Seroprevalence and risk factors of Hepatitis B virus infection among diabetic patients in Bahir Dar, Ethiopia

Hepatitis B virus (HBV) infection remains a major global health problem, with a disproportionately high burden in low- and middle-income countries. Due to frequent healthcare exposure and impaired immunity, people with diabetes mellitus (DM) are more likely to acquire HBV. Despite this, there is a lack of information regarding the seroprevalence and the risk factors HBV among diabetes patients This study aimed to determine the seroprevalence of Hepatitis B virus infection and identify associated factors among diabetes mellitus patients attending the diabetic clinic in Bahir Dar, Northwest Ethiopia. A hospital-based cross-sectional study was conducted among 323 diabetes mellitus patients attending diabetic clinic in Bahir Dar, Northwest Ethiopia from August 1, 2025, to October 30, 2025. Data on sociodemographic characteristics, sexual and clinical history, and HBV-related knowledge were collected using structured questionnaires. Blood samples were analyzed for hepatitis B surface antigen (HBsAg) using SNIBE maglumi machine. Binary and multivariable logistic regression analyses were performed to identify factors associated with HBV infection. Statistical significance was set at p < 0.05. The prevalence of HBsAg was 10.5% (95% CI 7.5–14.4%), placing the study population within the high-intermediate endemicity category according to WHO criteria. HBV infection was significantly associated with marital status, with those who were single (aOR = 3.45; 95% CI 1.21–9.85) and divorced/widowed (aOR = 2.30; 95% CI 1.01–5.27) having greater odds. HBV positive was independently linked to poor glycemic control (aOR = 2.40; 95% CI 1.12–5.14). Lack of HBV vaccination (aOR = 2.85; 95% CI 1.05–7.76) was behavioral factor that also markedly increased the risk of infection and having one lifetime sexual partners (aOR = 0.22; 95% CI 0.08–0.61) was a protective factor for HBV infection. The highest association was found with a family history of hepatitis infection (aOR = 15.20; 95% CI 5.85–39.48). HBV infection is highly prevalent among diabetic patients in the study area. Significant predictors of HBV infection included marital status, poor glycemic control, one sexual partner as protective, lack of hepatitis vaccine, and a family history of hepatitis. Reducing the HBV burden in this high-risk population requires strengthening HBV vaccination programs, enhancing glycemic control, and putting in place focused health education on sexual and household transmission risks.