Risk factors associated with hepatitis B virus infection among patients attending gastroenterology outpatient department at public hospitals in Northeast Ethiopia: a hospital-based unmatched case-control study.

backgroundHepatitis B virus (HBV) infection is a major global health issue. Ethiopia is among the high endemic areas, with prevalence of infection more than 8%. However, data regarding factors associated with its acquisition in the study area is scarce. Therefore, this study aimed to explain factors associated with acquisition of HBV.

methodsA hospital-based unmatched case-control study was conducted in two government hospitals in Northeast Ethiopia, both of which serve as treatment centers for hepatitis. The source population included adult patients visiting the gastroenterology outpatient departments of these hospitals. A total of 288 participants were selected consecutively from June to December 2023. Data were collected using a structured questionnaire from cases; those with hepatitis B virus infection, or hepatitis B surface antigen (HBsAg) positive and controls; those who did not have hepatitis B infection, or HBsAg negative. Data analysis was performed by STATA version 17 for description statistics, bivariate and multivariable logistic regression to evaluate predictable variables for possible risk of HBV infection.

resultsA total of 288 participants (96 cases and 192 controls) were included. The median age of participants was 30 years. The proportion of females was higher among cases than controls (71.8% vs. 52.0%). A higher proportion of cases had multiple lifetime sexual partners (36.5% vs. 26%), a family history of hepatitis (40.6% vs. 20.3%), and a history of tattoos or ear piercing (74% vs. 36%). Multivariable analysis identified multiple sexual partners (AOR = 2.07; 95%CI: 1.07-4.00), traditional practices; tattooing, ear piercing, tonsillectomy; (AOR = 6.43; 95%CI: 3.12-13.23), and family history of hepatitis (AOR = 2.83; 95% CI: 1.48-5.42) as significant risk factors. Regarding age, higher proportion of infection is at age below35 years and a downward trend was noted as age increases. Among the cases, the proportion of females is higher than that of males (71.8 vs. 22.7%; P = 0.001).

conclusionMultiple sexual partners, family history of hepatitis, and traditional practices such as tattooing, ear piercing, and sharing sharps were strongly associated with HBV infection. Public health efforts should specifically target these individuals to address the identified risk factors and halt transmission dynamics. The greater number of cases below 35 years, and females with a decreasing tendency with age may be due to early disease progression and reduced survival rates among older individuals and males. This emphasizes there should be an expansion of early screening, especially for at-risk populations, to limit the progression of HBV. CLINICAL TRIAL NUMBER: Not applicable.