Environmental Stressors and Viral Hepatitis: Rethinking Disease Ecology in an Era of Climate Change

Abstract

Viral hepatitis remains a major global public health challenge, with hepatitis A–E viruses causing substantial morbidity and mortality despite advances in vaccination, antiviral therapy, and surveillance. Increasing evidence suggests that environmental stressors—including climate change, air and water pollution, chemical contaminants, land-use change, urbanization, and biodiversity loss shape the disease ecology of viral hepatitis by influencing transmission, host susceptibility, disease progression, and health outcomes. This review synthesizes current evidence on the ecological determinants of viral hepatitis, the biological mechanisms linking environmental exposures to liver injury, virus-specific environmental interactions, and the potential of One Health, wastewater- based epidemiology, GIS, remote sensing, artificial intelligence, and environmental surveillance to strengthen hepatitis prediction and control. The review also identifies key knowledge gaps and future research priorities, emphasizing the need for interdisciplinary and climate-resilient public health strategies. Integrating environmental management with hepatitis prevention and control will be essential for achieving the WHO goal of eliminating viral hepatitis as a public health threat by 2030, particularly in vulnerable countries such as India.