Information on the burden of hepatitis B infection is required for targeted interventions and streamlining the diagnosis and treatment facilities across various healthcare levels in India. Therefore, this study was aimed at determining the prevalence of hepatitis B infection and associated factors among the adult population in a rural area of South India.

A community-based cross-sectional study was conducted among the rural adult population aged 18 years and above between January 2021 and April 2022. Alere DetermineTM HBsAg rapid diagnostic test kit (RDT) was used to detect hepatitis B surface antigen (HBsAg) and a Chemiluminescent immunoassay (CLIA) test was used for confirmatory diagnosis. Data on the behavioral and clinical risk factors for HbsAg and other basic socio-demographic details were captured using a pre-tested, structured questionnaire.

Total 5169 participants were included in the study. The mean (SD) age was 41 (15.7) years and 50% were males. About 20% reported alcohol use and 10% reported tobacco use. The prevalence of hepatitis B infection was 2.5% (95% CI = 2.05–2.91), of whom 10 (7.9%) had a known history of hepatitis B infection. Alcohol use (PR 2.8, 95% CI = 1.9 – 4.2), tobacco use (PR 2.8, 95% CI = 1.6–5.1), history of blood transfusion (PR 7.8, 95% CI = 4.7–13.0), history of dental procedures (PR 3.6, 95% CI = 2.5–5.1), tattoos (PR 3.5, 95% CI = 2.1–5.8) and having more than one sex partner (PR 6.8, 95% CI = 1.1–41.2) were significantly associated with hepatitis B infections.

Nearly three out of 100 individuals had hepatitis B infection in rural areas. Efforts to address hepatitis B transmission prevention holistically and with a public health approach must be enhanced.