Ask most Nigerians to name the world’s deadliest diseases, and you will probably hear malaria, HIV, cancer or diabetes. Hepatitis rarely comes up.

That is surprising because viral hepatitis kills about 1.3 million people every year, making it one of the deadliest infectious diseases in the world. It claims almost as many lives annually as tuberculosis, yet it hardly gets the same level of public attention.

The biggest reason is simple. Hepatitis is good at hiding. Unlike illnesses that make people feel sick almost immediately, hepatitis can quietly damage the liver for years without giving any clear warning signs. Many people continue with work, raise families and go about their daily lives without knowing anything is wrong until the disease has reached a dangerous stage.

That is the reality behind World Hepatitis Day, observed every 28 July. It is a reminder that while medicine has made huge progress against hepatitis, millions of people are still being diagnosed far too late.

This year’s theme, “Hepatitis: Let’s Break It Down,” is the World Health Organisation’s call to remove the financial, social and healthcare barriers that stop people from getting tested and treated.

The challenge remains enormous. According to the WHO, 287 million people were living with chronic hepatitis B or C in 2024, while 28 million people in the Eastern Mediterranean Region alone are currently living with the disease. Despite better vaccines and treatments, the world is still not on track to eliminate viral hepatitis as a public health threat by 2030.

The virus that gives you no reason to worry

One of the reasons hepatitis continues to catch people off guard is that it does not behave the way most people expect serious illnesses to behave. Malaria usually comes with fever. Food poisoning can leave you vomiting within hours. Even many long-term illnesses eventually force people to seek medical help because something feels wrong.

Hepatitis B and hepatitis C can be completely different. Someone can live with the virus for 10, 20 or even 30 years without feeling ill. All that time, the liver keeps doing its job while the infection quietly causes damage in the background.

When symptoms finally appear, they often arrive late. Constant tiredness, yellowing of the eyes, swollen legs, a swollen stomach or unexplained weight loss may not be the beginning of the illness. They may be signs that the liver has already suffered serious damage.

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That is why doctors often describe hepatitis as a silent killer. Many people only find out they have it while donating blood, applying for a new job, preparing for surgery or going for a routine medical check-up. It is not unusual for someone to feel perfectly healthy on the outside while their liver has been under attack for years.

The frustrating part is that this story is now largely preventable. A vaccine can protect people against hepatitis B. Hepatitis C can now be cured in more than 95 percent of cases with antiviral medicines taken for about eight to 12 weeks. For people living with hepatitis B, treatment can greatly reduce the risk of liver failure and liver cancer.

The tools are already available. The problem is that too many people never get the chance to use them because they do not know they are infected.

Why Nigerians should not ignore hepatitis

Although this year’s WHO figures focus on the Eastern Mediterranean Region, Nigeria has every reason to pay attention.

The country has one of the highest hepatitis B burdens in Africa. Health authorities estimate that between 8 million and 12 million Nigerians are living with chronic hepatitis B, while millions of others are affected by hepatitis C. Yet awareness remains low, and many people have never been tested.

Part of the problem is misinformation. Some people believe hepatitis is caused only by excessive alcohol consumption. Others think it affects only older people. Neither is true.

Hepatitis B spreads through infected blood and body fluids. A mother can pass it to her baby during childbirth if the right preventive measures are not taken. The virus can also spread through unsafe injections, poorly sterilised medical equipment and the sharing of razors, clippers and needles.

The good news is that many of these infections can be prevented. According to the WHO, vaccination remains one of the strongest defences against hepatitis B. Yet only 45 percent of babies worldwide received the hepatitis B birth-dose vaccine within their first 24 hours of life in 2024, leaving millions of newborns at risk.

Improving vaccination, making testing easier and ensuring more people can access treatment remain some of the biggest steps countries must take if they hope to eliminate hepatitis as a public health threat.

A simple test could save your life

Perhaps the most important message from this year’s World Hepatitis Day is that hepatitis is no longer a disease medicine cannot fight. It is becoming a disease that far too many people simply do not know they have.

The science is already there. Vaccines work. Reliable tests exist. Effective treatments can prevent complications and, in the case of hepatitis C, even cure the infection. For many Nigerians, the next step is surprisingly simple. Most people know their blood group. Many know their genotype. Very few know their hepatitis status.

Yet a simple blood test could detect the virus years before it develops into liver cirrhosis, liver failure or liver cancer. Sometimes the biggest threat to your health is not the illness that makes the loudest noise. It is the one that quietly keeps working in the background while you believe everything is fine.

Cynthia Nwanonyiri