A virus that remains silent for years: how to recognize hepatitis before the development of cirrhosis

      On July 28, the World Hepatitis Day is celebrated. Its goal is to draw attention to one of the most dangerous liver diseases, which often develops almost asymptomatically and remains unnoticed for a long time. Meanwhile, without timely treatment, viral hepatitis can lead to cirrhosis, liver cancer, and other severe complications.

      Elena Tikhomolova, the chief freelance specialist in infectious diseases of the Ministry of Health of the Nizhny Novgorod Region, explained why the disease is called insidious, what symptoms should not be ignored, and how to reduce the risk of infection.

      The dangers of hepatitis

      According to the specialist, hepatitis is an inflammation of the liver, during which the cells of the organ are gradually destroyed. The causes of the disease can be not only viruses but also alcohol abuse, poor nutrition, toxic substances, including some medications, as well as an unhealthy lifestyle.

      In viral hepatitis, doctors distinguish between two forms of the disease - acute and chronic. Acute hepatitis develops immediately after infection and usually lasts up to six months. During this period, the immune system tries to completely eliminate the virus. If this does not happen, the disease can progress to a chronic form. This most often concerns hepatitis B and C.

      Chronic inflammation gradually leads to damaged liver cells being replaced by connective tissue. This is how fibrosis develops. If the process goes too far and a significant part of the organ loses its functions, cirrhosis of the liver forms.

      This is why the disease poses a serious threat. The liver performs many vital functions: it detoxifies toxins and allergens, participates in metabolism, synthesizes hormones and blood coagulation factors, maintains necessary glucose levels, and serves as a kind of blood reservoir. When healthy tissue is replaced by connective tissue, the organ gradually fails to perform its tasks. The final stage can be liver failure, which poses a threat to life.

      Types of viral hepatitis and how infection occurs

      Today, five main hepatitis viruses are known - A, B, C, D, and E. The most severe consequences are most often associated with hepatitis B and C, which can progress to a chronic form.

      The routes of infection transmission vary. Hepatitis A and E are primarily spread through the fecal-oral route - through contaminated water, food, and household contacts.

      Hepatitis B, C, and D viruses are found in human biological fluids - blood, saliva, semen, and vaginal secretions. Infection occurs if the virus enters the bloodstream or comes into contact with damaged skin or mucous membranes.

      The most common risk factors include the use of injectable drugs with shared syringes, unprotected sexual contacts, transmission of infection to a child during childbirth, transfusion of untested blood, as well as getting tattoos, piercings, or manicures using non-sterile instruments. Sharing razors, toothbrushes, and manicure tools can also be a source of infection.

      Symptoms to pay attention to

      Recognizing the disease at an early stage can be difficult. Often, a person only feels increased fatigue, reduced performance, headaches, or muscle pain. These symptoms are associated with the presence of the virus in the body and do not indicate significant liver damage.

      Bright signs usually appear only when the organ is seriously damaged. Patients may develop jaundice, dark urine, skin itching, spider veins, reddening of the palms, abdominal pain, nausea, and vomiting. In severe cases of the disease, bleeding from the esophageal veins, impaired blood coagulation, fluid accumulation in the abdominal cavity, and hepatic encephalopathy - brain damage due to the accumulation of toxic substances - may occur.

      Why it is important to undergo examination

      Specialists recommend not to wait for symptoms to appear but to undergo regular examinations. According to Elena Tikhomolova, chronic viral hepatitis can go unnoticed for years.

      To detect hepatitis B, a blood test for the surface antigen HBsAg is conducted. For diagnosing hepatitis C, an antibody test for the virus (anti-HCV) is performed. Both tests are included in the mandatory health insurance program and can be done for free with a referral from a local therapist.

      However, a positive result for antibodies to the hepatitis C virus does not necessarily mean the presence of chronic disease. It only indicates that the body has ever come into contact with the virus. To confirm the diagnosis, additional testing using the PCR method is necessary to determine the presence of the virus in the blood.

      How to reduce the risk of infection

      Preventive measures can help reduce the risk of infection. For hepatitis A and E, the main importance lies in consuming safe drinking water, maintaining personal hygiene, thoroughly washing vegetables and fruits, and ensuring proper cooking of food.

      For the prevention of hepatitis B, C, and D, it is important to use only sterile instruments for any procedures involving skin damage, to refrain from using injectable drugs, not to share razors, toothbrushes, and manicure tools, to carefully choose medical and cosmetic facilities, to avoid casual sexual contacts, and to use barrier contraceptive methods.

      Additionally, vaccination against hepatitis B remains an effective protective measure. It also prevents infection with the hepatitis D virus.

      At the same time, specialists emphasize that it is impossible to completely eliminate the risk of infection, so regular examinations remain one of the most important measures for maintaining health.

      On the eve of World Hepatitis Day, the NIA "Nizhny Novgorod" editorial team found out that in the first six months of 2026, the incidence of acute viral hepatitis decreased by 53% compared to the same period in 2025. The rate was 1.05 cases per 100,000 residents. This is 22% lower than the average incidence rate in Russia. Additionally, in the Nizhny Novgorod region, the total number of patients with chronic viral hepatitis B and C decreased by 20%.

      Since 2025, a national project "Long and Active Life" has been implemented on the instruction of the President of the Russian Federation, Vladimir Putin. The goals of this project include conducting preventive medical examinations and dispensarization. In turn, the national project "Long and Active Life" aims to increase life expectancy by 2030 and involves updating clinics, outpatient clinics, FAPs, attracting qualified medical personnel to medical institutions, applying new approaches in the prevention, diagnosis, and treatment of chronic diseases, improving emergency medical care and rehabilitation systems, developing a network of national research centers, and digitizing the industry.

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