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Sun N, He F, Sun J, Zhu G. Viral hepatitis in China during 2002-2021: epidemiology and influence factors through a country-level modeling study. BMC Public Health 2024; 24:1820. [PMID: 38978017 PMCID: PMC11232300 DOI: 10.1186/s12889-024-19318-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Accepted: 07/01/2024] [Indexed: 07/10/2024] Open
Abstract
BACKGROUND Viral hepatitis imposes a heavy disease burden worldwide and is also one of the most serious public health problems in China. We aimed to describe the epidemiological characteristics of hepatitis in China and to investigate the influencing factors. METHODS We first used the JoinPoint model to analyze the percentage change (APC) and average annual percentage change (AAPC) of hepatitis in Chinese provinces from 2002 to 2021. We then explored the influencing factors by using the time-series global principal component analysis (GPCA) and the panel fixed-effects model. RESULTS The disease burden varied across different provinces from 2002 to 2021. The AAPC of the total HAV incidence decreased by 10.39% (95% CI: [-12.70%, -8.02%]) from 2002 to 2021. Yet the AAPC of HBV, HCV, and HEV increased by 1.50% (95% CI: [0.23%, 2.79%]), 13.99% (95% CI: [11.28%, 16.77%]), and 7.10% (95% CI: [0.90%, 13.69%]), respectively. The hotspots of HAV, HBV, HCV, and HEV moved from the west to the center, from the northwest to the southeast, from the northeast to the whole country, and from the northeast to the southeast, respectively. Different types of viral hepatitis infections were associated with hygiene, pollutant, and meteorological factors. Their roles in spatial-temporal incidence were expressed by panel regression functions. CONCLUSIONS Viral hepatitis infection in China showed spatiotemporal heterogeneity. Interventions should be tailored to its epidemiological characteristics and determinants of viral hepatitis.
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Affiliation(s)
- Ning Sun
- School of Mathematics and Computing Science, Guangxi Colleges and Universities Key Laboratory of Data Analysis and Computation, Guilin University of Electronic Technology, Guilin, 541004, China
- Center for Applied Mathematics of Guangxi (GUET), Guilin, 541004, China
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Fangli He
- School of Mathematics and Computing Science, Guangxi Colleges and Universities Key Laboratory of Data Analysis and Computation, Guilin University of Electronic Technology, Guilin, 541004, China
- Center for Applied Mathematics of Guangxi (GUET), Guilin, 541004, China
| | - Jiufeng Sun
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China.
| | - Guanghu Zhu
- School of Mathematics and Computing Science, Guangxi Colleges and Universities Key Laboratory of Data Analysis and Computation, Guilin University of Electronic Technology, Guilin, 541004, China.
- Center for Applied Mathematics of Guangxi (GUET), Guilin, 541004, China.
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Zheng Z, Lin X, Huang Y, Zhang C, Zhang Z. Trends and age-period-cohort effect on incidence of hepatitis B from 2008 to 2022 in Guangzhou, China. Sci Rep 2024; 14:13370. [PMID: 38862511 PMCID: PMC11166960 DOI: 10.1038/s41598-024-63796-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 06/03/2024] [Indexed: 06/13/2024] Open
Abstract
Hepatitis B virus (HBV) infection is highly prevalent in Guangzhou, China. This study aimed to examine the long-term trend of HB incidence from 2008 to 2022 and the independent impacts of age, period, and cohort on the trends. HBV data were collected from the China Information System for Disease Control and Prevention. Joinpoint regression was utilized to examine temporal trends, and an age-period-cohort model was employed to estimate the effects of age, period, and cohort. A total of 327,585 HBV cases were included in this study. The incidence of chronic and acute HB showed a decreasing trend in Guangzhou over the past 15 years, with an average annual percent change of - 4.31% and - 16.87%, respectively. Age, period, and cohort all exerted significant effects. The incidence of HB was higher in males than in females and non-central areas compared to central areas. Age groups of 0-4 years and 15-24 years were identified as high-risk groups. The period relative risks for chronic HB incidence decreased initially and then stabilized. Cohorts born later had lower risks. Chronic HB incidences remain high in Guangzhou, especially among males, younger individuals, and residents of non-central areas. More efforts are still needed to achieve hepatitis elimination targets.
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Affiliation(s)
- Zhiwei Zheng
- Guangzhou Center for Disease Control and Prevention, Guangzhou, 510440, China
| | - Xinqi Lin
- Guangzhou Center for Disease Control and Prevention, Guangzhou, 510440, China
| | - Yong Huang
- Guangzhou Center for Disease Control and Prevention, Guangzhou, 510440, China.
