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. 2025 May 8;15(1):16141.
doi: 10.1038/s41598-025-99864-2.

Association between resolved hepatitis B virus infection and depression in American adults : a cross-sectional study

Zihan Qin #  1 , Yizhuo Liu #  1 , Yifei Liu  1 , Anqi Yang  2 , Ruoyi Zhang  3 , Kun Zhang  4 , Shutian Zhang  5
Affiliations

Association between resolved hepatitis B virus infection and depression in American adults : a cross-sectional study

Zihan Qin et al. Sci Rep. .

Abstract

Hepatitis B virus (HBV) infection is a global health concern, and it can potentially affect mental health like depression. Resolved HBV infection, often perceived as a milder form of HBV infection, are often overlooked, and the association between it and depression remains unclear. This study aims to investigate the association between resolved HBV infection and depression. A cross-sectional analysis was conducted using the National Health and Nutrition Examination Survey (NHANES) data from 2005 to 2018, including 20,655 adult Americans. Resolved HBV infection was defined as HBV surface antigen (HBsAg) negative and HBV core antibody (HBcAb) positive. Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9) score. Propensity score matching (PSM) was performed to balance baseline characteristics. Algorithms such as inverse probability of treatment weighting (IPTW) were also applied. Among the participants, 1,551 (7.5%) were reported to have resolved HBV infection. Depression was reported by 1,796 participants (8.7%), with a higher prevalence among those with resolved HBV infection (10.6%) compared to those without HBV infection(8.5%). PSM and IPTW revealed a significantly positive association between resolved HBV infection and depression (PSM: OR = 1.40, 95%CI 1.09-1.79, p = 0.008; IPTW: OR = 1.48, 95%CI 1.26-1.74, p < 0.001). Subgroup and sensitivity analyses supported the robustness of the findings. The results suggest a complex relationship between resolved chronic viral infections and mental health. Based on this finding, it is advisable to conduct psychological monitoring and offer support to individuals who have achieved a functional cure for HBV. Further prospective studies are still needed to reveal the potential mechanism.

Keywords: Adults; Depression; NHANES; Resolved hepatitis B virus infection.

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Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests. Informed consent: All individuals provided written consent. Institutional review board statement: Institutional Research Ethics Review Board of the CDC approved the protocol for the NHANES survey. The protocol was approved by the NCHS Ethics Review Board with informed consent from all participants.

Figures

Fig. 1
Fig. 1
Flow diagram of the sample selection from the National Health and Nutrition Examination Survey (NHANES) 2005–2018. HBV, hepatitis B virus; SSRI, selective serotonin reuptake inhibitor use.
Fig. 2
Fig. 2
Forest plot showing the association between resolved HBV infection and depression using different statistical models. IPTW, inverse probability of treatment weighting; PA, pairwise algorithmic; Ow, overlap weight; OR, odds ratios; CI, confidence intervals.
Fig. 3
Fig. 3
Association between resolved HBV infection and depression in different stratifications. PIR, poverty income ratio; BMI, body mass index; SSRI, selective serotonin reuptake inhibitor use; HBV, hepatitis B virus; OR, odds ratios; CI, confidence intervals.
See this image and copyright information in PMC

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