广东省1990-2019年急性病毒性肝炎疾病负担分析

目的 了解1990-2019年广东省急性病毒性肝炎的疾病负担情况及变化趋势，为广东省肝炎防治提供参考依据。方法 资料来源于2019全球疾病负担研究数据库广东省1990-2019年的相关数据。急性病毒性肝炎包括甲型肝炎（甲肝）、乙型肝炎（乙肝）、丙型肝炎（丙肝）和戊型肝炎（戊肝）。对不同时期的分年龄、性别构成的发病、死亡以及伤残调整寿命年（DALY）数据进行描述与分析，以及年估计变化百分比（EAPC），以描述急性病毒性肝炎疾病负担的变化趋势。结果 1999- 2019年广东省急性病毒性肝炎疾病负担均呈逐年下降趋势，其中死亡率与DALY年龄标化率下降趋势尤为明显。2019年在急性病毒性肝炎患者4 365 221例中，急性乙肝患者占51.43%（2 245 087例），而急性乙肝的死亡病例占急性病毒性肝炎死亡病例的77.18%（106/138）。在不同年龄组中，除急性乙肝高发于成年人外，急性甲肝、急性乙肝和急性戊肝等其他肝炎发病率总体随着年龄增长呈下降趋势。除<5岁年龄组的急性病毒性肝炎死亡率稍高外，其他年龄组的急性病毒性肝炎死亡率均随年龄增长呈上升趋势。男性的急性病毒性肝炎总体发病率和死亡率均高于女性。结论 1999-2019年广东省急性病毒性肝炎疾病负担总体有所下降，但始终高于全国平均水平，须进一步加强对广东省不同人群尤其是儿童及老年人的肝炎预防与筛查工作。

Disease burden of acute viral hepatitis in Guangdong Province, 1990-2019

Objective To examine the burden and trends of acute viral hepatitis in Guangdong Province from 1990 to 2019, and provide reference evidences for hepatitis prevention and control in the province. Methods Data on acute viral hepatitis (hepatitis A, B, C, and E) in Guangdong from 1990 to 2019 were extracted from the Global Burden of Disease Study 2019 database. The incidence, prevalence, mortality, and disability-adjusted life years (DALY) data were analyzed by age and gender, and the estimated annual percentage change (EAPC) was calculated to describe the changing trends in disease burden. Results From 1999 to 2019, the standardized incidence, prevalence, mortality, and DALY of acute viral hepatitis in Guangdong were higher than the national averages. In 2019, 51.43% (2 245 087/4 365 221) of acute viral hepatitis cases in Guangdong Province were mainly attributed to hepatitis B, and 77.18% (106/138) of deaths were due to acute hepatitis B. In different age groups, except for acute hepatitis B, which was more common in adults, the incidence rates of other types of viral hepatitis such as hepatitis A, B, and E showed an overall decreasing trend with age. The mortality rates of different types of acute viral hepatitis, except for the <5 age group, increased with age. The overall incidence and mortality rates of acute viral hepatitis were higher in men than in women. Conclusions The overall burden of acute viral hepatitis in Guangdong declined in 2019, but remained higher than the national level. Further efforts are needed to strengthen hepatitis prevention and screening in different population in Guangdong Province, especially in children and the elderly.