A NEW large-scale study has revealed that immunity to hepatitis B virus (HBV) may offer significant protection against Type 2 diabetes, even in individuals with no history of HBV infection. Researchers suggest this potential dual benefit of HBV vaccination could support its wider use, particularly in areas with high burdens of both diseases. Notably, individuals with strong HBV immunity had a markedly lower risk of developing diabetes, by as much as 43%.
Using anonymised electronic health records from the TriNetX database, researchers conducted a retrospective cohort study of adults who had undergone hepatitis B surface antibody (HBsAb) testing and who had no prior diagnosis of HBV or diabetes. The study excluded anyone already diagnosed with diabetes or with a history of HBV infection. Diabetes was defined by diagnosis codes, use of diabetes medication, or HbA1c levels of 6.5% or higher. The researchers applied propensity score matching to balance demographic and clinical characteristics between HBV-immunised and unimmunised groups.
The findings revealed that individuals with HBV immunity had a 15% lower risk of developing diabetes compared to those without immunity (hazard ratio [HR]: 0.85; 95% CI: 0.84–0.87). A dose–response relationship was observed, with higher HBsAb levels corresponding to greater reductions in diabetes risk. Compared to individuals with low antibody levels (<10 mIU/mL), those with levels ≥100 mIU/mL had a 19% lower risk (HR: 0.81), and those with levels ≥1000 mIU/mL had a 43% lower risk (HR: 0.57). Age stratification showed the protective effect was strongest in younger adults aged 18 to 44, who had a 20% lower risk (HR: 0.80), compared with 11% in those aged 45 to 64 (HR: 0.89) and 12% in those 65 or older (HR: 0.88).
The study’s findings suggest that HBV vaccination could have a preventative role in diabetes as well as in hepatitis B, particularly for younger adults. However, the observational design means causality cannot be confirmed, and residual confounding may remain despite matching. Further research, including prospective trials, would be needed to establish a definitive link. Nonetheless, the evidence highlights a potentially valuable role for HBV vaccination in broader public health strategies aimed at curbing the global rise in diabetes.
Reference
Phan NQ et al. Potential Protective Effect of Hepatitis B Immunity Against Diabetes Mellitus: A Retrospective Propensity-Matched Cohort Study. Oral Presentation 350. EASD 2025. 15-19 September, 2025.
