HBV and HCV Burden in a Greek Hospital Population (2018–2024): Trends and Correlates of HBsAg and Anti-HCV Positivity

Background: Hepatitis B and C remain a major public health challenge in Greece, particularly amid demographic shifts, migration, and evolving socioeconomic conditions. Updated epidemiological data are essential to guide public health planning and prevention strategies. Methods: A repeated cross-sectional study was conducted among adults (n = 36,085) attending the General Hospital of Nikaia “Agios Panteleimon”, Piraeus, Greece, from 2018 to 2024. Participants consisted of inpatients and outpatients, including recognized high-risk groups. Serological markers assessed current hepatitis B infection (HBsAg) and past or recent hepatitis C exposure (anti-HCV). Associations were examined using univariate and multivariate logistic regression, reporting adjusted odds ratios (aORs) and 95% confidence intervals (CIs). Results: Overall prevalence was 4.65% for HBsAg (n = 1677) and 6.6% for anti-HCV (n = 2378). Females had significantly lower odds compared to males for both markers (HBsAg aOR = 0.24, anti-HCV aOR = 0.77, both p < 0.001). Anti-HCV prevalence declined with age, with the ≥70 group showing the lowest odds (aOR = 0.24, p < 0.001). For HBsAg, older age groups also showed reduced odds, particularly ages 60–69 (aOR = 0.49, p < 0.001) and ≥70 (aOR = 0.75, p = 0.005). Compared to Attica region, most regions had significantly lower odds of both infections, including Thrace (HBsAg aOR = 0.08; anti-HCV aOR = 0.32, both p < 0.001), Crete (HBsAg aOR = 0.13; anti-HCV aOR = 0.35, both p < 0.001), and Macedonia (HBsAg aOR = 0.37; anti-HCV aOR = 0.64, both p < 0.001). Compared to 2018, the odds were markedly higher in 2023 and peaked in 2024 for both infections (anti-HCV aOR = 1.78; HBsAg aOR = 3.10, both p < 0.001 for 2024). High-risk social groups demonstrated substantially elevated odds of anti-HCV (aORs 3.9–5.51, all p < 0.001), but had lower odds of HBsAg (aORs 0.32–0.60, all p ≤ 0.001). Conclusions: Increasing prevalence trends, regional disparities, and pronounced differences among vulnerable groups highlight the urgent need for strengthened screening, vaccination, and targeted hepatitis B and C prevention strategies, particularly among healthcare-attending and high-risk populations in Greece.