Global, regional, and national burden of chronic hepatitis B, 1990–2021, and projections to 2030: An urgent call for action to achieve hepatitis B elimination goals by 2030

Chronic hepatitis B (CHB) represents a major barrier to achieving the hepatitis B elimination goals by 2030. We aimed to estimate the burden of CHB and its temporal trend from 1990 to 2021, and to project the extent of this burden up to 2030. We extracted data on the incidence, prevalence, mortality, and disability-adjusted life years (DALYs) of CHB from Global Burden of Diseases, Injuries, and Risk Factors Study 2021. Temporal trends of age-standardized rates from 1990 to 2021 were assessed by Joinpoint regression model. Bayesian Age-Period-Cohort model was employed to predict the incidence, prevalence, mortality, and DALYs of CHB up to 2030. Global prevalent cases of CHB were estimated at 283.64 million in 2021, with a slight decline of 8.32% in the number of prevalent cases from 1990 to 2021. CHB resulted in 431.96 thousand global deaths in 2021, and the number of CHB-related deaths increased by 20.04% during these periods. East Asia, South Asia, Western Sub-Saharan Africa, Southeast Asia, and Eastern Sub-Saharan Africa remained among the regions with the highest burden of CHB in 2021. Age-standardized rates of CHB significantly decreased during 1990-2021, and these rates were projected to continuously decline during 2022-2030. Despite evident declines in age-standardized incidence, prevalence, mortality, and DALYs of CHB over the past three decades, significant challenges remain in achieving hepatitis B elimination goals by 2030. Findings stress the need for comprehensive hepatitis B interventions, including vaccination, screening, and antiviral therapy, to reduce CHB burden and speed elimination.