The silent infection moving through Kashmir households

On World Hepatitis Day, doctors in Kashmir warn that hepatitis B and C often remain undetected for years, with many patients discovering the infection only through routine tests

On a cold April morning, 29-year-old Aafan walked into a hospital in Srinagar expecting nothing more than a formality.

He needed a medical clearance before his visa application to Dubai, where a new job awaited him.

The blood draw took a few minutes. The results took a day, and they changed the direction of his life.

He tested positive for hepatitis B, a viral infection that can inflame and scar the liver for years without producing a single symptom.

Doctors told him to bring in his family for screening. What followed left him shaken.

“What came as an even bigger shock was that four out of our 10 family members also tested positive for hepatitis B,” Aafan said, asking that his real name be withheld. “It was a nerve-racking moment for our family. We were immediately started on treatment.”

His story is becoming common in Kashmir, where hepatologists describe a disease that spreads largely unseen until a visa screening, a pre-employment checkup, or an unrelated hospital visit exposes it.

Hepatitis B and C, transmitted through infected blood and body fluids, often settle into the body for decades before symptoms surface, by which point some patients have already developed cirrhosis or liver cancer.

Hepatitis A and E, spread through contaminated food and water, tend to cause shorter, more visible illness.

Hepatitis D infects only people already carrying hepatitis B, worsening the underlying disease.

“Most of the hepatitis B and C patients we diagnose are completely asymptomatic,” said Dr. Ajeet Singh Bhadoria, a hepatologist who serves on multiple World Health Organization and national expert committees on liver disease.

“They come to us for routine health check-ups, pre-employment or visa screening, blood donation, or unrelated medical investigations, and that is when we discover the infection.”

The figures he cites paint a stark picture of a society caught off guard.

Hepatitis B affects roughly 2.5 percent of Kashmir’s population, close to the national figure. Hepatitis C affects nearly 2.1 percent, almost double the countrywide average.

Behind those percentages sit thousands of people going about their lives, unaware that a virus is working on their livers.

Haris, 35, learned of his infection in a setting built entirely around helping someone else.

After seeing an online appeal for an A-positive blood donor for a sick child at Srinagar’s Children Hospital, he rushed in to give blood. The screening that followed found hepatitis B in his own bloodstream.

“I had gone there to save someone’s life, but instead found myself beginning treatment for the infection,” Haris told Free Press Kashmir.

Doctors traced the likely source to a dental procedure he had undergone a year earlier, one detail among many that illustrates how easily the virus passes between people through blood contact that seems routine and harmless at the time.

Dr. Bhadoria said people who inject drugs, healthcare workers, dialysis patients, those needing repeated blood transfusions, individuals with high-risk sexual exposure, and infants born to infected mothers face the greatest danger.

He urged regular testing for those groups, and something broader for everyone else. “Every adult should get tested for hepatitis at least once in their lifetime,” he said.

Solid district-by-district data remains scarce, though localized studies point to a heavier burden in parts of North and South Kashmir, particularly Anantnag, Pulwama and Shopian.

Bhadoria cautioned against reading too much into those figures, since they come from limited surveys rather than comprehensive regional comparisons.

He also pushed back against a popular theory linking the annual Amarnath Yatra or general tourism to rising hepatitis B or C numbers, noting that both viruses spread through blood and body fluids rather than crowds.

“Large gatherings do raise the odds of hepatitis A and E outbreaks,” he said, “when sanitation around food and drinking water breaks down under the weight of so many visitors.”

What troubles doctors most is how little the public understands about the disease itself.

Bhadoria said many Kashmiris still conflate jaundice with hepatitis, unaware that jaundice is merely a symptom while hepatitis is one of several conditions capable of causing it.

“Few know that a vaccine exists for hepatitis B,” the medic says, “or that the infection can progress for years without any outward sign of trouble.”

There is, however, real reason for hope once someone is diagnosed.

Hepatitis B cannot usually be cured outright, but modern medication suppresses the virus, slows liver damage, and lowers the odds of passing the infection to others.

Hepatitis C, by contrast, can now be cured entirely with antiviral drugs when caught and treated early.

Screening, diagnosis, and treatment are available free through the National Viral Hepatitis Control Programme, with designated centers operating in every district of Kashmir.

For Aafan, the diagnosis changed the course of his life and brought his entire family into treatment. And for Haris, an act of generosity became an unexpected discovery about his own health.

Their experiences underline what doctors like Bhadoria say time and again: hepatitis B often goes unnoticed until it has already affected the liver.

“Hepatitis is often a silent disease,” Bhadoria said. “Every adult should get tested for hepatitis at least once. If you test positive, seek treatment. If you test negative, get vaccinated against hepatitis B. Early detection and timely treatment remain our best tools to prevent serious liver disease.”