Global, Regional, and National Burden of Chronic Hepatitis B-Related Cirrhosis From 1990 to 2021 and Projections to 2050: A Finding From the Global Burden of Disease Study 2021.

INTRODUCTION

Chronic hepatitis B (CHB) is a widespread liver infection caused by hepatitis B virus, affecting 296 million people globally. The disease often progresses to severe conditions such as cirrhosis, hepatocellular carcinoma, and liver failure. The aim of this study was to evaluate the global, regional, and national burden of CHB-related cirrhosis from 1990 to 2021 and projected the disease development from 2022 to 2050.

METHODS

In this study, data from the Global Burden of Disease 2021 database were used to analyze the global burden of CHB-related cirrhosis. Metrics such as incidence, prevalence, deaths, disability-adjusted life-years (DALYs), years lived with disability, and years of life lost were examined. Descriptive analysis explored the burden distribution by sex, age, Sociodemographic Index levels, and country in 1990 and 2021. Trend analysis used estimated annual percentage change to assess changes in age-standardized rates over time. The Autoregressive Integrated Moving Average model and the exponential smoothing model were applied to predict future trends.

RESULTS

In 2021, CHB-related cirrhosis caused 4.8 million incident cases, 432,000 deaths, and 13.9 million DALYs globally, with decreasing trends in age-standardized incidence rate, age-standardized mortality rate, and age-standardized DALYs rate since 1990. Men exhibited higher burdens than women. Age-specific analysis revealed the highest age-standardized incidence rate in those aged younger than 5 years and the highest age-standardized mortality rate in the 85-89 years age group. Regionally, the greatest burden was observed in low Sociodemographic Index areas, with Sierra Leone and Egypt showing the highest rates. Projections indicate stable mortality but declining incidence and slightly increasing DALYs globally by 2050, with minor sex-specific variations.

DISCUSSION

The 2021 Global Burden of Disease Study highlights progress in reducing CHB-related cirrhosis. Targeted efforts and lessons from successful interventions are essential to further alleviate this burden and improve outcomes worldwide.