Trends and projections of incidence and mortality of acute viral hepatitis in China from 1990 to 2021_West China Medical Journal

Authors：

JIN Zhimei ¹ , HUANG Wenlong ¹ , CHEN Yongze ¹ , WANG Shihong ¹ , LAI Fengxia ¹ , YANG Zhibin ² , DING Haifeng ³ ,  XU Ruhong ⁴ ,  YU Haibing ^1,5

1. School of Public Health, Guangdong Medical University, Department of Endocrinology and Metabolism, the First Dongguan Affiliated Hospital of Guangdong Medical University, Dongguan Chronic Disease Prevention and Control Key Laboratory, Dongguan, Guangdong 523808, P. R. China;
2. School of Information Engineering, Guangdong Medical University, Dongguan, Guangdong 523808, P. R. China;
3. Department of Geriatrics, the First Dongguan Affiliated Hospital of Guangdong Medical University, Dongguan, Guangdong 523808, P. R. China;
4. Department of Pulmonary and Critical Care Medicine, Dongguan Ninth People’s Hospital (Dongguan Hospital for Infectious Diseases), Dongguan, Guangdong 523808, P. R. China;
5. The First Dongguan Affiliated Hospital, Guangdong Medical University, State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Dongguan, Guangdong 523808, P. R. China;

Corresponding?author：

XU Ruhong, Email: 67292122@qq.com; YU Haibing, Email: hby616688@gdmu.edu.cn

Keywords：

Acute viral hepatitis; incidence; mortality; autoregressive integrated moving average model

DOI：

10.7507/1002-0179.202411100

Video：

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Objective To analyze the incidence and mortality of acute viral hepatitis in China, project its trends from 2022 to 2030, and provide valuable insights for the prevention and control of viral hepatitis. Methods The incidence and mortality rates of acute viral hepatitis in China from 1990 to 2021 were extracted from the Global Burden of Disease 2021 database. The change rates and the estimated annual percentage change (EAPC) for each indicator were calculated. Additionally, an autoregressive integrated moving average (ARIMA) model was used to project the incidence and mortality of acute viral hepatitis in China from 2022 to 2030. Results From 1990 to 2021, the incidence rates of acute hepatitis A (AHA), acute hepatitis B (AHB), acute hepatitis C (AHC), and acute hepatitis E (AHE) in China all showed a declining trend (EAPC=?1.980%, ?2.664%, ?2.078%, ?1.686%; P<0.05), with a particularly marked decrease in mortality (EAPC=?11.662%, ?7.411%, ?12.541%, ?7.504%; P<0.05). According to ARIMA model projections, the incidence rates of AHA and AHB were expected to continue declining from 2022 to 2030, while the incidence rates of AHC and AHE were expected to rise. In 2030, the projected incidence rates of AHA, AHB, AHC, and AHE were 890.425/100000, 824.158/100000, 59.202/100000, and 300.377/100000, respectively. The mortality rates of AHA, AHC, and AHE were projected to remain stable from 2022 to 2030, while the mortality rate of AHB was expected to decline. In 2030, the projected mortality rates of AHA, AHB, AHC, and AHE were 0.002/100000, 0/100000, 0.004/100000, and 0.011/100000, respectively. Conclusions From 1990 to 2021, the overall incidence and mortality of acute viral hepatitis in China showed a downward trend. However, the incidence rates of AHC and AHE may present an upward trend in the future, which suggests that the government and relevant health authorities should adjust their prevention and control strategies in a timely manner.

Citation： JIN Zhimei, HUANG Wenlong, CHEN Yongze, WANG Shihong, LAI Fengxia, YANG Zhibin, DING Haifeng, XU Ruhong, YU Haibing. Trends and projections of incidence and mortality of acute viral hepatitis in China from 1990 to 2021. West China Medical Journal, 2025, 40(7): 1110-1117. doi: 10.7507/1002-0179.202411100 Copy

