Scientific Letters
Vol. 17 No. 1 (2025): Review Articles, Original Article, Scientific Letter, Case Reports Letter to the Editor
https://doi.org/10.4084/MJHID.2025.018

Risk Factors of Hepatitis B Virus Infection in the Kurdistan Region of Iraq: A Cross-Sectional Study

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Received: December 27, 2024
Accepted: February 10, 2025
Published: February 27, 2025
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HBV; Iraq; Risk factors

Authors

Nawfal R Hussein
https://orcid.org/0000-0002-7813-9198
Department of Biomedical Sciences, College of Medicine, University of Zakho, Zakho, Kurdistan Region, Iraq, Iraq.
Halder J Abozait
halder01jamal@gmail.com
https://orcid.org/0009-0003-8035-2443
Department of Internal Medicine, College of Medicine, University of Duhok, Duhok, Kurdistan region, Iraq, Iraq.
Ibrahim A Naqid
https://orcid.org/0000-0002-7223-2690
Department of Biomedical Sciences, College of Medicine, University of Zakho, Zakho, Kurdistan Region, Iraq, Iraq.
Nashwan MR Ibrahim
Department of Surgery, College of Medicine, University of Duhok, Duhok, Kurdistan region, Iraq, Iraq.
Fatima K Khalid
Department of Biomedical Sciences, College of Medicine, University of Zakho, Zakho, Kurdistan Region, Iraq, Iraq.
Dildar H Musa
Department of Surgery, College of Medicine, University of Duhok, Duhok, Kurdistan region, Iraq, Iraq.
Zana SM Saleem
https://orcid.org/0009-0002-8841-0292
Department of Internal Medicine, College of Medicine, University of Duhok, Duhok, Kurdistan region, Iraq, Iraq.

Abstract

Background and Objectives: Hepatitis B virus (HBV) poses a significant public health challenge worldwide, contributing to substantial morbidity and mortality. Despite the availability of effective vaccines, immunoglobulins and antiviral medications, HBV prevalence remains high in developing regions. This study investigates the potential risk factors associated with HBV infection in the Kurdistan region of Iraq to aid in developing targeted prevention strategies.

 

Design and Methods: A cross-sectional study was conducted involving 4091 participants from Duhok and Zakho, in Kurdistan region of Iraq. Data on demographics and potential risk factors were collected via a structured questionnaire. HBV surface antigen (HBsAg) was screened using enzyme-linked immunosorbent assay (ELISA) to determine infection status. Statistical analysis included univariate and multivariate logistic regression to identify independent risk factors.

 

Results: The mean age of enrolled participants was 29.33 years ± 10.74. Among them, 2851/4091 (69.69%) were females, 3385/4091 (82.74%) were residents of city and 3682/4091 (88.68%) were married. The prevalence of HBV infection among them was 3.67% (150/4091) and the following factors were significantly associated with HBV infection: female gender (p = 0.001), rural residency (p = 0.001), being married (p = 0.0014). Though a history of general operation and tattooing was found to be associated with HBV infection, this association was lost in multivariate analysis (p > 0.05) possibly due to confounding effect. A history of receiving blood or dental procedure was not significantly associated with HBV infection (p > 0.05).

 

Conclusion: The prevalence of HBV infection in Duhok and Zakho remains high and several predictive factors were identified which can be used to target infection control measures. Future research should focus on a population-based study to investigate the prevalence and risk factors of HBV infection to better inform public health policies.

