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Global burden and trends of acute viral hepatitis among children and adolescents from 1990 to 2019: a systematic analysis of the Global Burden of Disease Study 2019

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Abstract

Background

Children and adolescents are at high risk for acute viral hepatitis (AVH), but epidemiological research focusing on them has been overshadowed by adult chronic B and C. We provide global, regional, and national estimates of the AVH burden and their trends on people under 20 years from 1990 to 2019.

Methods

AVH data from Global Burden of Disease Study (GBD) 2019 was used. Incidence and disability-adjusted life years (DALYs) were calculated, analyzing trends with estimated annual percentage change (EAPC) and Joinpoint regression.

Results

In 2019, 156.39 (95% uncertainty interval 145.20–167.16) million new cases of AVH were reported among children and adolescents globally, resulting in 1.98 (1.50–2.55) million DALYs. Incidence rates for young children (< 5 years), older children (5–9 years), and adolescents (10–19 years) were 12,799 (11,068–14,513), 5,108 (4829–5411), and 3020 (2724–3339) per 100,000 population, respectively. The global AVH incidence displayed a linear decline with an EAPC of − 0.66 (− 0.68 to − 0.65). High-incidence regions included sub-Saharan Africa, Oceania, South Asia, and Central Asia, with India, Pakistan, and Nigeria facing the greatest burden. Leading causes were hepatitis A, followed by hepatitis E, B, and C. All hepatitis types showed declining trends, especially hepatitis B. Furthermore, we confirmed the association between the AVH incidence and the socioeconomics, vaccine, and advanced liver diseases.

Conclusion

Effective vaccines and treatments for hepatitis B and C offer eradication opportunities. Broadening diagnostic and therapeutic coverage is vital to address disparities in service provision for children and adolescents.

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Funding

This work was supported by the Shanghai Jiaotong University High Level Project [KJ2-0101-22-1200], Shanghai Key Research Center Class A [2022ZZ01016], and Medical Innovation Research Special Project of Shanghai Science and Technology Innovation Action [22Y2190040].

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Authors and Affiliations

  1. Department of Liver Surgery, School of Medicine, Renji Hospital, Shanghai Jiao Tong University, No. 1630 Dongfang Road, Shanghai, 200127, China

    Wanglong Xiao, Yiwen Chen, Jiaxu Zhang, Yongbing Qian & Qiang Xia

  2. Shanghai Engineering Research Center of Transplantation and Immunology, Shanghai, China

    Wanglong Xiao, Jiaxu Zhang, Yongbing Qian & Qiang Xia

  3. Shanghai Institute of Transplantation, Shanghai, China

    Wanglong Xiao, Jiaxu Zhang, Yongbing Qian & Qiang Xia

  4. Department of General Surgery, School of Medicine, Xinhua Hospital, Shanghai Jiao Tong University, Shanghai, China

    Jingwei Zhao

  5. School of Biological and Biomedical Sciences, Queen Mary University of London, London, UK

    Xingzhu Liu & Chang Xu

Authors
  1. Wanglong Xiao
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  2. Jingwei Zhao
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  3. Yiwen Chen
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  4. Xingzhu Liu
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  5. Chang Xu
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  8. Qiang Xia
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Contributions

W.X., J.Z., and Y.C. conceptualized the study and drafted the initial manuscript. W.X. performed statistical analysis and visualization. X.L., C.X., J.Z. and Y.Q. reviewed and verified the manuscript. Y.Q. and Q.X. designed and supervised the study and provided critical revisions and suggestions. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Yongbing Qian or Qiang Xia.

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Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Ethical approval

This is an observational study. The Shanghai Jiao Tong University Affiliated Renji Hospital Research Ethics Committee has confirmed that no ethical approval is required.

Data availability

Visit https://ghdx.healthdata.org/ to access the dataset used in this study.

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Xiao, W., Zhao, J., Chen, Y. et al. Global burden and trends of acute viral hepatitis among children and adolescents from 1990 to 2019: a systematic analysis of the Global Burden of Disease Study 2019. Hepatol Int (2024). https://doi.org/10.1007/s12072-024-10640-2

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