The Evolving Burden of Hepatitis B and C: Past Trends and Future Projections from the Global Burden of Disease Study 2021.
Chen Yue Y, Mao He-Hui HH, Zhang Ming-Jing MJ, Zhang Jin-Yan JY et al.
Hepatitis B and C continue to pose significant challenges to global public health, and this study is aimed at evaluating their burden. Leveraging data from the Global Burden of Disease 2021, we analyzed age-standardized mortality rates (ASMRs) and age-standardized disability-adjusted life year rates (ASDRs) for hepatitis B and C from 1990 to 2021 using Joinpoint regression, age-period-cohort models, and decomposition analysis. Bayesian age-period-cohort models were applied to project future trends up to 2036. Additionally, we assessed the burden attributable to modifiable risk factors and its association with socioeconomic indicators. From 1990 to 2021, the global ASMR for hepatitis B declined from 12.19 to 7.57 per 100,000, and the ASMR for hepatitis C decreased from 8.18 to 6.10 per 100,000. Despite these decreases, the absolute numbers of deaths and DALYs continued to increase, mainly driven by population growth and aging. In 2021, males carried a disproportionately higher burden of hepatitis B and C compared to females. Moreover, countries with low socioeconomic development faced a greater burden. Notably, high alcohol consumption accounted for 16.20% of hepatitis B DALYs, while drug use was responsible for 49.49% of hepatitis C DALYs. By 2036, ASMRs are projected to decline further to 5.90 per 100,000 for hepatitis B and 5.23 per 100,000 for hepatitis C. Although ASMRs and ASDRs have declined, the global burden of hepatitis B and C remains considerable. Continued efforts in vaccination, antiviral treatment, and control of key risk factors are crucial, especially in populations with a high burden.