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2.	Biswas S, Kumar R, Shalimar, et al. Viral hepatitis-induced acute liver failure. Indian J Gastroenterol, 2024, 43(2): 312-324.
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8.	GBD 2019 Europe Hepatitis B & C Collaborators. Hepatitis B and C in Europe: an update from the Global Burden of Disease Study 2019. Lancet Public Health, 2023, 8(9): e701-e716.
9.	GBD 2019 Hepatitis B Collaborators. Global, regional, and national burden of hepatitis B, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Gastroenterol Hepatol, 2022, 7(9): 796-829.
10.	余文周, 王富珍, 溫寧, 等. 中國深化醫療改革十年免疫規劃助力全民健康. 中國疫苗和免疫, 2020, 26(5): 602-606.
11.	Migueres M, Lhomme S, Izopet J. Hepatitis A: epidemiology, high-risk groups, prevention and research on antiviral treatment. Viruses, 2021, 13(10): 1900.
12.	Liu Z, Shi O, Zhang T, et al. Disease burden of viral hepatitis A, B, C and E: a systematic analysis. J Viral Hepat, 2020, 27(12): 1284-1296.
13.	張家瑋, 周敏, 蘇永健, 等. 基于 Joinpoint 回歸模型分析 2005—2021 我國甲型肝炎發病趨勢. 華南預防醫學, 2024, 50(7): 604-607, 612.
14.	國家衛生健康委員會. 國家免疫規劃疫苗兒童免疫程序及說明(2021 年版). 中國病毒病雜志, 2021, 11(4): 241-245.
15.	邱嘉敏, 曾芳芳, 程琛, 等. 廣東省 1990-2019 年急性病毒性肝炎疾病負擔分析. 中華流行病學雜志, 2024, 45(3): 365-372.
16.	Ouyang G, Pan G, Li Q, et al. Global burden of acute hepatitis E between 1990 and 2019 and projections until 2030. Liver Int, 2024, 44(6): 1329-1342.
17.	曾丹藝. 1990-2019 年全球范圍急性病毒性肝炎的負擔及其與社會經濟發展狀況的關系. 廈門: 廈門大學, 2022.
18.	中國肝炎防治基金會. 成人甲型肝炎疫苗接種專家建議. 中國病毒病雜志, 2023, 13(6): 401-412.
19.	劉杰, 郭世成, 伍鳳云, 等. 2014-2021 年江西省急性乙型病毒性肝炎流行特征分析. 預防醫學, 2024, 36(1): 58-60.
20.	Lao TT. Immune persistence after hepatitis B vaccination in infancy - fact or fancy?. Hum Vaccin Immunother, 2016, 12(5): 1172-1176.
21.	李生浩, 張黎, 張瑞仙. 1990-2019 年中國丙型病毒性肝炎疾病負擔評估. 中國感染控制雜志, 2022, 21(10): 971-976.
22.	周梅, 姚麗熙, 吳銀蓮, 等. 1990-2044 年中國丙型病毒性肝炎相關疾病的疾病負擔分析及預測. 中國血吸蟲病防治雜志, 2023, 35(5): 476-485.
23.	Epstein RL, Espinosa C. Hepatitis C virus in neonates and infants. Clin Perinatol, 2021, 48(2): 343-357.
24.	Hajarizadeh B, Cunningham EB, Reid H, et al. Direct-acting antiviral treatment for hepatitis C among people who use or inject drugs: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol, 2018, 3(11): 754-767.
25.	Yu S, Wang Q, Wang S, et al. Burden of acute viral hepatitis - China, 1990-2019. China CDC Wkly, 2020, 2(31): 579-586.
26.	王朝華. 31 例老年人急性肝炎臨床特點分析. 實用老年醫學, 2010, 24(1): 83-84.
27.	Valamparampil J, Kelly D. Viral hepatitis necessitating liver transplantation in children. Transplantation, 2024, 108(1): 127-136.
28.	賈夢山. 2019-2021 年周口市病毒性肝炎病例流行特征分析. 華南預防醫學, 2022, 48(8): 967-969.
29.	Stawinska-Witoszynska B, Klos J, Moryson W, et al. Trends in the incidence of acute hepatitis B in the Polish population and their determinants. Medicina (Kaunas), 2021, 57(8): 738.
30.	袁磊, 張水軍. 性別與性激素對乙肝病毒易感性及其免疫應答的影響. 河南醫學研究, 2019, 28(10): 1919-1921.
31.	Box G. Box and Jenkins: time series analysis, forecasting and control//Mills TC. A very British affair: six britons and the development of time series analysis during the 20th century. London; Palgrave Macmillan UK. 2013: 161-215.
32.	Schaffer AL, Dobbins TA, Pearson SA. Interrupted time series analysis using autoregressive integrated moving average (ARIMA) models: a guide for evaluating large-scale health interventions. BMC Med Res Methodol, 2021, 21(1): 58.
33.	朱宗元, 于青. ARIMA 模型在我國病毒性肝炎發病率預測中的應用. 中國衛生統計, 2011, 28(1): 65-67.
34.	Zhang C, Liu Y, Zhao H, et al. Global patterns and trends in total burden of hepatitis B from 1990 to 2019 and predictions to 2030. Clin Epidemiol, 2022, 14: 1519-1533.
35.	Scott N, Sacks-Davis R, Wade AJ, et al. Australia needs to increase testing to achieve hepatitis C elimination. Med J Aust, 2020, 212(8): 365-370.
36.	丁勇, 吳靜, 武丹, 等. ARIMA 乘積季節模型預測我國戊肝的發病趨勢. 南京醫科大學學報(自然科學版), 2020, 40(11): 1725-1729.
37.	鄭慧敏, 薛允蓮, 黃燕飛, 等. ARIMA 模型在深圳市法定傳染病發病趨勢預測的應用. 實用預防醫學, 2016, 23(2): 240-243.
38.	Huang D, Lai H, Shi X, et al. Global temporal trends and projections of acute hepatitis E incidence among women of childbearing age: age-period-cohort analysis 2021. J Infect, 2024, 89(4): 106250.
39.	Su X, Zheng L, Zhang H, et al. Secular trends of acute viral hepatitis incidence and mortality in China, 1990 to 2019 and its prediction to 2030: the Global Burden of Disease Study 2019. Front Med (Lausanne), 2022, 9: 842088.

