlights adults over 40 years of age and those aged 3544 as age groups that account for a large proportion of chronic infectionsDr Kulkarni adds that people born to mothers with Hepatitis C and individuals who have had potential blood contact with infected individuals should also consider testing Importantly symptoms should not determine whether someone gets tested ldquoPeople without symptoms may still carry the virus A simple blood test can identify infection before serious complications develop The treatment revolution that changed everything For decades a Hepatitis C diagnosis created fear because treatment was difficult prolonged and unpredictablerdquo he saysThat landscape has changed dramatically According to Borkar the biggest breakthrough came with DirectActing Antivirals commonly known as DAAs Earlier treatment relied on Interferon and Ribavirin Those therapies lasted up to fortyeight weeks and frequently caused severe fatigue anaemia depression and flulike symptomsFor Indiarsquos predominant genotype 3 strain cure rates remained only around 40 to 50 per cent Since 2014 antiviral treatment has transformed outcomes DAAs directly interrupt viral replication and make treatment shorter simpler and significantly more effectiveToday treatment generally lasts only eight to twelve weeks Side effects are usually mild and often limited to headaches or fatigue Most importantly cure rates now exceed 95 per cent Borkar notes that India benefits from access to affordable generic medicines including sofosbuvir velpatasvir ledipasvir and daclatasvir Treatment costs have reduced substantially and government programmes under the National Viral Hepatitis Control Programme provide medicines free of cost for eligible patientsIndian studies have reported cure rates ranging from 912 to 981 per cent matching outcomes seen internationally For patients diagnosed today Hepatitis C has become one of the most treatable viral diseasesWhat to do if your test comes back positiveReceiving a positive result can feel overwhelming but experts emphasise that panic is unnecessary Dr Kulkarni says the first step is consultation with a liver specialist or gastroenterologist ldquoAdditional blood tests and imaging may be needed to evaluate liver health before selecting treatmentMost patients begin antiviral therapy that lasts between eight and twelve weeks Success depends heavily on completing treatment as prescribed and attending followup appointmentsrdquoLifestyle choices also matter according to experts Patients are generally advised to avoid alcohol prioritise nutrition maintain physical activity where appropriate and support overall liver health during treatment The earlier treatment begins the greater the opportunity to prevent longterm complications Even patients who already have cirrhosis benefit because treatment reduces ongoing damage and lowers future cancer riskFeeling healthy does not always mean being healthyHepatitis C remains one of medicinersquos quietest infections People can live for years without symptoms while liver damage continues silently which is exactly why awareness mattersThe goal is not fear It is recognition that everyday decisions where we get a tattoo how carefully procedures are performed whether we share grooming tools and when we choose testing influence longterm healthToday Hepatitis C is preventable detectable and in most cases curable but cure begins with one thing that many people still postpone getting tested If there is uncertainty about past exposure do not wait for symptoms The liver rarely complains early Listening before it does may make all the difference