Changing prevalence of chronic hepatitis B virus infection in China between 1973 and 2021: a systematic literature review and meta-analysis of 3740 studies and 231 million people

被引:67
作者
Liu, Zhenqiu [1 ,2 ,3 ]
Lin, Chunqing [4 ]
Mao, Xianhua [5 ]
Guo, Chengnan [6 ,7 ]
Suo, Chen [3 ,6 ,7 ]
Zhu, Dongliang [6 ]
Jiang, Wei [1 ,2 ]
Li, Yi [6 ]
Fan, Jiahui [1 ,2 ]
Song, Ci [8 ]
Zhang, Tiejun [3 ,6 ,7 ]
Jin, Li [1 ,2 ,3 ]
De Martel, Catherine [9 ]
Clifford, Gary M. [9 ,13 ]
Chen, Xingdong [1 ,2 ,3 ,10 ,11 ,12 ]
机构
[1] Fudan Univ, State Key Lab Genet Engn, Human Phenome Inst, Shanghai, Peoples R China
[2] Fudan Univ, Sch Life Sci, Shanghai, Peoples R China
[3] Fudan Univ, Taizhou Inst Hlth Sci, Taizhou, Peoples R China
[4] Chinese Acad Med Sci & Peking Union Med Coll, Natl Clin Res Ctr Canc, Natl Canc Ctr, Canc Hosp, Beijing, Peoples R China
[5] Univ Hong Kong, Dept Med, Li Ka Shing Fac Med, Hong Kong, Peoples R China
[6] Fudan Univ, Sch Publ Hlth, Dept Epidemiol, Shanghai, Peoples R China
[7] Fudan Univ, Key Lab Publ Hlth Safety, Minist Educ, Shanghai, Peoples R China
[8] Nanjing Med Univ, Sch Publ Hlth, Dept Epidemiol, Nanjing, Peoples R China
[9] Int Agcy Res Canc IARC WHO, Early Detect Prevent & Infect Branch, Lyon, France
[10] Fudan Univ, Huashan Hosp, Natl Clin Res Ctr Aging & Med, Shanghai, Peoples R China
[11] Fudan Univ, Yiwu Res Inst, Yiwu, Peoples R China
[12] Fudan Univ, Shanghai, Peoples R China
[13] Int Agcy Res Canc, Lyon, France
基金
中国国家自然科学基金;
关键词
META-ANALYSIS; HEPATITIS B; HBV INFECTION; PREVENTION; VACCINATION; EPIDEMIOLOGY; ELIMINATION; POPULATION; DECADES; MEN;
D O I
10.1136/gutjnl-2023-330691
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Objective China concentrates a large part of the global burden of HBV infection, playing a pivotal role in achieving the WHO 2030 global hepatitis elimination target.Methods We searched for studies reporting HBV surface antigen (HBsAg) seroprevalence in five databases until January 2023. Eligible data were pooled using a generalised linear mixed model with random effects to obtain summary HBsAg seroprevalence. Linear regression was used to estimate annual percentage change (APC) and HBsAg prevalence in 2021.Results 3740 studies, including 231 million subjects, were meta-analysed. HBsAg seroprevalence for the general population decreased from 9.6% (95% CI 8.4 to 10.9%) in 1973-1984 to 3.0% (95% CI 2.1 to 3.9%) in 2021 (APC=-3.77; p<0.0001). Decreases were more pronounced in children <5 years (APC=-7.72; p<0.0001) and 5-18 years (-7.58; p<0.0001), than in people aged 19-59 years (-2.44; p<0.0001), whereas HBsAg seroprevalence increased in persons >= 60 years (2.84; p=0.0007). Significant decreases were observed in all six major Chinese regions, in both men (APC=-3.90; p<0.0001) and women (-1.82; p<0.0001) and in high-risk populations. An estimated 43.3 million (95% uncertainty interval 30.7-55.9) persons remained infected with HBV in China in 2021 (3.0%), with notable heterogeneity by region (<1.5% in North China to>6% in Taiwan and Hong Kong) and age (0.3%, 1.0%, 4.7% and 5.6% for <5 years, 5-18 years, 19-59 years and >= 60 years, respectively).Conclusions China has experienced remarkable decreases in HBV infection over the last four decades, but variations in HBsAg prevalence persist in subpopulations. Ongoing prevention of HBV transmission is needed to meet HBV elimination targets by 2030.Trial registration number PROSPERO (CRD42021284217)
引用
收藏
页码:2354 / 2363
页数:10
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