Department of Epidemiology, National Vaccine Innovation Platform, Centre for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China.
Department of Infectious Diseases, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
J Glob Health. 2024 Apr 19;14:04077. doi: 10.7189/jogh.14.04077.
The current study uniquely focuses on the global incidence and temporal trends of acute hepatitis C (AHC) and hepatitis C virus (HCV)-related cirrhosis among women of reproductive age (15-49 years) from 1990-2019. The risk of vertical transmission and adverse perinatal outcomes associated with HCV infection underscores the importance of prioritising these women in HCV prevention efforts.
Leveraging the Global Burden of Disease 2019 data, we calculated age-standardised incidence rates (ASIR) and assessed temporal trends via the average annual percent change from joinpoint regression. The age-period-cohort model was employed to understand further the effects of age, period, and birth cohort.
Over the 30 years, global incidences of AHC and HCV-related cirrhosis in reproductive-age women increased by 46.45 and 72.74%, respectively. The ASIR of AHC was highest in low sociodemographic index regions but showed a declining trend. Conversely, the ASIR of HCV-related cirrhosis displayed unfavourable trends in low, low-middle, and high sociodemographic index regions. Special attention is necessary for sub-Saharan Africa, high-income North America, Eastern Europe, and Central Asia due to their high incidence rates or increasing trends of AHC and HCV-related cirrhosis. Notably, the age-period-cohort model suggests a recent resurgence in AHC and HCV-related cirrhosis risk.
The current study is the first to thoroughly evaluate the trends of AHC and HCV-related cirrhosis among reproductive-age women, shedding light on previously unexplored aspects of HCV epidemiology. Our findings identify critical areas where health care systems must adapt to the changing dynamics of HCV infection. The detailed stratification by region and nation further enables the development of localised prevention and treatment strategies.
本研究独特地关注了 1990 年至 2019 年期间全球育龄妇女（15-49 岁）中急性丙型肝炎（AHC）和丙型肝炎病毒（HCV）相关肝硬化的全球发病率和时间趋势。HCV 感染相关的垂直传播风险和不良围产期结局强调了优先考虑这些妇女进行 HCV 预防工作的重要性。
利用 2019 年全球疾病负担数据，我们计算了年龄标准化发病率（ASIR），并通过连接点回归评估了时间趋势。年龄-时期-队列模型用于进一步了解年龄、时期和出生队列的影响。
在 30 年期间，全球育龄妇女 AHC 和 HCV 相关肝硬化的发病率分别增加了 46.45%和 72.74%。AHC 的 ASIR 在低社会人口指数地区最高，但呈下降趋势。相反，低、中低和高社会人口指数地区的 HCV 相关肝硬化的 ASIR 呈不利趋势。由于 AHC 和 HCV 相关肝硬化的发病率或发病率上升趋势较高，需要特别关注撒哈拉以南非洲、高收入北美、东欧和中亚地区。值得注意的是，年龄-时期-队列模型表明 AHC 和 HCV 相关肝硬化的风险最近出现了反弹。
本研究首次全面评估了育龄妇女中 AHC 和 HCV 相关肝硬化的趋势，揭示了 HCV 流行病学中以前未被探索的方面。我们的发现确定了医疗保健系统必须适应 HCV 感染不断变化动态的关键领域。按地区和国家进行的详细分层进一步使制定本地化的预防和治疗策略成为可能。
