Hepatitis B prevalence reaches 41.9% in Ethiopian chronic liver disease patients

A facility-based cross-sectional study found hepatitis B virus infection in 41.9% of patients with chronic liver disease treated at three public referral hospitals in Bahir Dar, Northwest Ethiopia. Researchers assessed 320 patients from October 2023 through January 2024, combining structured questionnaires, physical examinations and medical-chart reviews. HBsAg positivity, indicating the presence of hepatitis B surface antigen, was identified in 134 participants, giving a prevalence of 41.9% with a 95% confidence interval of 36.5% to 47.5%.

The hospital-based design establishes the burden among people already receiving care for chronic liver disease, but it does not show whether hepatitis B caused their underlying liver disease or how common infection is in the wider regional population. The study focused on patients with established chronic liver disease, a group described in the research as vulnerable to acute or superimposed hepatitis B infection. The authors noted that such infections can trigger rapid hepatic decompensation, accelerate progression toward cirrhosis and increase the lifetime risk of neoplastic transformation.

Its primary result was the prevalence of HBsAg positivity and the statistical associations between this status and reported or recorded characteristics. Multivariable binary logistic regression identified several characteristics associated with positive HBsAg status. HIV-positive participants had three times the adjusted odds of positivity compared with HIV-negative patients, with an adjusted odds ratio of 3.00 and a 95% confidence interval of 1.40 to 6.80.

A family history of liver disease was associated with 4.70 times the adjusted odds, with a 95% confidence interval of 1.90 to 11.00, while a history of dental procedures was associated with 4.50 times the adjusted odds, with a 95% confidence interval of 2.00 to 10.00. Contact with a person who had jaundice was also associated with higher odds of positivity, with an adjusted odds ratio of 2.40 and a 95% confidence interval of 1.20 to 4.80. These are associations in the sampled population, not evidence that any listed exposure transmitted the virus.

Because hepatitis B prevalence was high in the study population, the investigators also applied a modified Poisson regression model with robust variance to complement the odds-ratio estimates with adjusted prevalence ratios. In that model, HIV-positive status was associated with an adjusted prevalence ratio of 1.68, with a 95% confidence interval of 1.20 to 2.35. Family history of liver disease was associated with a ratio of 1.76, with a 95% confidence interval of 1.29 to 2.40.

Contact with a jaundiced person had an adjusted prevalence ratio of 1.48, with a 95% confidence interval of 1.14 to 1.92, and a history of dental procedures had a ratio of 1.62, with a 95% confidence interval of 1.21 to 2.17. The logistic and modified Poisson analyses pointed in the same direction for these four predictors. Post-hoc power calculations indicated greater than 85% statistical power for the primary multivariable predictors.

That calculation was performed after model fitting and does not eliminate uncertainties associated with the sample size, model specification, confounding or the cross-sectional design. In particular, the study cannot establish the timing or route of infection, determine whether identified characteristics preceded HBsAg positivity, or measure changes in prevalence over time. The referral-hospital setting also limits generalization: the participants were patients attending selected public facilities in Bahir Dar, rather than a population-based sample representing all people with chronic liver disease in Northwest Ethiopia.

Within those limits, the 41.9% estimate documents a substantial hepatitis B burden among the chronically ill patients attending the three hospitals during the study period. The hospital sample included patients with chronic liver disease, so the result should not be presented as a regional prevalence estimate for the general population. Nor does the cross-sectional analysis demonstrate that HIV, family history, dental procedures or contact with a jaundiced person caused infection.

The adjusted estimates identify groups with higher observed prevalence in this clinical setting, while their confidence intervals show the degree of precision around each association. The authors proposed that the results may inform regional planning for hepatitis B screening within liver clinics, evaluation of targeted adult vaccination strategies and stronger use of standard infection-control measures in health facilities. The immediate research contribution is instead a cross-sectional measurement of HBsAg prevalence and its reported correlates among 320 chronic liver disease patients in a defined Ethiopian hospital network.

For interpreting the results, the study type and population are central. It was a facility-based, cross-sectional assessment conducted from October 2023 to January 2024, not a longitudinal study or a clinical trial. Its strongest supported conclusion is that hepatitis B infection was common among the sampled chronic liver disease patients, with HIV positivity, family history of liver disease, dental-procedure history and contact with a jaundiced person each associated with higher adjusted prevalence or odds of HBsAg positivity.

Subject of Research: Prevalence and associated factors of hepatitis B virus infection among chronic liver disease patients in Bahir Dar, Ethiopia

Article Title: High burden of Hepatitis B virus infection among chronic liver disease patients in Northwest Ethiopia: a cross-sectional study (2023–2024)

Article References: Mekonen, S., Molla, M., & Ayele, Y. Y. (2026). High burden of Hepatitis B virus infection among chronic liver disease patients in Northwest Ethiopia: a cross-sectional study (2023–2024). BMC Infectious Diseases. https://doi.org/10.1186/s12879-026-14312-4

Image Credits: AI Generated

DOI: 10.1186/s12879-026-14312-4

Keywords: hepatitis B, HBV, chronic liver disease, Bahir Dar, Ethiopia, cross-sectional study, HBsAg, HIV, prevalence, public hospitals, High, burden