HBsAb, HBsAg and HDV prevalence across Israeli sociodemographic groups

A nationally representative Israeli survey found hepatitis B surface antibody seropositivity in 42.8% of 2,423 people tested in 2023, with substantial differences by birth cohort, ethnicity, socioeconomic status and place of residence. The study also screened 1,000 additional samples from selected immigrant populations: hepatitis B surface antigen was detected in 9% of samples from immigrants from Ethiopia and from Ukraine, while hepatitis D virus was found in 8.2% of HBsAg-positive carriers from Africa.

The research combined a population-wide serosurvey with targeted testing among selected immigrant communities. Investigators screened the nationally representative sample for hepatitis B surface antibodies, or HBsAb, and analyzed results by age, sex, ethnicity, socioeconomic status and residential setting. In the separate immigrant sample, they assessed hepatitis B surface antigen, or HBsAg, and screened HBsAg-positive samples for hepatitis D virus, or HDV. The two components therefore measured different outcomes in different populations and were not equivalent to a uniform national survey of HBsAg and HDV prevalence.

HBsAb seropositivity was 49.2% among people born in or after 1992, when universal hepatitis B vaccination was introduced nationally, compared with 36.0% among those born before that year, a difference reported as p < 0.0001. The results also showed lower antibody positivity among people with lower socioeconomic status and among those living in peripheral areas. For the comparisons reported by the researchers, the odds ratio was 1.51 for high versus low socioeconomic status, with a 95% confidence interval of 1.29–1.78, and 1.61 for central versus peripheral residency, with a 95% confidence interval of 1.23–2.09. Ethnic patterns also varied with age: Jewish and other minority populations had higher rates in younger cohorts, whereas the Arab population had higher rates among older participants. These were cross-sectional associations, and the reported data do not establish that vaccination, ethnicity, socioeconomic conditions or residence caused the observed differences.

Among the selected immigrant samples, HBsAg prevalence was 9% among people from Ethiopia and 9% among people from Ukraine. Among HBsAg-positive carriers from Africa, 8.2% also tested positive for HDV. The reported estimate applies to the African carrier group represented in the study and should not be interpreted as a separate prevalence value for every African population. Moreover, because the immigrant component included selected populations rather than a nationally representative sample covering all origins, the study does not establish a comprehensive prevalence of HBsAg or HDV among all immigrants in Israel.

The findings show that the national vaccination program coincided with higher HBsAb seropositivity in the younger birth cohort, while important seropositivity gaps remained across demographic and social groups. The targeted immigrant results further document HBsAg prevalence in Ethiopian and Ukrainian samples and HDV coinfection among African HBsAg-positive carriers. The investigators concluded that screening strategies should be considered, particularly for high-risk immigrants and specified immigrant populations, while the study’s cross-sectional design and selected sampling limit conclusions about causes, changes over time and population-wide prevalence.

Subject of Research: Hepatitis B seroprevalence and hepatitis D coinfection across Israeli demographic and immigrant populations

Article Title: National HBsAb serosurvey and HBsAg/Hepatitis D coinfection prevalence across sociodemographic and immigrant populations in Israel

Article References: Yael, G., Keren, A., Lital, K.-B., Shoshana, A. S., Orit, P., Orna, M., & Ravit, B. (2026). National HBsAb serosurvey and HBsAg/Hepatitis D coinfection prevalence across sociodemographic and immigrant populations in Israel. BMC Infectious Diseases. https://doi.org/10.1186/s12879-026-14403-2

Image Credits: AI Generated

DOI: 10.1186/s12879-026-14403-2

Keywords: hepatitis B, hepatitis D, HBsAb, HBsAg, serosurvey, viral infections, immigrant health, Israel, socioeconomic disparities, national vaccination, National, Hepatitis