From the Guidelines
Risk factors for hepatitis include exposure to contaminated blood, sexual contact without protection, and other modes of transmission, as outlined in the most recent guidelines 1. The most recent and highest quality study, published in 2024, identifies the following risk factors for HBV infection: personal or parental history of an intermediate to high prevalence of HBV infection in one’s birthplace, household and sexual contact with HBsAg-positive persons, individuals with multiple sexual partners or history of sexually transmitted diseases, individuals who have been inmates of correctional facilities, patients with chronically elevated aspartate aminotransferase or alanine aminotransferase levels, patients with a history of injection drug use, males who have sex with other males, and patients positive for HCV or HIV 1. Some key points to consider:
- HBV infection can be transmitted through percutaneous or mucous membrane exposure to HBV-infected blood or body fluids 1
- Certain populations face higher risk, including healthcare workers, men who have sex with men, people with HIV, those on hemodialysis, and travelers to regions with high hepatitis prevalence 1
- Understanding these risk factors helps in prevention through vaccination (for hepatitis A and B), practicing safe sex, avoiding needle sharing, and maintaining good hygiene 1 It is essential to note that the risk factors vary by hepatitis type (A through E), with some being primarily bloodborne (B, C) while others spread through contaminated food and water (A, E) 1. Prevention and treatment strategies should prioritize vaccination, safe sex practices, and avoidance of needle sharing to reduce the risk of hepatitis transmission 1.
From the FDA Drug Label
Hepatitis B virus (HBV) reactivation has been reported in HCV/HBV coinfected patients who were undergoing or had completed treatment with HCV direct acting antivirals, and who were not receiving HBV antiviral therapy. Cases have been reported in patients who are HBsAg positive and also in patients with serologic evidence of resolved HBV infection (i.e., HBsAg negative and anti-HBc positive).
The risk factors for hepatitis include:
- Coinfection with HCV and HBV: Patients coinfected with HCV and HBV are at risk of HBV reactivation when undergoing treatment with HCV direct-acting antivirals.
- Lack of HBV antiviral therapy: Patients not receiving HBV antiviral therapy are at risk of HBV reactivation.
- Serologic evidence of resolved HBV infection: Patients with serologic evidence of resolved HBV infection (HBsAg negative and anti-HBc positive) are at risk of HBV reactivation.
- Immunosuppressant or chemotherapeutic agents: Patients receiving certain immunosuppressants or chemotherapeutic agents may be at increased risk of HBV reactivation 2, 3.
From the Research
Hepatitis Risk Factors
The risk factors for hepatitis include:
- Injecting drug use, which can lead to the transmission of viral hepatitis through nonsterile injection practices, unprotected sexual contact, and unsanitary living conditions 4
- Unprotected sex, which can increase the risk of hepatitis B transmission 5
- Mother-to-baby transmission during birth, which is a common mode of transmission for hepatitis B worldwide 5
- Immigration from HBV-endemic countries, which can increase the risk of chronic HBV infection 5
- Parenteral risk factors, such as needlestick exposure, which can increase the risk of hepatitis B and C transmission 6, 7
- Tattoos, which have been identified as a risk factor for sporadic hepatitis C infection 7
- Sexually transmitted diseases, which can increase the risk of hepatitis C transmission 7
- Heavy alcohol intake, which can increase the risk of sporadic hepatitis C infection 7
- Low socioeconomic status, which can increase the risk of hepatitis transmission due to limited access to healthcare and vaccination 8
- Homelessness, which can increase the risk of hepatitis transmission due to poor living conditions and limited access to healthcare 8
Vulnerable Populations
Certain populations are more vulnerable to hepatitis transmission, including:
- Intravenous drug users, who are at high risk for contracting and spreading viral hepatitis 4, 8
- Sex workers, who are at increased risk for hepatitis B and C transmission due to unprotected sex 8
- Homeless people, who are at increased risk for hepatitis transmission due to poor living conditions and limited access to healthcare 8
- Immigrants from HBV-endemic countries, who may be at high risk for chronic HBV infection 5