Department of Liver Diseases, The Third People's Hospital of Shenzhen, The Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, Guangdong 518100, China; National Clinical Research Center for Infectious Diseases, Shenzhen, Guangdong 518100, China.
Department of Liver Diseases, The Third People's Hospital of Shenzhen, The Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, Guangdong 518100, China; National Clinical Research Center for Infectious Diseases, Shenzhen, Guangdong 518100, China.
J Infect. 2024 Oct;89(4):106250. doi: 10.1016/j.jinf.2024.106250. Epub 2024 Aug 23.
BACKGROUND & AIMS: Acute hepatitis E (AHE) poses a significant threat to global public health, particularly among women of childbearing age (WCBA), who are at heightened risk for severe pregnancy-related complications. This study aimed to delineate the temporal trends and project future incidence of AHE in WCBA, providing insights crucial for targeted prevention and control strategies.
Data on AHE incidence from the Global Health data 2021. The age-period-cohort (APC) model was applied to analyze trends across different age groups, periods, and birth cohorts, and the Bayesian APC model was utilized for forecasting future epidemiological trajectories.
Globally, AHE incidence numbers among WCBA rose from 2,831,075 in 1992 to 3,420,786 in 2021, while the age-standardized incidence rate (ASIR) declined from 194.66 to 179.54 per 100,000 with a global net drift of -0.28%. However, high SDI regions showed a contrasting trend with a positive net drift of 0.02%. The age effect was consistent across SDI regions and globally, showing a decrease with advancing age, while unfavorable period and cohort effects were exhibited in high-SDI region. At the national level, locations exhibited varying trends of change. The BAPC model predicted a total of 3,759,384 AHE global cases in WCBA by 2030, with an expected mild increase in the ASIR. The outlook for the management and containment of AHE is grim in certain countries, including India.
The study revealed a complex epidemiological landscape of AHE in WCBA, with increasing global incidence numbers juxtaposed against a declining ASIR. The AHE burden by 2030 remain severe among WCBA. Young WCBA and high SDI region merit particular attention. The findings underscore the need for region-specific strategies to curb the projected rise in AHE incidence and align with the 2030 WHO goals.
急性戊型肝炎（AHE）对全球公共卫生构成重大威胁，尤其是生育年龄妇女（WCBA），她们面临严重妊娠相关并发症的风险增加。本研究旨在描绘 WCBA 中 AHE 的时间趋势并预测未来的发病率，为有针对性的预防和控制策略提供重要见解。
使用 2021 年全球健康数据中的 AHE 发病率数据。应用年龄-时期-队列（APC）模型分析不同年龄组、时期和出生队列的趋势，并使用贝叶斯 APC 模型预测未来的流行病学轨迹。
全球范围内，WCBA 中的 AHE 发病率从 1992 年的 2831075 例上升到 2021 年的 3420786 例，而年龄标准化发病率（ASIR）从 194.66 例下降到 179.54 例/100000，全球净漂移为-0.28%。然而，高 SD 地区显示出相反的趋势，净漂移为 0.02%。年龄效应在所有 SD 地区和全球范围内都是一致的，随着年龄的增长而下降，而在高 SD 地区则表现出不利的时期和队列效应。在国家层面，不同地点的变化趋势也不同。BAPC 模型预测到 2030 年，全球 WCBA 中共有 3759384 例 AHE 病例，ASIR 预计会略有上升。在某些国家，包括印度，AHE 的管理和控制前景严峻。
本研究揭示了 WCBA 中 AHE 的复杂流行病学情况，全球发病率不断上升，而 ASIR 却在下降。到 2030 年，WCBA 中的 AHE 负担仍然严重。年轻的 WCBA 和高 SD 地区需要特别关注。这些发现强调了需要制定针对特定地区的策略来遏制预计的 AHE 发病率上升，并与 2030 年世卫组织目标保持一致。
