Prevalence of hearing loss and other ear disorders among patients with hepatitis B infection: a nationwide retrospective Polish cohort study

Reports from Asian populations have suggested that chronic hepatitis B virus (HBV) infection may predispose patients to hearing impairment, particularly sudden sensorineural hearing loss, yet evidence from Europe has been lacking. To address this gap, we conducted a nationwide, retrospective analysis of the prevalence of ear and hearing disorders among patients hospitalized with HBV infection in Poland between 2012 and 2023, using the national hospital discharge database. Hospital records with ICD-10 codes for acute or chronic HBV infection were examined, and cases with concomitant ear or hearing disorders were identified. In total, 80,181 HBV-related hospitalizations were recorded, of which 36.6% represented first-time admissions, while the remainder were repeat hospitalizations. Diagnoses of hearing loss were rare, occurring in only 0.05% of first-time and 0.04% of all hospitalizations, and all affected patients were adults. Hearing loss diagnoses, including those encompassing both conductive and sensorineural forms, were exceptionally uncommon. Notably, conditions most frequently discussed in the context of HBV, such as sensorineural hearing loss, were rare and showed no tendency to recur across repeated admissions. Importantly, the prevalence of hearing disorders in this HBV-infected cohort was substantially lower than that reported for the general population, suggesting no increased prevalence of auditory disorders among patients with HBV infection in this setting. These findings indicate that, in contrast to observations from parts of Asia, chronic HBV infection is not associated with an increased prevalence of hearing impairment in this European population. Discrepancies with Asian studies likely reflect multiple regional factors, including differences in HBV genotype distribution, disease characteristics, healthcare practices, and host or environmental influences, rather than genotype alone.