- Institute of Public Health, Guangzhou Medical University & Guangzhou Center for Disease Control and Prevention, Guangzhou, 510440, China.
| | - Chunhuan Zhang
- Guangzhou Center for Disease Control and Prevention, Guangzhou, 510440, China.
| | - Zhoubin Zhang
- Guangzhou Center for Disease Control and Prevention, Guangzhou, 510440, China
- Institute of Public Health, Guangzhou Medical University & Guangzhou Center for Disease Control and Prevention, Guangzhou, 510440, China
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Ho E, Vanderlinden A, Govaerts L, De Fooz B, Van Damme P, Michielsen P, Vanwolleghem T. Opportunistic screening using point-of-care testing leads to successful linkage to care of HBV-infected migrant populations in a low endemic country. J Virus Erad 2024; 10:100369. [PMID: 38596321 PMCID: PMC11002856 DOI: 10.1016/j.jve.2024.100369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 03/22/2024] [Accepted: 03/25/2024] [Indexed: 04/11/2024] Open
Abstract
Background and aims In low endemic countries, screening for hepatitis B surface antigen (HBsAg) in migrants is cost-effective in reducing the disease burden of hepatitis B virus (HBV) infections, but linkage to care (LTC) remains a challenge. This study aims to guide future screening initiatives, with 3 objectives: 1. to compare LTC between different ethnic groups screened for HBsAg with point-of-care testing (POCT) in an outreach setting; 2. to estimate the proportion of HBsAg seropositivity for ethnic minorities; and 3. to investigate the association between seropositivity and HBV risk factors. Methods Opportunistic outreach screenings using finger prick HBsAg tests were performed at civic integration programmes between 11/2017 and 09/2022. If an individual tested positive, an appointment was given immediately at the outpatient hepatology clinic for follow-up and confirmation of HBsAg positivity in blood. Dedicated personnel contacted these individuals to motivate them for further LTC, which was defined as being assessed by a hepatologist, a blood test and an abdominal ultrasound. Results A total of 677 people from different ethnicities (Asian, Middle Eastern and African) were serologically screened using POCT. The observed positivity for HBsAg was 3.4 % (95% CI 2.17-5.05, 23/677). Apart from ethnicity and male sex, none of the surveyed HBV risk factors were associated with HBsAg seropositivity. All HBsAg positive individuals were linked to care and assessed by a hepatologist, despite the COVID-19 pandemic increase in time to follow-up of 82 days (95% CI 51-112 days) vs. 24 days (95% CI 5-43 days, p = 0.008)).Among HBV-infected patients, 31.8% (7/22), 100 % (22/22) and 26.1% (6/23) met the criteria for treatment indication, intrafamilial transmission risk and need for hepatocellular carcinoma surveillance, respectively. Conclusion The proportion of HBsAg seropositivity in ethnic minorities was 3.4%. POCT and commitment of dedicated personnel can overcome previously identified barriers resulting in a 100% LTC.
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Affiliation(s)
- Erwin Ho
- University of Antwerp, Viral Hepatitis Research Group, Laboratory of Experimental Medicine and Paediatrics, Antwerpen, Belgium
- Antwerp University Hospital, Department of Gastroenterology and Hepatology, Edegem, Belgium
| | - Axelle Vanderlinden
- University of Antwerp, Viral Hepatitis Research Group, Laboratory of Experimental Medicine and Paediatrics, Antwerpen, Belgium
- Antwerp University Hospital, Department of Gastroenterology and Hepatology, Edegem, Belgium
| | - Liesbeth Govaerts
- Antwerp University Hospital, Department of Gastroenterology and Hepatology, Edegem, Belgium
| | - Bo De Fooz
- Antwerp University Hospital, Department of Gastroenterology and Hepatology, Edegem, Belgium
| | | | - Peter Michielsen
- University of Antwerp, Viral Hepatitis Research Group, Laboratory of Experimental Medicine and Paediatrics, Antwerpen, Belgium
- Antwerp University Hospital, Department of Gastroenterology and Hepatology, Edegem, Belgium
| | - Thomas Vanwolleghem
- University of Antwerp, Viral Hepatitis Research Group, Laboratory of Experimental Medicine and Paediatrics, Antwerpen, Belgium
- Antwerp University Hospital, Department of Gastroenterology and Hepatology, Edegem, Belgium
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Bai S, Dang W, Hong W, Liao W, Smith RD. The prevalence of hepatitis B in Chinese general population from 2018 to 2022: a systematic review and meta-analysis. BMC Infect Dis 2024; 24:211. [PMID: 38365596 PMCID: PMC10870619 DOI: 10.1186/s12879-024-09103-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 02/05/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND Within China, Hepatitis B virus (HBV) infection remains widely prevalent and one of the major public health problems. There have been only two previous estimates of its prevalence at the population level in China, with the latest survey conducted in 2006. A meta-analysis estimated the prevalence of HBV within China between 2013 and 2017 as 7%. This review provides an updated estimate of HBV prevalence in China from 2018 to 2022. METHODS Systematic searches of literature from January 1, 2018 to December 25, 2022 were conducted in four international databases (Medline, Web of Science, Embase, Cochrane Database of Systematic Reviews) and three Chinese databases (CNKI, CBM, and WanFang data). Random-effects meta-analyses were conducted to calculate the pooled HBV prevalence with 95% confidence intervals in the overall population and subgroups. Publication bias, heterogeneity between studies, and study quality were assessed. RESULTS Twenty-five articles were included in the meta-analysis. The pooled prevalence of HBV infection in the Chinese general population from 2018 to 2022 was 3% (95%CI: 2-4%). The prevalence of HBV infection was similar between males and females (both 3%), while rural areas had a higher prevalence than urban areas (3% vs 2%). The highest prevalence of HBV was reported in the eastern provinces (4, 95%CI: 2-6%). The HBV prevalence of people aged ≥18 years old (6, 95%CI: 4-8%) was higher than people aged < 18 years old (0, 95%CI: 0-1%). CONCLUSION Compared to the previous meta-analysis prevalence in 2013-2017, the updated meta-analysis estimated prevalence of HBV infection (3%) from 2018 to 2020 showed a decreasing trend, suggesting China had moved into a lower intermediate epidemic area (2-5%). However, the prevalence of HBV in rural areas and eastern regions was still higher than the national average. People aged ≥18 years old showed a higher HBV prevalence. HBV prevention should be prioritized in the highest-prevalence areas and high-risk populations. Due to heterogeneity in data collection methods among studies, there remains a need for systematic surveillance of nationwide HBV prevalence.