1. 國家疾病預防控制局. 2024 年 2 月全國法定傳染病疫情概況. 中國病毒病雜志, 2024, 14(3): 232.
2. Biswas S, Kumar R, Shalimar, et al. Viral hepatitis-induced acute liver failure. Indian J Gastroenterol, 2024, 43(2): 312-324.
3. Schweitzer A, Horn J, Mikolajczyk RT, et al. Estimations of worldwide prevalence of chronic hepatitis B virus infection: a systematic review of data published between 1965 and 2013. Lancet, 2015, 386(10003): 1546-1555.
4. Varol M, Licka Dieye N, Zang M, et al. Hepatitis C virus exposure and infection in the perinatal period. Curr Pediatr Rev, 2022, 19(1): 21-33.
5. Viral hepatitis elimination - time to act. Nat Rev Gastroenterol Hepatol, 2024, 21(8): 529.
6. Almeida PH, Matielo CEL, Curvelo LA, et al. Update on the management and treatment of viral hepatitis. World J Gastroenterol, 2021, 27(23): 3249-3261.
7. GBD 2021 Diseases and Injuries Collaborators. Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet, 2024, 403(10440): 2133-2161.
8. GBD 2019 Europe Hepatitis B & C Collaborators. Hepatitis B and C in Europe: an update from the Global Burden of Disease Study 2019. Lancet Public Health, 2023, 8(9): e701-e716.
9. GBD 2019 Hepatitis B Collaborators. Global, regional, and national burden of hepatitis B, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Gastroenterol Hepatol, 2022, 7(9): 796-829.
10. 余文周, 王富珍, 溫寧, 等. 中國深化醫療改革十年免疫規劃助力全民健康. 中國疫苗和免疫, 2020, 26(5): 602-606.
11. Migueres M, Lhomme S, Izopet J. Hepatitis A: epidemiology, high-risk groups, prevention and research on antiviral treatment. Viruses, 2021, 13(10): 1900.
12. Liu Z, Shi O, Zhang T, et al. Disease burden of viral hepatitis A, B, C and E: a systematic analysis. J Viral Hepat, 2020, 27(12): 1284-1296.
13. 張家瑋, 周敏, 蘇永健, 等. 基于 Joinpoint 回歸模型分析 2005—2021 我國甲型肝炎發病趨勢. 華南預防醫學, 2024, 50(7): 604-607, 612.
14. 國家衛生健康委員會. 國家免疫規劃疫苗兒童免疫程序及說明(2021 年版). 中國病毒病雜志, 2021, 11(4): 241-245.
15. 邱嘉敏, 曾芳芳, 程琛, 等. 廣東省 1990-2019 年急性病毒性肝炎疾病負擔分析. 中華流行病學雜志, 2024, 45(3): 365-372.
16. Ouyang G, Pan G, Li Q, et al. Global burden of acute hepatitis E between 1990 and 2019 and projections until 2030. Liver Int, 2024, 44(6): 1329-1342.
17. 曾丹藝. 1990-2019 年全球范圍急性病毒性肝炎的負擔及其與社會經濟發展狀況的關系. 廈門: 廈門大學, 2022.
18. 中國肝炎防治基金會. 成人甲型肝炎疫苗接種專家建議. 中國病毒病雜志, 2023, 13(6): 401-412.
19. 劉杰, 郭世成, 伍鳳云, 等. 2014-2021 年江西省急性乙型病毒性肝炎流行特征分析. 預防醫學, 2024, 36(1): 58-60.
20. Lao TT. Immune persistence after hepatitis B vaccination in infancy - fact or fancy?. Hum Vaccin Immunother, 2016, 12(5): 1172-1176.
21. 李生浩, 張黎, 張瑞仙. 1990-2019 年中國丙型病毒性肝炎疾病負擔評估. 中國感染控制雜志, 2022, 21(10): 971-976.
22. 周梅, 姚麗熙, 吳銀蓮, 等. 1990-2044 年中國丙型病毒性肝炎相關疾病的疾病負擔分析及預測. 中國血吸蟲病防治雜志, 2023, 35(5): 476-485.
