Common risk factors in the development of HBV infection include sexual contact with infected individuals, sharing a household with a carrier, intravenous drug use, travel to endemic regions, perinatal transmission from infected mothers to infants, and certain occupations.

Individuals who are at increased risk of hepatitis B infection include:^[1][2]

• Infants born to infected mothers
• Young children in day-care or residential settings with other children in endemic areas
• Sexual/household contacts of infected persons
• Patients and employees in hemodialysis centers
• Injection drug users sharing unsterilized needles
• People sharing unsterilized medical or dental equipment
• People providing or receiving acupuncture and/or tattooing with unsterilized medical devices
• Persons living in regions or travelling to regions with endemic hepatitis B
  • Country of origin is the major risk factor for HBV infection (prevalence threshold of 2% or greater to define countries with high risk for HBV infection)
• Sexually active heterosexuals
• Lack of vaccination in infancy
• Men who have sex with men
• Hemophilia patients
• Travel to areas where hepatitis B is common

Frequent and routine exposure to blood or serum is the common denominator of healthcare occupational exposure.^[3]

Hepatitis B virus presents in all patients with infection. Patients who are either HBsAg-positive or anti HBc-positive are at the risk of hepatitis B reactivation.

Patients are at risk for HBV reactivation in the following conditions:^{[4][5][6][7][8][9]}

• Receive immunosuppressive therapy
  • Chemotherapy agents
  • Tumor necrosis factor (TNF) inhibitor (Infliximab)
  • Methotrexate (particularly following its withdrawal)
  • Abatacept
  • Ustekinumab
  • Anti-CD 20 agents (Rituximab and Ofatumumab)
  • High to moderate dose glucocorticoids
• Patients treated with direct-acting antivirals for hepatitis C
  • Daklinza
  • Epclusa
  • Exviera
  • Harvoni
  • Olysio
  • Sovaldi
  • Viekira Pak/ Viekira Pak XR
  • Technivie
  • Zepatier