Over time, important causes are often recognized with official annual observances to raise awareness and encourage public engagement. World Hepatitis Day, held on July 28, is one such example. It was designated by the World Health Organization (WHO) in 2010 to raise global awareness of hepatitis and to eliminate hepatitis through prevention, diagnosis, and treatment.

This day was chosen to commemorate Dr. Baruch Samuel Blumberg, who discovered the hepatitis B virus, for his contributions to making hepatitis virus treatment possible for humanity. However, even today, many people, including myself as a hepatitis expert, are unaware that World Hepatitis Day has been established. In this column, I will explore the causes of hepatitis and liver cancer and reflect on the importance of hepatitis in conjunction with World Hepatitis Day.

Hepatitis refers to any inflammation of the liver, regardless of the cause. Common causes include hepatitis A, B, and C viruses, medications, toxic substances, and alcohol. Among the various causes of hepatitis, acute hepatitis A, which is completely cured, does not progress to cirrhosis or liver cancer in most cases. The problem arises when hepatitis progresses to chronic hepatitis (inflammation lasting six months or longer), with the most common causes being infection with hepatitis B or C viruses. Among these, hepatitis B virus accounts for approximately 70 percent of chronic hepatitis cases in the United States and about 60 percent of cirrhosis cases. Therefore, prevention and treatment of hepatitis B virus infection are essential to reduce the progression to cirrhosis and, ultimately, to reduce the incidence of liver cancer.

Most chronic hepatitis B patients in Korea are infected at birth or before the age of one through vertical transmission from their parents (perinatal or vertical infection). Since 2002, Korea has provided free hepatitis B vaccination for all newborns. Infants born to infected mothers also receive immunoglobulin vaccination, resulting in approximately a 95 percent reduction in vertical transmission.

In addition, treatments for chronic hepatitis B have shown little resistance and prevent the progression to cirrhosis and liver cancer when taken long-term. However, unlike hepatitis C treatments, there are no medications that can cure hepatitis B in the short term, so long-term, continuous use is necessary. Hepatitis C, which accounts for about 10-15 percent of chronic hepatitis in Korea, differs from hepatitis B, which is mainly transmitted through vertical infection, in that half of the cases are caused by exposure to contaminated blood through intravenous drug abuse, needle stick injuries, acupuncture, and tattoos in adults. In adults, about 80 percent of those infected with hepatitis C do not clear the virus naturally and develop chronic hepatitis C. Since there is no vaccine for hepatitis C, preventing exposure to contaminated blood is the most important preventive measure. Hepatitis C can be cured in 95 percent of patients with just two to three months of medication, so early diagnosis and treatment before progression to cirrhosis or liver cancer are of utmost importance.

Thanks to the efforts of the Korean Association for the Study of the Liver and the Korean Liver Cancer Association, starting in 2025, all citizens will be able to receive a hepatitis C antibody test as part of the national health screening program when they turn 56 years old. Additionally, if the antibody test results are positive, individuals can receive a confirmatory hepatitis C test (RNA test) free of charge at nearby hospitals or clinics. The World Health Organization aims to eliminate hepatitis C by 2030 through the prevention of transmission, early detection, and treatment.

In Korea, as the number of hepatitis C patients who have been cured increases, the number of patients visiting liver specialists has decreased significantly. However, since over 80 percent of liver cancer patients have cirrhosis, it is true that surveillance tests for early detection of liver cancer are often neglected in cases of chronic hepatitis that have not progressed to cirrhosis. However, in the case of chronic hepatitis B, liver cancer can develop without progressing to cirrhosis, so the same surveillance tests for liver cancer are necessary as for cirrhosis. Additionally, even after being cured of hepatitis C, liver cancer can develop later, so regular liver cancer screenings are necessary even after treatment.

In conclusion, chronic hepatitis can progress to cirrhosis and liver cancer, posing a life-threatening condition. Through prevention, early diagnosis, and treatment, it is possible to ultimately reduce liver cancer-related mortality. July 28, World Hepatitis Day, is crucial for raising awareness about hepatitis and taking proactive steps to address the issue on a national scale.