Trends in Comorbidities and Fatalities Among First-Time Hepatitis B Hospitalizations in Poland (2012-2023)

BACKGROUND The clinical profile of patients hospitalized with hepatitis B virus (HBV) is increasingly influenced by coexisting conditions and death patterns. This study aimed to assess comorbidities and fatality rates among patients hospitalized for the first time with HBV between 2012 and 2023. MATERIAL AND METHODS A 12-year retrospective nationwide analysis of first-time HBV hospitalizations in Poland was conducted using data from the Nationwide General Hospital Morbidity Study. RESULTS Digestive diseases (15.6%), cardiovascular diseases (10.5%), and endocrine and metabolic disorders (9.6%) were the most prevalent comorbidities. Between 2012 and 2023, marked increases were observed in digestive (12.3%-27.4%) and metabolic (8.5%-18.5%) disorders, while circulatory diseases rose from 7.4% to 18.6% with post-2019 stabilization. Immune-related and genitourinary disorders demonstrated sustained post-2019 growth, whereas several categories, including neoplasms and respiratory diseases, showed growth-decline patterns. Hypertension and liver fibrosis were the most frequent individual diagnoses, with sustained or stepwise increases over time. Age-stratified analyses revealed a shift from infection-related conditions in younger patients toward cardiometabolic and advanced hepatic diseases in older groups. Fatality rates increased from 6.8-15.9 per 1000 hospitalizations (2012-2019) to 23.1-30.7 per 1000 (2020-2023), peaking during 2020-2021, with higher mortality in men. CONCLUSIONS First-time HBV hospitalizations are increasingly characterized by multimorbidity and rising fatality rates, particularly in older patients. These findings highlight a growing clinical and public health burden, underscoring the need for integrated, age-tailored management and improved surveillance to reduce mortality and optimize HBV care.