Global, regional, and national burdens of hepatitis B-associated cirrhosis in children and adolescents from 1990 to 2019 and joinpoint regression

Abstract

Background: The global burden of hepatitis B-associated cirrhosis in children and adolescents must be understood and investigated. Methods: The incidence, prevalence, and disability-adjusted life years (DALYs) were extracted from the GBD database, and calculations were performed at global, regional, and national level. The joinpoint model was used to calculate the annual percentage change (APC) and annual average percentage change (AAPC). Findings: Globally, the prevalence of children and adolescents with hepatitis B-associated cirrhosis decreased from 125,053.98 × 10^3 in 1990 to 46,400.33 × 10^3 in 2019. Compared with 1990, the incidence of cirrhosis increased in low (95.51%) and low-middle SDI areas (26.47%), whereas it decreased in other SDI areas. The AAPC of prevalence has increased in low-middle SDI areas (AAPC 0.12 [95% CI: 0.04– 0.20]). At the regional level, the East Asia region has experienced the largest reduction. Conversely, Western Sub-Saharan Africa was the most serious region. Notably, South Asia was the only region where the AAPC of cirrhosis incidence (AAPC 0.77 [95% CI: 0.68–0.86]) increased. Conclusions: Globally, the overall burden of hepatitis B-associated cirrhosis in children and adolescents has declined significantly, but the number of cirrhosis cases in low-middle and low-SDI areas has increased. The incidence in South Asia is rising, and the burden on Africa remains serious. Prevention and treatment of hepatitis B-associated cirrhosis in children and adolescents should not be ignored.