23. Epstein RL, Espinosa C. Hepatitis C virus in neonates and infants. Clin Perinatol, 2021, 48(2): 343-357.
24. Hajarizadeh B, Cunningham EB, Reid H, et al. Direct-acting antiviral treatment for hepatitis C among people who use or inject drugs: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol, 2018, 3(11): 754-767.
25. Yu S, Wang Q, Wang S, et al. Burden of acute viral hepatitis - China, 1990-2019. China CDC Wkly, 2020, 2(31): 579-586.
26. 王朝華. 31 例老年人急性肝炎臨床特點分析. 實用老年醫學, 2010, 24(1): 83-84.
27. Valamparampil J, Kelly D. Viral hepatitis necessitating liver transplantation in children. Transplantation, 2024, 108(1): 127-136.
28. 賈夢山. 2019-2021 年周口市病毒性肝炎病例流行特征分析. 華南預防醫學, 2022, 48(8): 967-969.
29. Stawinska-Witoszynska B, Klos J, Moryson W, et al. Trends in the incidence of acute hepatitis B in the Polish population and their determinants. Medicina (Kaunas), 2021, 57(8): 738.
30. 袁磊, 張水軍. 性別與性激素對乙肝病毒易感性及其免疫應答的影響. 河南醫學研究, 2019, 28(10): 1919-1921.
31. Box G. Box and Jenkins: time series analysis, forecasting and control//Mills TC. A very British affair: six britons and the development of time series analysis during the 20th century. London; Palgrave Macmillan UK. 2013: 161-215.
32. Schaffer AL, Dobbins TA, Pearson SA. Interrupted time series analysis using autoregressive integrated moving average (ARIMA) models: a guide for evaluating large-scale health interventions. BMC Med Res Methodol, 2021, 21(1): 58.
33. 朱宗元, 于青. ARIMA 模型在我國病毒性肝炎發病率預測中的應用. 中國衛生統計, 2011, 28(1): 65-67.
34. Zhang C, Liu Y, Zhao H, et al. Global patterns and trends in total burden of hepatitis B from 1990 to 2019 and predictions to 2030. Clin Epidemiol, 2022, 14: 1519-1533.
35. Scott N, Sacks-Davis R, Wade AJ, et al. Australia needs to increase testing to achieve hepatitis C elimination. Med J Aust, 2020, 212(8): 365-370.
36. 丁勇, 吳靜, 武丹, 等. ARIMA 乘積季節模型預測我國戊肝的發病趨勢. 南京醫科大學學報(自然科學版), 2020, 40(11): 1725-1729.
37. 鄭慧敏, 薛允蓮, 黃燕飛, 等. ARIMA 模型在深圳市法定傳染病發病趨勢預測的應用. 實用預防醫學, 2016, 23(2): 240-243.
38. Huang D, Lai H, Shi X, et al. Global temporal trends and projections of acute hepatitis E incidence among women of childbearing age: age-period-cohort analysis 2021. J Infect, 2024, 89(4): 106250.
39. Su X, Zheng L, Zhang H, et al. Secular trends of acute viral hepatitis incidence and mortality in China, 1990 to 2019 and its prediction to 2030: the Global Burden of Disease Study 2019. Front Med (Lausanne), 2022, 9: 842088.

West China Medical Journal

Trends and projections of incidence and mortality of acute viral hepatitis in China from 1990 to 2021

Abstract Full text Figures/Tables Video References Cited by

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