Analysis of Incidence Trends and Predictions of Acute Hepatitis C in China Based on the Age-Period-Cohort Model.

OBJECTIVE

To analyze the incidence trends of acute hepatitis C (AHC) in China from 1990 to 2021, predict future trends, and explore the drivers of AHC incidence.

METHODS

Data on AHC incidence in China were collected from the Global Burden of Disease (GBD) 2021 database. Age-period-cohort (APC) model was used to examine the effects of age, period, and birth cohort. The Bayesian Age-period-cohort (BAPC) model was used to predict future incidence trends, and the decomposition algorithm was used to attribute the incidence trends to population aging, population growth, and age-specific changes from 1990 to 2021.

RESULTS

Between 1990 and 2021, the incidence of AHC in China continued to decline. The net drift was -1.76% (95% CI -2.11% to -1.41%). A W-shaped local drift and L-shaped longitudinal age curve were observed. The overall local drift was below zero for most age groups, except for the 80-and-older age groups. The highest risks of AHC incidence were observed in the age groups of 0 to 4, 5 to 9, and 80 and older. Downward trends were observed for both period and cohort effects. A higher risk was observed for the birth cohorts of 1922 to 1936 than for the adjacent cohorts. The BAPC model projected that AHC incidence will indicate a relatively stable yet slowly increasing trend from 2022 to 2030, and that AHC incidence in 2030 will be 1.10 times higher than that in 2021. Epidemiological changes are the leading cause of the reduction in the AHC disease burden from 1990 to 2021.

CONCLUSION

Despite existing multitiered prevention strategies for AHC, epidemiological projections indicate a slow upward trajectory in disease burden in the future. Our study demonstrates the urgency of implementing optimized public health strategies, including population-wide active case detection and priority prevention policies, for high-risk populations.