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Citations

Crossref
Scopus
Google Scholar
Europe PMC
Global hepatitis report 2024: action for access in low- and middle-income countries. Geneva: World Health Organization; 2024. Licence: CC BY-NC-SA 3.0 IGO. Available at: https://www.who.int/publications/i/item/9789240091672
Li, Chunzheng, Chenyu Wei, and Xianguang Yang. "Hepatitis B Virus: Modes of Transmission, Immune Pathogenesis, and Research Progress on Therapeutic Vaccines." Exploration of Digestive Diseases 3, no. 6 (2024): 443-58. https://doi.org/10.37349/edd.2024.00060.
di Filippo Villa, Diana, and Maria-Cristina Navas. "Vertical Transmission of Hepatitis B Virus—an Update." Microorganisms 11, no. 5. (2023). https://doi.org/10.3390/microorganisms11051140.
Pattyn, Jade, Greet Hendrickx, Alex Vorsters, and Pierre Van Damme. "Hepatitis B Vaccines." The Journal of Infectious Diseases 224, no. Supplement_4 (2021): S343-S51. https://doi.org/10.1093/infdis/jiaa668.
Hussein, Nawfal. "Risk Factors of Hepatitis B Virus Infection among Blood Donors in Duhok City, Kurdistan Region, Iraq." babol-caspjim 9, no. 1 (2018): 22-26. https://doi.org/10.22088/cjim.9.1.22.
Patel, Ankoor, Zahra Dossaji, Kapil Gupta, Katerina Roma, Toni-Marie Chandler, Carlos D. Minacapelli, Kaitlyn Catalano, Robert Gish, and Vinod Rustgi. "The Epidemiology, Transmission, Genotypes, Replication, Serologic and Nucleic Acid Testing, Immunotolerance, and Reactivation of Hepatitis B Virus." Gastro Hep Advances 3, no. 2 (2024): 139-50. https://doi.org/10.1016/j.gastha.2023.10.008.
Hussein, Nawfal R., Dildar H. Musa, Dawan Jamal Hawezy, Ferhad M. R. Ahmed, Fatma Kamal Khalid, Ibrahim A. Naqid, and Mahde Saleh Assafi. "A Study on the Prevalence and the Risk Factors of Hepatitis B Virus Infection in Kurdistan Region, Iraq: A Multicenter Study: Prevalence and the Risk Factors of HBV." Journal of Contemporary Medical Sciences 7, no. 5 (10/26 2021). https://doi.org/10.22317/jcms.v7i5.1037.
Hussein N R, Mohammed Abdullah I, Mohammed Younus O, Taher A M, Salim A A, et al. “Prevalence of HBV, HCV and HIV Infections Among Syrian Refugees in Kurdistan Region, Iraq.” Int J Infect. 2017;4(2):e39420. https://doi.org/10.5812/iji.39420.
European Centre for Disease Prevention and Control. Hepatitis B. In: ECDC. Annual epidemiological report for 2022. Stockholm: ECDC; 2024. Available at: https://www.ecdc.europa.eu/en/publications-data/hepatitis-b-annual-epidemiological-report-2022.
Nawfal, Hussein, Zana Zana, Ibrahim Nashwan, Assafi Mahde, and Daniel Shameran. "The Prevalence of HBV Infection in Renal Transplant Recipients and the Impact of Infection on Graft Survival." Acta Medica Iranica 57, no. 6 (11/17 2019). https://doi.org/10.18502/acta.v57i6.1884.
Khalid FK, Rasheed NA, Hussein NR, Naqid IA. “A study of HBV infection and its risk factors in pregnant women in Zakho city, Iraq.” PLoS ONE 17(8): e0273362. (2022). https://doi.org/10.1371/journal.pone.0273362.
Al Juboury A, Salih H, Al-Assadi M, Ali AM. “Seroprevalence of hepatitis B and C among blood donors in Babylon Governorate-Iraq.” Med J Babylon 2010; 7:121-9. Available at: https://repository.uobabylon.edu.iq/eprint_archive/medicine_edition5/Seroprevalence%20of%20Hepatitis%20B%20and%20C%20among%20Blood%20Donors%20in%20Babylon%20Governorate-Iraq.doc.
