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

1.	国家疾病预防控制局. 2024 年 2 月全国法定传染病疫情概况. 中国病毒病杂志, 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.
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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.
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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.	张家玮, 周敏, 苏永健, 等. 基于 Joinpoint 回归模型分析 2005—2021 我国甲型肝炎发病趋势. 华南预防医学, 2024, 50(7): 604-607, 612.
14.	国家卫生健康委员会. 国家免疫规划疫苗儿童免疫程序及说明(2021 年版). 中国病毒病杂志, 2021, 11(4): 241-245.
15.	邱嘉敏, 曾芳芳, 程琛, 等. 广东省 1990-2019 年急性病毒性肝炎疾病负担分析. 中华流行病学杂志, 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.	曾丹艺. 1990-2019 年全球范围急性病毒性肝炎的负担及其与社会经济发展状况的关系. 厦门: 厦门大学, 2022.
18.	中国肝炎防治基金会. 成人甲型肝炎疫苗接种专家建议. 中国病毒病杂志, 2023, 13(6): 401-412.
19.	刘杰, 郭世成, 伍凤云, 等. 2014-2021 年江西省急性乙型病毒性肝炎流行特征分析. 预防医学, 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, 张黎, 张瑞仙. 1990-2019 年中国丙型病毒性肝炎疾病负担评估. 中国感染控制杂志, 2022, 21(10): 971-976.
22.	周梅, 姚丽熙, 吴银莲, 等. 1990-2044 年中国丙型病毒性肝炎相关疾病的疾病负担分析及预测. 中国血吸虫病防治杂志, 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.	王朝华. 31 例老年人急性肝炎临床特点分析. 实用老年医学, 2010, 24(1): 83-84.
27.	Valamparampil J, Kelly D. Viral hepatitis necessitating liver transplantation in children. Transplantation, 2024, 108(1): 127-136.
28.	贾梦山. 2019-2021 年周口市病毒性肝炎病例流行特征分析. 华南预防医学, 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, 张水军. 性别与性激素对乙肝病毒易感性及其免疫应答的影响. 河南医学研究, 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 模型在我国病毒性肝炎发病率预测中的应用. 中国卫生统计, 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, 吴静, 武丹, 等. ARIMA 乘积季节模型预测我国戊肝的发病趋势. 南京医科大学学报(自然科学版), 2020, 40(11): 1725-1729.
37.	郑慧敏, 薛允莲, 黄燕飞, 等. ARIMA 模型在深圳市法定传染病发病趋势预测的应用. 实用预防医学, 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. 国家疾病预防控制局. 2024 年 2 月全国法定传染病疫情概况. 中国病毒病杂志, 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, 温宁, 等. 中国深化医疗改革十年免疫规划助力全民健康. 中国疫苗和免疫, 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. 张家玮, 周敏, 苏永健, 等. 基于 Joinpoint 回归模型分析 2005—2021 我国甲型肝炎发病趋势. 华南预防医学, 2024, 50(7): 604-607, 612.
14. 国家卫生健康委员会. 国家免疫规划疫苗儿童免疫程序及说明(2021 年版). 中国病毒病杂志, 2021, 11(4): 241-245.
15. 邱嘉敏, 曾芳芳, 程琛, 等. 广东省 1990-2019 年急性病毒性肝炎疾病负担分析. 中华流行病学杂志, 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. 曾丹艺. 1990-2019 年全球范围急性病毒性肝炎的负担及其与社会经济发展状况的关系. 厦门: 厦门大学, 2022.
18. 中国肝炎防治基金会. 成人甲型肝炎疫苗接种专家建议. 中国病毒病杂志, 2023, 13(6): 401-412.
19. 刘杰, 郭世成, 伍凤云, 等. 2014-2021 年江西省急性乙型病毒性肝炎流行特征分析. 预防医学, 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, 张黎, 张瑞仙. 1990-2019 年中国丙型病毒性肝炎疾病负担评估. 中国感染控制杂志, 2022, 21(10): 971-976.
22. 周梅, 姚丽熙, 吴银莲, 等. 1990-2044 年中国丙型病毒性肝炎相关疾病的疾病负担分析及预测. 中国血吸虫病防治杂志, 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. 王朝华. 31 例老年人急性肝炎临床特点分析. 实用老年医学, 2010, 24(1): 83-84.
27. Valamparampil J, Kelly D. Viral hepatitis necessitating liver transplantation in children. Transplantation, 2024, 108(1): 127-136.
28. 贾梦山. 2019-2021 年周口市病毒性肝炎病例流行特征分析. 华南预防医学, 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, 张水军. 性别与性激素对乙肝病毒易感性及其免疫应答的影响. 河南医学研究, 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 模型在我国病毒性肝炎发病率预测中的应用. 中国卫生统计, 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, 吴静, 武丹, 等. ARIMA 乘积季节模型预测我国戊肝的发病趋势. 南京医科大学学报(自然科学版), 2020, 40(11): 1725-1729.
37. 郑慧敏, 薛允莲, 黄燕飞, 等. ARIMA 模型在深圳市法定传染病发病趋势预测的应用. 实用预防医学, 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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