Department of Hepatology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China; Hepatology Research Institute, Fujian Medical University, Fuzhou, Fujian, China; School of Medicine, Xiamen University, Xiamen, Fujian, China.
Department of Statistics, School of Economics, Xiamen University, Xiamen, Fujian, China.
J Hepatol. 2021 Sep;75(3):547-556. doi: 10.1016/j.jhep.2021.04.035. Epub 2021 May 4.
BACKGROUND & AIMS: Acute viral hepatitis (AVH) represents an important global health problem; however, the progress in understanding AVH is limited because of the priority of combating persistent HBV and HCV infections. Therefore, an improved understanding of the burden of AVH is required to help design strategies for global intervention.
Data on 4 major AVH types, including acute hepatitis A, B, C, and E, excluding D, were collected by the Global Burden of Disease (GBD) 2019 database. Age-standardized incidence rates and disability-adjusted life year (DALY) rates for AVH were extracted from GBD 2019 and stratified by sex, level of socio-demographic index (SDI), country, and territory. The association between the burden of AVH and socioeconomic development status, as represented by the SDI, was described.
In 2019, there was an age-standardized incidence rate of 3,615.9 (95% CI 3,360.5-3,888.3) and an age-standardized DALY rate of 58.0 (47.3-70.0) per 100,000 person-years for the 4 major types of AVH. Among the major AVH types, acute hepatitis A caused the heaviest burden. There was a significant downward trend in age-standardized DALY rates caused by major incidences of AVH between 1990 and 2019. In 2019, regions or countries located in West and East Africa exhibited the highest age-standardized incidence rates of the 4 major AVH types. These rates were stratified by SDI: high SDI and high-middle SDI locations recorded the lowest incidence and DALY rates of AVH, whereas the low-middle SDI and low SDI locations showed the highest burden of AVH.
The socioeconomic development status and burden of AVH are associated. Therefore, the GBD 2019 data should be used by policymakers to guide cost-effective interventions for AVH.
We identified a negative association between socioeconomic development status and the burden of acute viral hepatitis. The lowest burden of acute viral hepatitis was noted for rich countries, whereas the highest burden of acute viral hepatitis was noted for poor countries.
急性病毒性肝炎（AVH）是一个重要的全球健康问题；然而，由于优先考虑对抗持续性乙型肝炎病毒（HBV）和丙型肝炎病毒（HCV）感染，对 AVH 的认识进展有限。因此，需要更好地了解 AVH 的负担，以帮助制定全球干预策略。
通过 2019 年全球疾病负担（GBD）数据库收集了包括甲型肝炎、乙型肝炎、丙型肝炎和戊型肝炎（不包括丁型肝炎）在内的 4 种主要 AVH 类型的数据。从 GBD 2019 中提取了 AVH 的年龄标准化发病率和残疾调整生命年（DALY）率，并按性别、社会人口指数（SDI）水平、国家和地区进行分层。描述了 AVH 负担与代表社会经济发展状况的 SDI 之间的关联。
2019 年，4 种主要 AVH 类型的年龄标准化发病率为 3615.9（95%CI 3360.5-3888.3）/10 万人口年，年龄标准化 DALY 率为 58.0（47.3-70.0）/10 万人口年。在主要的 AVH 类型中，急性甲型肝炎造成的负担最重。1990 年至 2019 年，主要 AVH 类型的年龄标准化 DALY 率呈显著下降趋势。2019 年，位于西非和东非的地区或国家报告的 4 种主要 AVH 类型的年龄标准化发病率最高。按 SDI 分层：高 SDI 和高-中 SDI 地区的 AVH 发病率和 DALY 率最低，而中-低 SDI 和低 SDI 地区的 AVH 负担最重。
社会经济发展状况与 AVH 的负担相关。因此，决策者应使用 GBD 2019 数据来指导 AVH 的具有成本效益的干预措施。
我们发现社会经济发展状况与急性病毒性肝炎的负担呈负相关。富裕国家的急性病毒性肝炎负担最低，而贫穷国家的急性病毒性肝炎负担最高。
