关键词: 乙型病毒性肝炎, 疾病负担, 伤残调整寿命年, 发病率, 患病率, 死亡率, Joinpoint回归分析, 中国

Abstract: Objective　To measure the burden of hepatitis B⁃associated diseases in China from 1990 to 2019, and to predict its changes from 2020 to 2030. Methods　The age⁃standardized prevalence, incidence, mortality and disability⁃adjusted life years (DALY) rate of hepatitis B⁃associated diseases in China from 1990 to 2019 were extracted from the Global Burden of Disease 2019 (GBD 2019) data resources, and the trends in burdens of hepatitis B⁃associated diseases were evaluated from 1990 to 2019 using estimated annual percentage change (EAPC) and annual percent change (APC). In addition, the changes in the burden of hepatitis B⁃associated diseases were predicted in China from 2020 to 2023 using the Bayesian model. Results　The overall incidence of hepatitis B⁃associated diseases reduced from 2 725.98/105 in 1990 to 1 397.31/105 in 2019 in China [estimated annual percentage change (EAPC) = −2.35%, 95% confidential interval (CI): (−2.58%, −2.13%)], with a reduction in the prevalence from 12 239.53/105 in 1990 to 6 566.12/105 in 2019 [EAPC = −2.34%, 95% CI: (−2.54%, −2.14%)], a reduction in the mortality from 24.67/105 in 1990 to 8.07/105 in 2019 [EAPC = −4.92%, 95% CI: (−5.37%, −4.47%)], and a reduction in the DALYs rate from 793.38/105 in 1990 to 247.71/105 in 2019 [(EAPC = −5.15%, 95% CI: (−5.64%, −4.66%)]. The DALYs of hepatitis B⁃associated diseases were mainly attributed to liver cancer, and the DALYs of hepatitis B⁃associated diseases appeared a tendency towards a rise in China from 2012 to 2019 [APC = 1.30%, 95% CI: (0.16%, 2.45%)]. The overall burden of hepatitis B⁃associated diseases was higher in males than in females, and the DALYs rate of hepatitis B⁃associated diseases increased with age, with the greatest DALY rate seen among patients at ages of 50 to 69 years. The overall incidence of hepatitis B⁃associated diseases was projected to be 866.79/105 in China in 2030, with the greatest incidence seen in acute hepatitis B (854.87/105), and the burden of hepatitis B⁃associated diseases was predicted to decline in China from 2020 to 2030; however, the burden of liver disease was projected to appear a tendency towards a rise. Conclusions　The burden of hepatitis B⁃associated diseases appears an overall tendency towards a decline in China from 1990 to 2030; however, the burden of liver cancer appears a tendency towards aggravation. Early diagnosis and treatment of liver cancer should be given a high priority.

Key words: Hepatitis B, Burden of disease, Disability?adjusted life year, Incidence, Prevalence, Mortality, Joinpoint regression analysis, China