Huang Deliang, Jiang Jinyan, Peng Jinghan, Zhu Zhibin, Chen Yuanyuan, Zhang Siyu, Lai Huiyi, Yu Hong, Zhao Qi, Wu Yanna, Chen Yanping, Chen Jun
Department of Liver Diseases, The Third People's Hospital of Shenzhen, The Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, Guangdong, China.
National Clinical Research Center for Infectious Diseases, Shenzhen, Guangdong, China.
J Clin Transl Hepatol. 2025 Aug 28;13(8):609-618. doi: 10.14218/JCTH.2025.00101. Epub 2025 May 30.
Acute hepatitis E (AHE) in the elderly can lead to severe complications including liver failure and mortality, yet the epidemiological landscape remains poorly characterized. This study aimed to assess the burden, trends, and health inequalities of AHE among the elderly over the past three decades, and to further predict its changes by 2030.
Data on AHE in the elderly were obtained from the Global Burden of Disease 2021. The burden of AHE was analyzed by trends, decomposition, cross-country inequalities, and predictive analysis.
In 2021, the global incidence and Disability-Adjusted Life Years (DALYs) for AHE among the elderly were recorded as 1,130,013.35 and 20,084.77, respectively. Although there were significant differences in the incidence and DALYs across countries, the number of incident cases increased from 1990 to 2021, with a slight rise in age-standardized rates, while the number and age-standardized rate of DALYs showed a declining trend. Decomposition analysis revealed that population growth and aging are the drivers of changes in incidence, while epidemiological changes somewhat offset the increases in DALYs driven by population growth. Low socio-demographic index countries bear a disproportionate burden of elderly AHE, although inequality gaps have narrowed over time. Notably, up to 2030, the number of incident cases and DALYs will continue increasing. The burden in elderly women was more pronounced than in men.
The burden of elderly AHE, as a major public health issue, remains substantial. While cross-country inequities have been alleviated over time, the pressure on lower socio-demographic index countries to control the disease remains high. AHE in elderly women requires further attention. This emphasizes the significant challenges faced in controlling and managing elderly AHE.
老年人急性戊型肝炎（AHE）可导致包括肝衰竭和死亡在内的严重并发症，但流行病学情况仍未得到充分描述。本研究旨在评估过去三十年中老年人AHE的负担、趋势和健康不平等状况，并进一步预测到2030年其变化情况。
老年人AHE的数据来自《2021年全球疾病负担》。通过趋势分析、分解分析、跨国不平等分析和预测分析对AHE的负担进行了分析。
2021年，全球老年人AHE的发病率和伤残调整生命年（DALYs）分别记录为1,130,013.35和20,084.77。尽管各国的发病率和DALYs存在显著差异，但从1990年到2021年发病病例数有所增加，年龄标准化率略有上升，而DALYs的数量和年龄标准化率呈下降趋势。分解分析表明，人口增长和老龄化是发病率变化的驱动因素，而流行病学变化在一定程度上抵消了人口增长导致的DALYs增加。社会人口指数较低的国家承担着不成比例的老年人AHE负担，尽管不平等差距随着时间的推移有所缩小。值得注意的是，到2030年，发病病例数和DALYs将继续增加。老年女性的负担比男性更明显。
老年人AHE的负担作为一个主要的公共卫生问题仍然很大。虽然随着时间的推移跨国不平等现象有所缓解，但社会人口指数较低的国家控制该病的压力仍然很大。老年女性的AHE需要进一步关注。这凸显了在控制和管理老年人AHE方面面临的重大挑战。
