1990 年至 2019 年全球、中国、印度和美国丙型肝炎病毒负担。

The burden of hepatitis C virus in the world, China, India, and the United States from 1990 to 2019.

机构信息

Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases, Peking University Hepatology Institute, Peking University People's Hospital, Beijing, China.

National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.

出版信息

Front Public Health. 2023 Mar 2;11:1041201. doi: 10.3389/fpubh.2023.1041201. eCollection 2023.

BACKGROUND AND AIM

Hepatitis C virus infection can lead to an enormous health burden worldwide. Investigating the changes in HCV-related burden between different countries could provide inferences for disease management. Hence, we aim to explore the temporal tendency of the disease burden associated with HCV infection in China, India, the United States, and the world.

METHODS

Detailed data on the total burden of disease related to HCV infection were collected from the Global Burden of Disease (GBD) 2019 database. Joinpoint regression models were used to simulate the optimal joinpoints of annual percent changes (APCs). Further analysis of the age composition of each index over time and the relationship between ASRs and the socio-demographic Index (SDI) were explored. Finally, three factors (population growth, population aging, and age-specific changes) were deconstructed for the changes in the number of incidences, deaths, and DALYs.

RESULTS

It was estimated that 6.2 million new HCV infections, 0.54 million HCV-related deaths, and 15.3 million DALYs worldwide in 2019, with an increase of 25.4, 59.1, and 43.6%, respectively, from 1990, are mainly due to population growth and aging. China experienced a sharp drop in age-standardized rates in 2019, the United States showed an upward trend, and India exhibited a fluctuating tendency in the burden of disease. The incidence was increasing in all locations recently.

CONCLUSION

HCV remains a global health concern despite tremendous progress being made. The disease burden in China improved significantly, while the burden in the United States was deteriorating, with new infections increasing recently, suggesting more targeted interventions to be established to realize the 2030 elimination goals.

背景与目的

丙型肝炎病毒（HCV）感染可导致全球巨大的健康负担。研究不同国家间 HCV 相关负担的变化可为疾病管理提供推断。因此，我们旨在探讨中国、印度、美国和全球 HCV 感染相关疾病负担的时间趋势。

方法

从全球疾病负担（GBD）2019 数据库中收集了与 HCV 感染相关的总疾病负担的详细数据。使用 Joinpoint 回归模型模拟了年度百分比变化（APC）的最佳连接点。进一步分析了各指标随时间的年龄构成以及 ASR 与社会人口指数（SDI）之间的关系。最后，对发病率、死亡率和伤残调整生命年（DALY）的变化进行了三个因素（人口增长、人口老龄化和特定年龄变化）的分解。

结果

据估计，2019 年全球有 620 万例新的 HCV 感染、0.54 万例 HCV 相关死亡和 1530 万 DALY，分别比 1990 年增加了 25.4%、59.1%和 43.6%，主要原因是人口增长和老龄化。中国的年龄标准化率在 2019 年急剧下降，美国呈上升趋势，印度的疾病负担呈波动趋势。最近所有地区的发病率都在增加。