Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
Acute hepatitis B in the vaccination era: Predictors of functional cure and chronicity
David Yardeni, Inna Lipnizkiy, Ali Abu Juma’a, Naim Abu-Freha, Anat Nevo-Shor, Ohad Etzion, Department of Gastroenterology and Liver Diseases, Soroka University Medical Center, Beersheba 84101, Southern, Israel
Julianna Gershbaum Tobin, Medical School for International Health, Soroka University Medical Center, Beersheba 84101, Southern, Israel
Bryan Itkowitz, Clinical Research Center, Soroka University Medical Center, Beersheba 84101, Southern, Israel
Ayelet Keren-Naus, Laboratory of Virology Services, Soroka University Medical Center, Beer Sheva 84101, Israel
May Turgeman, Department of Internal Medicine E, Soroka University Medical Center, Beersheba 84101, Southern, Israel
Robert Gareth Gish, Hepatitis B Foundation, Doylestown, PA 18902, United States
Author contributions: Yardeni D and Etzion O contributed to the conception and design of the study as well as writing of manuscript and approval of final draft; Gershbaum Tobin J and Itkowitz B contributed to the data analysis as well as editing, writing and review of the manuscript and performed the formal statistical analysis; Lipnizkiy I, Abu Juma’a A, Abu-Freha N, Keren-Naus A, Turgeman M and Nevo-Shor A provided resources and performed a review and editing of the manuscript; Gish RG performed a revision of the manuscript and approved the final draft.
AI contribution statement: AI tools were not used during the preparation of this study.
Institutional review board statement: The study was approved by the Institutional Review Board of Soroka University Medical Center and was conducted in compliance with the Declaration of Helsinki, Good Clinical Practice guidelines, and local regulatory requirements.
Informed consent statement: For this study of existing patient data, the Institutional Review Board of Soroka University Medical Center granted a full waiver of informed consent (Approval No. 0138-23-SOR) on September 26, 2023, under study protocol SCRC23018.
Conflict-of-interest statement: All authors declare no conflict-of-interest in this study.
Data sharing statement: The data that support the findings of this study are available from the corresponding author upon reasonable request.
Corresponding author: David Yardeni, MD, Department of Gastroenterology and Liver Diseases, Soroka University Medical Center, 151 Rager Blvd., Beersheba 84101, Southern, Israel. yardeda@post.bgu.ac.il
Received: June 8, 2026
Revised: June 30, 2026
Accepted: July 31, 2026
Published online: August 27, 2026
Processing time: 73 Days and 12.8 Hours
Revised: June 30, 2026
Accepted: July 31, 2026
Published online: August 27, 2026
Processing time: 73 Days and 12.8 Hours
Core Tip
Core Tip: The widespread availability of the universal hepatitis B virus (HBV) vaccination reduced acute HBV incidence in developed countries. Acute HBV usually resolves with functional cure in > 95% of adults. In our study we evaluated all acute HBV cases in southern Israel between 2004-2022 and found a striking 34% chronicity rate. Further analysis revealed that a background of diabetes and low socioeconomic status were found to strongly predict chronic infection. These findings highlight the need for risk stratification in acute HBV patients from vulnerable populations.