Department of Public Health and Medicinal Administration, Faculty of Health Sciences, University of Macau, Macao SAR, China.
BMC Infect Dis. 2024 Feb 16;24(1):211. doi: 10.1186/s12879-024-09103-8.
Within China, Hepatitis B virus (HBV) infection remains widely prevalent and one of the major public health problems. There have been only two previous estimates of its prevalence at the population level in China, with the latest survey conducted in 2006. A meta-analysis estimated the prevalence of HBV within China between 2013 and 2017 as 7%. This review provides an updated estimate of HBV prevalence in China from 2018 to 2022.
Systematic searches of literature from January 1, 2018 to December 25, 2022 were conducted in four international databases (Medline, Web of Science, Embase, Cochrane Database of Systematic Reviews) and three Chinese databases (CNKI, CBM, and WanFang data). Random-effects meta-analyses were conducted to calculate the pooled HBV prevalence with 95% confidence intervals in the overall population and subgroups. Publication bias, heterogeneity between studies, and study quality were assessed.
Twenty-five articles were included in the meta-analysis. The pooled prevalence of HBV infection in the Chinese general population from 2018 to 2022 was 3% (95%CI: 2-4%). The prevalence of HBV infection was similar between males and females (both 3%), while rural areas had a higher prevalence than urban areas (3% vs 2%). The highest prevalence of HBV was reported in the eastern provinces (4, 95%CI: 2-6%). The HBV prevalence of people aged ≥18 years old (6, 95%CI: 4-8%) was higher than people aged < 18 years old (0, 95%CI: 0-1%).
Compared to the previous meta-analysis prevalence in 2013-2017, the updated meta-analysis estimated prevalence of HBV infection (3%) from 2018 to 2020 showed a decreasing trend, suggesting China had moved into a lower intermediate epidemic area (2-5%). However, the prevalence of HBV in rural areas and eastern regions was still higher than the national average. People aged ≥18 years old showed a higher HBV prevalence. HBV prevention should be prioritized in the highest-prevalence areas and high-risk populations. Due to heterogeneity in data collection methods among studies, there remains a need for systematic surveillance of nationwide HBV prevalence.
在中国，乙型肝炎病毒（HBV）感染仍然广泛流行，是主要的公共卫生问题之一。此前仅有两项针对中国人群 HBV 流行率的全国性估计，最近的一次调查是在 2006 年进行的。一项荟萃分析估计，2013 年至 2017 年期间中国 HBV 的流行率为 7%。本综述提供了 2018 年至 2022 年中国 HBV 流行率的最新估计。
从 2018 年 1 月 1 日至 2022 年 12 月 25 日，在四个国际数据库（Medline、Web of Science、Embase、Cochrane 系统评价数据库）和三个中文数据库（CNKI、CBM 和万方数据）中进行了文献系统检索。采用随机效应荟萃分析计算总体人群和亚组中 HBV 总流行率及其 95%置信区间。评估了发表偏倚、研究间异质性和研究质量。
共纳入 25 项荟萃分析。2018 年至 2022 年，中国一般人群中 HBV 感染的总流行率为 3%（95%CI：2-4%）。男性和女性的 HBV 感染率相似（均为 3%），而农村地区的流行率高于城市地区（3%比 2%）。东部省份报告的 HBV 流行率最高（4，95%CI：2-6%）。≥18 岁人群的 HBV 流行率（6，95%CI：4-8%）高于<18 岁人群（0，95%CI：0-1%）。
与 2013-2017 年之前的荟萃分析流行率相比，本次更新的荟萃分析估计 2018-2020 年 HBV 感染流行率（3%）呈下降趋势，表明中国已进入低中度流行地区（2-5%）。然而，农村地区和东部地区的 HBV 流行率仍高于全国平均水平。≥18 岁人群 HBV 流行率较高。应优先在流行率最高的地区和高危人群中开展 HBV 预防工作。由于研究间数据收集方法存在异质性，仍需对全国 HBV 流行率进行系统监测。
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