Objective  To analyze the behavioral factors influencing of new hepatitis B virus (HBV) infection in diabetic patients, so as to provide evidence for reducing the risk of new HBV infection in diabetic patients.

  Methods  A nested case-control study was conducted to follow up and observe 4586 diabetic patients. The 114 diabetic patients who newly developed HBV infection during the follow-up period were selected as the case group, and 228 diabetic patients who did not develop HBV infection in the same period were selected as the control group from the cohort population at a matching ratio of 1∶2 according to the age ±2 years. Questionnaire surveys and laboratory examinations were conducted in the cohort. The contents of the questionnaire included family history of hepatitis B, history of trauma, history of receiving/donating blood, individual-related behavioral characteristics, diabetes severity, and behavior related to diabetes treatment and management. In addition, the blood samples of the cohort were tested for hepatitis B surface antigen (HBsAg) by enzyme-linked immunosorbent assay (ELISA). The conditional logistic regression model was used to analyze the related behavioral factors affecting new HBV infection in diabetic patients.

  Results  The median ages of the HBV group and the control group were 64 years old and 66 years old, respectively. There was no statistically significant difference in the composition of sex, age, ethnicity, occupation and amount of formal education between the two groups (P>0.05). Multivariate analysis showed that diabetic patients with a family history of hepatitis B (OR=13.052, 95% CI: 3.799 to 44.847) had a higher risk of new HBV infection, while diabetic patients who used blood collection/injection devices in a standardized way (OR=0.189, 95%CI: 0.082 to 0.436), safety locking blood glucose needles (OR=0.142, 95% CI: 0.073 to 0.276) and venous blood collection needles (OR=0.019, 95% CI: 0.001 to 0.262) and self-testing of blood sugar at home (OR=0.466, 95% CI: 0.222 to 0.980) had a lower risk of new HBV infection.

  Conclusion  Family history of hepatitis B is an independent factor that increases the risk for new HBV infection in diabetic patients. During the process of long-term blood glucose management of diabetic patients, standardized use of blood collection/injection devices, use of safer types of blood sampling lancet, and self-testing of blood glucose help can reduce the risk of HBV infection.