Deniz Armağan DENİZ, Mehmet Hadi YAŞA, Sevin KIRDAR, İmran KURT ÖMÜRLÜ
Meandros Medical and Dental Journal - 2026;27(3):501-508
Objective: Hepatitis B virus (HBV) infection remains a major cause of chronic liver disease worldwide. This study aimed to describe the seroprevalence of hepatitis B and D markers in HBsAg-positive patients followed in a tertiary hepatology clinic and to identify clinical factors independently associated with HBV-related cirrhosis. Materials and Methods: This single-centre retrospective cohort study included 603 consecutive HBsAg-positive adults who attended the gastroenterology and hepatology outpatient clinics between May 2015 and May 2017. Patients were classified, in accordance with EASL 2017 criteria, as inactive HBV carriers, chronic hepatitis B (CHB) or HBV-related cirrhosis. Demographic data, alcohol and tobacco habits, and comorbidities were extracted from electronic medical records. Factors independently associated with cirrhosis were identified by multivariable binary logistic regression. Results: Mean age was 49.1 +/- 14.7 years and 57.5% were male. Patients were classified as inactive carriers in 35.5% (n=214), CHB in 42.1% (n=254) and HBV-related cirrhosis in 22.4% (n=135; compensated 53.3%, decompensated 46.7%). HBeAg was detected in 17.1%, anti-HBe in 82.8% and anti-HDV in 13.7% of the cohort. HBV-DNA exceeded 2,000 IU/mL in 63.8% of patients. Both HBV-DNA load and anti-HDV positivity were significantly higher in cirrhotic patients than in the other groups (p<0.001 and p=0.014). In multivariable analysis, advanced age (adjusted OR 1.08 per year, 95% CI 1.06-1.11), male sex (aOR 2.21, 1.34-3.65), diabetes mellitus (aOR 3.16, 1.78-5.62) and anti-HDV positivity (aOR 3.43, 1.74-6.77) were independently associated with cirrhosis. Daily alcohol consumption was significantly more frequent in cirrhotic than in non-cirrhotic patients (18.6% vs 4.2%, p=0.001). Conclusion: In this hospital-based cohort of HBsAg-positive adults, older age, male sex, diabetes mellitus and anti-HDV positivity were independently associated with cirrhosis, and daily alcohol use may further increase its prevalence. These findings underline the importance of routine HDV screening in all HBsAg-positive individuals and of structured metabolic and lifestyle assessment in HBV care.
