The findings challenge previous studies from Asia that suggested people with chronic HBV infection may face a higher risk of hearing problems, including sudden sensorineural hearing loss.

HBV is one of the most common causes of chronic viral infections worldwide. The virus primarily attacks liver cells, causing acute or chronic inflammation and, over time, potentially leading to cirrhosis and hepatocellular carcinoma. Infection occurs mainly through contact with infected blood and other bodily fluids, including during medical procedures, sexual contact or from mother to child during childbirth. Vaccination provides effective protection against infection.

Scientists from medical universities in Poznań, Białystok, Katowice, Kielce and Warsaw, together with the National Institute of Public Health – National Institute of Hygiene, analysed data from Poland’s national hospitalisation database covering 2012-2023. They identified more than 80,000 cases of acute or chronic HBV infection and examined the occurrence of ear diseases and hearing disorders among those patients.

The researchers found that hearing loss diagnoses were extremely rare. Hearing disorders were recorded in only 0.05 percent of patients during their first hospitalisation and in 0.04 percent of all HBV-related hospitalisations. The cases included both conductive and sensorineural hearing loss.

The analysis also found no increase in hearing disorders among patients who were hospitalised repeatedly, a pattern that could have suggested an effect of long-term infection.

“It's been known for years that HBV can also cause various extrahepatic symptoms,” said Professor Piotr Rzymski, a medical biologist at the Poznań University of Medical Sciences, in research information provided to PAP.

In recent years, studies from Taiwan reported a several-fold higher risk of sudden sensorineural hearing loss among patients with chronic hepatitis B, while research from China and Iran suggested a link between HBV infection and poorer hearing test results, particularly at high frequencies.

Researchers have proposed several biological mechanisms that could explain such a connection, including chronic inflammation caused by HBV, damage to the small blood vessels supplying the inner ear and the virus’s potential effects on tissues outside the liver.

Interest in the issue also grew after research suggested that composer Ludwig van Beethoven had been infected with HBV, which may have been linked to his progressive hearing loss.

The authors said their findings do not completely rule out an effect of HBV on hearing in individual patients, but they found no evidence that chronic hepatitis B is a significant risk factor for hearing disorders in a European population.

They added that differences between the Polish findings and reports from Asia may reflect population-specific factors, including different dominant HBV genotypes, variations in the course of infection, disparities in access to healthcare and environmental or genetic influences.

The publication is available here: https://doi.org/10.1038/s41598-026-55873-3

Katarzyna Czechowicz (PAP)

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