National trends in acute viral hepatitis in China from 1990–2023: An analysis of the Global Burden of Disease 2023 update

BACKGROUND: The prerequisite for achieving the goal of the World Health Organization to completely eliminate viral hepatitis by 2030 is China's accurate understanding of the current disease burden, thereby providing a basis for formulating and optimizing intervention measures. METHODS: Based on the Global Burden of Disease (GBD) 2023 dataset, we extracted data on acute hepatitis A, B, C, and E in China, including incidence, mortality, disability-adjusted life years (DALYs), and their corresponding age-standardized rates (ASRs). To account for differences in age and sex distributions, we calculated ASRs based on the age-specific data extracted from the GBD 2023 dataset. To further assess temporal patterns across different age groups, we estimated the average annual percent change (AAPC). We applied the autoregressive integrated moving average model to project acute viral hepatitis (AVH) disease burden for 2024-2030. RESULTS: In 2023, there were an estimated 48.7 million incidence cases of AVH in China, including approximately 19.0 million cases of acute hepatitis A (AHA), 19.2 million cases of acute hepatitis B (AHB), 1.35 million cases of acute hepatitis C (AHC), and 9.2 million cases of acute hepatitis E (AHE). From 1990 to 2023, the overall age-standardized incidence rates (ASIR) of the four major AVH types in China declined (AAPC = -0.90%, 95% confidence interval [CI]: -0.93% to -0.87%). In the previous decade, divergent trends were observed. The ASIR of AHC increased (AAPC = 1.42%, 95% CI: 1.39-1.46%), AHE remained stable (AAPC = -0.04%, 95% CI: -0.39-0.32%), whereas AHA and AHB decreased. Moreover, the age-standardized mortality and DALYs rates for AVH significantly decreased. Age-specific analysis further revealed an upward trend in standardized incidence among individuals aged 25-29 years (AAPC = 0.14%, 95% CI: 0.10-0.19%). A continued decline in the ASIR of AVH is projected for 2024-2030. CONCLUSIONS: In China, the overall burden of AVH has decreased between 1990 and 2023. AHB vaccination among younger populations should be strengthened, and targeted prevention and control strategies should be implemented for those at high risk of AHC, to curb the spread of the disease and reduce the overall burden.