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Affiliation(s)
- Shuwen Bai
- Department of Public Health and Medicinal Administration, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Wen Dang
- Department of Public Health and Medicinal Administration, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Wenying Hong
- Department of Public Health and Medicinal Administration, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Wenyu Liao
- Department of Public Health and Medicinal Administration, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Robert David Smith
- Department of Public Health and Medicinal Administration, Faculty of Health Sciences, University of Macau, Macao SAR, China.
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Hu J, Zhao J, Wang C, Jia M, Su M, Li S. Epstein-Barr virus reactivation correlates with worse outcomes for patients exposed to hepatitis B virus after haploidentical hematopoietic stem cell transplantation. Ann Hematol 2023; 102:3593-3601. [PMID: 37831153 DOI: 10.1007/s00277-023-05492-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 10/03/2023] [Indexed: 10/14/2023]
Abstract
Hepatitis B virus (HBV)has a high, chronic infection rate in Asian populations, but only few studies have analyzed the effect of Epstein-Barr virus (EBV) or Cytomegalovirus (CMV) reactivation in patients exposed to HBV after haploidentical hematopoietic stem cell transplantation (haplo-HSCT). This study aimed to assess the clinical outcomes of these patients. We conducted a retrospective research including 61 patients exposed to HBV after undergoing haplo-HSCT. The patients were classified into two groups: the CMV reactivation group and no CMV reactivation group. The results were compared between the two groups using the K-W test for continuous variables, Pearson's chi-square test for categorical variables, Kaplan-Meier curves to estimate overall survival (OS) and leukemia-free survival (LFS), and a Cox proportional hazards model to analyze multivariable influences. The 3-year cumulative HBV reactivation rate was 8.2%. The median duration of HBV reactivation was 16 months (16-22 months) after haplo-HSCT. The CMV reactivation group had a higher cumulative incidence of HBV reactivation than the group without CMV reactivation. The EBV reactivation was substantially higher in the CMV reactivation group compared to that in the no CMV reactivation group (37.0% vs.5.9% respectively; P = 0.002). Furthermore, EBV reactivation was a risk factor for 1-year LFS and 1-year OS. Based on our data, EBV reactivation was related to worse outcomes in patients exposed to HBV after haplo-HSCT, whereas CMV reactivation was not.
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Affiliation(s)
- Jiajia Hu
- Department of Clinical Laboratory, Peking University People's Hospital, No. 11 Xizhimen South Street, Xicheng District, Beijing, 100044, People's Republic of China
| | - Jie Zhao
- Department of Clinical Laboratory, Peking University People's Hospital, No. 11 Xizhimen South Street, Xicheng District, Beijing, 100044, People's Republic of China
| | - Chunyan Wang
- Department of Clinical Laboratory, Peking University People's Hospital, No. 11 Xizhimen South Street, Xicheng District, Beijing, 100044, People's Republic of China
| | - Mei Jia
- Department of Clinical Laboratory, Peking University People's Hospital, No. 11 Xizhimen South Street, Xicheng District, Beijing, 100044, People's Republic of China
| | - Ming Su
- Department of Clinical Laboratory, Peking University People's Hospital, No. 11 Xizhimen South Street, Xicheng District, Beijing, 100044, People's Republic of China.
| | - Shanshan Li
- Department of Clinical Laboratory, Peking University People's Hospital, No. 11 Xizhimen South Street, Xicheng District, Beijing, 100044, People's Republic of China.
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