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

Abstract Background Hepatitis B virus (HBV) remains a global health burden despite widespread vaccination efforts. This nationwide serosurvey aimed to assess Hepatitis B surface antibody (HBsAb) seropositivity in Israel and HBV/ Hepatitis D virus (HDV) prevalence among immigrant populations, in the context of universal HBV vaccination introduced nationally in 1992. Methods A representative sample of 2,423 individuals was collected in 2023, and screened for HBsAb. Hepatitis B surface antigen (HBsAg) prevalence was assessed in additional 1,000 samples of selected immigrant populations, and positive samples were screened for HDV. Data were analyzed by age, sex, ethnicity, and socioeconomic status. Results Overall HBsAb seropositivity was 42.8% (95% CI: 40.9–44.8%). HBsAb seropositivity was significantly higher in individuals born after in or after 1992 compared to those born before (49.2% vs. 36.0%, p < 0.0001). Significant disparities were observed: lower socioeconomic status and peripheral residency were associated with lower HBsAb seropositivity (compared to high SES: OR = 1.51, 95% CI: 1.29–1.78; and Central residency: OR = 1.61, 95% CI: 1.23–2.09). Ethnic differences were prominent, with Jews and other minorities population showing higher rates in younger cohorts, while Arab population had higher rates in older populations. HBsAg prevalence was high (9%) among immigrants from Ethiopia as well as from Ukraine, with HDV coinfection detection in 8.2% of HBsAg carriers from Africa. Conclusions While vaccination program has been effective, significant HBsAb and HBsAg seroprevalence gaps persist in the adult population and specific socio-demographic groups., Screening strategies should be considered, particularly for high-risk immigrants and specific immigrant populations.