Hussein, Nawfal R., and Azad M. Taher. "The Seroprevalence of HBV and HCV Infection in Newly Recruited Police in Duhok City, Kurdistan Region, Iraq." International Journal of Sciences: Basic and Applied Research (IJSBAR) 24, no. 1 (08/02 2015): 112-16. https://gssrr.org/index.php/JournalOfBasicAndApplied/article/view/4356.
Özkan, H. "Epidemiology of Chronic Hepatitis B in Turkey." [In eng]. Euroasian J Hepatogastroenterol 8, no. 1 (Jan-Jun 2018): 73-74. https://doi.org/10.5005/jp-journals-10018-1264.
Ozer, A., Y. Yakupogullari, A. Beytur, L. Beytur, M. Koroglu, F. Salman, and F. Aydogan. "Risk Factors of Hepatitis B Virus Infection in Turkey: A Population-Based, Case-Control Study: Risk Factors for HBV Infection." [In eng]. Hepat Mon 11, no. 4 (Apr 2011): 263-8. https://pubmed.ncbi.nlm.nih.gov/22087152/
Alavian, S. M., S. V. Tabatabaei, T. Ghadimi, F. Beedrapour, S. A. Kafi-Abad, A. Gharehbaghian, and H. Abolghasemi. "Seroprevalence of Hepatitis B Virus Infection and Its Risk Factors in the West of Iran: A Population-Based Study." [In eng]. Int J Prev Med 3, no. 11 (Nov 2012): 770-5. https://pubmed.ncbi.nlm.nih.gov/23189228/
Zhang, Wenjun, Chenyu Xu, Yanjing Rui, Jie Chen, Tingmei Chen, Yimin Dai, Biyun Xu, et al. "Efficacy of the Hepatitis B Vaccine Alone in the Prevention of Hepatitis B Perinatal Transmission in Infants Born to Hepatitis B E Antigen-Negative Carrier Mothers." Journal of Virus Eradication 8, no. 2 (2022/06/01/ 2022): 100076. https://doi.org/10.1016/j.jve.2022.100076.
Sheena, Brittney S., Lindsey Hiebert, Hannah Han, Helen Ippolito, Mohsen Abbasi-Kangevari, Zeinab Abbasi-Kangevari, Hedayat Abbastabar, et al. "Global, Regional, and National Burden of Hepatitis B, 1990–2019: A Systematic Analysis for the Global Burden of Disease Study 2019." The Lancet Gastroenterology & Hepatology 7, no. 9 (2022): 796-829. https://doi.org/10.1016/S2468-1253(22)00124-8.
Mohammed, Hussein, Aragaw Eshetie, and Dessie Melese. "Prevalence of Hepatitis B Virus and Associated Risk Factors among Adults Patients at Dessie Referral and Kemise General Hospitals in Northeastern Ethiopia." Health Science Reports 5, no. 3 (2022/05/01 2022): e659. https://doi.org/10.1002/hsr2.659.
Ayele, Abiyu, Dessie Abera, Melese Hailu, Muluken Birhanu, and Kassu Desta. "Prevalence and Associated Risk Factors for Hepatitis B and C Viruses among Refugees in Gambella, Ethiopia." BMC Public Health 20, no. 1 (2020/05/19 2020): 721. https://doi.org/10.1186/s12889-020-08893-1.
Khalil, Amira S., Nawfal R. Hussein, and Maida Y. Shamdeen. "Impact of Maternal Hbsag Carrier Status on Pregnancy Outcomes in Duhok City, Iraq." Asian Pacific Journal of Tropical Biomedicine 7, no. 11 (2017/11/01/ 2017): 1010-13. https://doi.org/10.1016/j.apjtb.2017.09.023.
Li, Xiaoqing, Yingjun Zheng, Adrian Liau, Biao Cai, Dongqing Ye, Feng Huang, Xiaorong Sheng, et al. "Hepatitis B Virus Infections and Risk Factors among the General Population in Anhui Province, China: An Epidemiological Study." BMC Public Health 12, no. 1 (2012/04/05 2012): 272. https://doi.org/10.1186/1471-2458-12-272.

How to Cite



“Risk Factors of Hepatitis B Virus Infection in the Kurdistan Region of Iraq: A Cross-Sectional Study” (2025) Mediterranean Journal of Hematology and Infectious Diseases, 17(1), p. e2025018. doi:10.4084/MJHID.2025.018.
Copyright (c) 2025 Nawfal R Hussein, Halder J Abozait, Ibrahim A Naqid, Nashwan MR Ibrahim, Fatima K Khalid, Dildar H Musa, Zana SM Saleem Creative Commons License

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