关键词: 丙型病毒性肝炎, 疾病负担, 伤残调整寿命年, 发病率, 患病率, 死亡率, 估算年度变化百分比

Abstract: Objective　To measure the burden of hepatitis C⁃associated diseases in China from 1990 to 2019, and to predict its changes from 2020 to 2044, so as to provide insights into formulation of the targeted hepatitis C control strategy. Methods 　The total burden due to hepatitis C⁃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 age⁃standardized prevalence, incidence, mortality and disability⁃adjusted life years (DALYs) rate of hepatitis C⁃associated acute hepatitis C (AHC), chronic liver diseases (CLD) and liver cancer in China from 1990 to 2019 were evaluated in China from 1990 to 2019 using estimated annual percentage change (EAPC). In addition, the changes in the burden of hepatitis C⁃associated diseases were predicted in China from 2020 to 2044 using a Bayesian model. Results　The prevalence, incidence, mortality and DALY rate of hepatitis C⁃associated diseases all appeared an overall tendency towards a decline in China from 1990 to 2019 (EAPC = −2.64%, −2.24%, −3.81% and −3.90%, respectively); however, there was a minor rise in the incidence and prevalence of hepatitis C⁃associated diseases from 2015 to 2019. The overall prevalence of hepatitis C⁃associated diseases reduced from 2 152.7/105 in 1990 to 1 254.1/105 in 2019 in China, with a reduction of 41.7%. The overall incidence reduced from 87.9/105 in 1990 to 55.0/105 in 2019 in China, with a reduction of 37.4%, and the highest incidence was seen for AHC, followed by CLD and liver cancer. The overall mortality and DALYs rate of hepatitis C⁃associated diseases was 4.0/105 and 100.8/105 in China from 1990 to 2019, with CLD showing the largest contributions to the gross mortality and DALYs. The mortality and DALY rate of hepatitis C⁃associated diseases were 5.5/105 and 142.4/105 among men in China in 2019, which were both much higher than among women (2.8/105 and 60.3/105, respectively), and the overall prevalence (1 604.9/105), mortality (30.2/105) and DALYs (437.1/105) of hepatitis C⁃associated diseases were all highest among patients at ages of 70 years and older, and the highest incidence was seen among patients at ages of 0 to 9 years (167.3/105). The incidence of hepatitis C⁃associated diseases was predicted to rise in China from 2020 to 2044; however, the DALYs was projected to appear a tendency towards a decline. Conclusions　Although the burden of hepatitis C⁃associated diseases showed a tendency towards a decline in China from 1990 to 2019, the burden remained high, and was predicted to slightly rise from 2020 to 2044. High attention should be paid to screening of hepatitis C among infants and treatment among adults.

Key words: Hepatitis C, Burden of disease, Disability?adjusted life year, Incidence, Prevalence, Mortality, Estimated annual percentage change