Prevalence and factors associated with HBsAg positivity among clinically suspected viral hepatitis patients in Northwest Ethiopia

Hepatitis B virus infection continues to be a major public health problem worldwide, particularly in sub-Saharan Africa and developing countries. It is a leading cause of chronic liver disease, cirrhosis, and hepatocellular carcinoma. Early detection of Hepatitis B virus infection among clinically suspected viral hepatitis patients is important for prevention, treatment, and control of transmission. The objective of this study was to determine the prevalence and factors associated with HBsAg positivity among clinically suspected viral hepatitis patients attending Felege Hiwot Comprehensive Specialized Hospital in Bahir Dar, Northwest Ethiopia. A hospital-based cross-sectional study was conducted from October to December 2025 among 204 clinically suspected viral hepatitis patients attending the outpatient department of Felege Hiwot Comprehensive Specialized Hospital. Participants were selected using a consecutive sampling technique. Socio-demographic, behavioral, and clinical data were collected using a structured interviewer-administered questionnaire. Approximately 3–5 mL venous blood samples were collected aseptically and tested for hepatitis B surface antigen using the SNIBE Maglumi chemiluminescence immunoassay analyzer according to the manufacturer’s instructions. Data were entered into EpiData version 3.1 and analyzed using SPSS version 26. Binary and multivariable logistic regression analyses were performed to identify factors associated with HBsAg positivity. Variables with p-value < 0.05 in multivariable analysis were considered statistically significant. The HBsAg positivity among clinically suspected viral hepatitis patients was 18% (36/204) (95% CI: 12.4%–22.9%). Participants aged above 35 years had higher odds of HBsAg positivity compared with those aged below 25 years (AOR = 2.85, 95% CI: 1.08–7.55; p = 0.035), alcohol consumption (AOR = 2.52, 95% CI: 1.13–5.63; p = 0.037), history of blood transfusion (AOR = 1.45, 95% CI: 1.04–2.94; p = 0.040), and sharing sharp materials (AOR = 1.72, 95% CI: 1.01–2.93; p = 0.046) were significantly associated with HBsAg positivity. HBsAg positivity was 18.0% among clinically suspected viral hepatitis patients attending the study hospital. Older age, history of blood transfusion, sharing of sharp materials, and alcohol consumption were independently associated with HBsAg positivity. Given the cross-sectional design, limited number of HBsAg-positive events, and potential residual confounding, these associations should not be interpreted causally. Strengthening appropriate HBsAg screening, vaccination, blood safety, and infection-prevention measures may help address the burden of HBV in the study setting.