Burden of viral hepatitis in China, 1990-2010

Objective To understand the sex and age specific prevalence, mortality and burden of disease of viral hepatitis A, B, C and E in China during the past 20 years. Methods Descriptive analysis was conducted on the sex and age specific prevalence, mortality and other disease burden indicators of viral hepatitis A, B, C and E in China by using the data from China viral hepatitis survey in Global Burden of Disease Study 2010 (GBD 2010), which were standardized according to the standardized population data in China in 2010. Results In 1990, a total of 5 912 987.44 cases of viral hepatitis, including 33 267.39 deaths were reported in China with the standardized prevalence of 42 903.75/10 million and standardized mortality of 348.06/10 million, the disability-adjusted life years (DALY) and standardized DALY rate were 1 480 678.28 person-years and 13 841.84 person years /10 million respectively, the years of life lost due to premature mortality (YLL) and standardized YLL rate were 1 366 636.53 person years and 13 016.86 person years/10 million respectively, and the years lived with disability (YLD) and standardized YLD rate were 114 041.75 person years and 825.15 person years /10 million, respectively. In 2010, the cases, standardized prevalence, deaths, YLD, and standardized YLD rate increased by 10.40%, 10.09%, 24.01%, 8.12% and 7.70%; respectively, but standardized mortality, DALY, standardized DALY rate, YLL and standardized YLL rate declined by 2.37%, 2.63%, 25.34%, 3.64% and 28.26% respectively. For hepatitis A, except the increase of cases and YLD in the group 15 years, all the indicators showed a downward trend in all the other age groups during the past 20 years. The prevalence rate and DALY rate of hepatitis A were high in age group 5 years, which were 73 523.00 /10 million and 5023.00 person years /10 million in 1990 and 73 333.00 /10 million and 1935 person years /10 million in 2010. The prevalence of hepatitis B declined with age, but the mortality increased substantially. The case number of hepatitis B was highest in age group 15-49 years, but the prevalence was lowest. The DALY of hepatitis B in age group 50-69 years increased rapidly during the past 20 years, which was 507 041.40 person-year in 2010, highest in all age groups. The prevalence of hepatitis C was high in age groups 15-49 years and 50-69 years, and the mortality of hepatitis C was high in age group70 years, which increased from 33.40 /10 million in 1990 to 52.80 /10 million in 2010, an increase of 36.74%. For hepatitis E, the prevalence and YLD rate in age groups 5 years and 5-14 years increased during the past 20 years, but the other indicators declined. All the indicators of hepatitis E in age groups 50-69 years and 70 years showed an upward trend during the past 20 years, the prevalence, mortality and DALY increased by 36.03%, 20.10% and 53.82% respectively in age group 50-69 years and 30.48%, 31.96% and 58.38% respectively in age group of 70 years. Conclusion It is necessary to take effective measures for the prevention and control of viral hepatitis according to the sex and age specific prevalence and mortality of viral hepatitis.