Objective: To describe the spatiotemporal characteristics and trend of incidence and mortality of hepatitis B in China from 2004 to 2021 and to identify its possible hotspots and potential high-risk areas for the disease.
Methods: Time trends in hepatitis B incidence and mortality were analyzed using Joinpoint regression models, and annual percentage change (APC) and average annual percentage change (AAPC) were calculated stratified by age. The spatial autocorrelation analysis of GeoDa and the space-time scanning analysis of SaTScan software were used to identify potential changes and regional differences in the spatial and temporal distribution of hepatitis B humans in China during the study period.
Results: From 2004 to 2021, the number of hepatitis B cases in China increased from 916,396 in 2004 to 976,233 in 2021 (AAPC=0.31%, P=0.665), and the number of deaths decreased from 783 in 2004 to 413 in 2021 (AAPC=-3.23%, P =0.076). There was an increasing trend of standardized incidence of hepatitis B in the age group over 30 years. The High-High cluster areas of incidence rate of hepatitis B in China from 2004 to 2012 were mainly concentrated in the northwest,and in the southeast from 2017 to 2021 were concentrated, while the High-Low cluster areas of mortality rate of hepatitis B were mainly concentrated in Beijing and Shanghai from 2004 to 2019.The results of space–time cluster analysis for incidence rate of hepatitis B in China from 2004 to 2018 included one primary clustering area and two secondary clustering areas. The primary clustering area was located in the west of China, including Tibet, Qinghai, Xinjiang and Gansu, and the high-risk time frame was from January 2006 to December 2012 (RR = 2.78, LLR = 300786.49, P < 0.001). The results of space–time cluster analysis for mortality rate of hepatitis B in China from 2004 to 2018 included one primary clustering area and two secondary clustering areas. The primary clustering area was located in Beijing of China, and the high-risk time frame was from January 2007 to December 2013 (RR = 12.14, LLR = 1120.197907, P < 0.001).
Conclusion: The overall trend incidence and mortality of hepatitis B in China has decreased over the 18-year period, but the number of hepatitis B incidences is on the rise. The spatial distribution of hepatitis B incidence rate in each region of the country had spatial positive correlation.Hepatitis B incidence and mortality rates vary widely in China with different epidemiologic trends affecting different locations and revealing different spatial changing patterns.