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. 2024 Jun 11;14(1):13370.
doi: 10.1038/s41598-024-63796-0.

Trends and age-period-cohort effect on incidence of hepatitis B from 2008 to 2022 in Guangzhou, China

Affiliations

Trends and age-period-cohort effect on incidence of hepatitis B from 2008 to 2022 in Guangzhou, China

Zhiwei Zheng et al. Sci Rep. .

Abstract

Hepatitis B virus (HBV) infection is highly prevalent in Guangzhou, China. This study aimed to examine the long-term trend of HB incidence from 2008 to 2022 and the independent impacts of age, period, and cohort on the trends. HBV data were collected from the China Information System for Disease Control and Prevention. Joinpoint regression was utilized to examine temporal trends, and an age-period-cohort model was employed to estimate the effects of age, period, and cohort. A total of 327,585 HBV cases were included in this study. The incidence of chronic and acute HB showed a decreasing trend in Guangzhou over the past 15 years, with an average annual percent change of - 4.31% and - 16.87%, respectively. Age, period, and cohort all exerted significant effects. The incidence of HB was higher in males than in females and non-central areas compared to central areas. Age groups of 0-4 years and 15-24 years were identified as high-risk groups. The period relative risks for chronic HB incidence decreased initially and then stabilized. Cohorts born later had lower risks. Chronic HB incidences remain high in Guangzhou, especially among males, younger individuals, and residents of non-central areas. More efforts are still needed to achieve hepatitis elimination targets.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Trends of the incidence rate of hepatitis B (HB) overall and by diagnosis types in Guangzhou, China during 2008–2022. (a, d, g) The comparison of crude incidence rate (CIR) and age-standardized incidence rate (ASIR) of HB. (b, e, h) The comparison of ASIR by sex. (c, f, i) The comparison of ASIR by region.
Figure 2
Figure 2
Annual percent change (APC) of hepatitis B (HB) incidence rate by diagnosis types in Guangzhou during 2008–2022, using a joinpoint regression model. (a, d) APCs of the age-standardized incidence rate (ASIR) for chronic and acute HB. (b, e) APCs for chronic and acute HB by sex. (c, f) APCs for chronic and acute HB by region.
Figure 3
Figure 3
The age, period, and cohort effects on chronic HB incidence by sex and by region; (a, b, c) Longitudinal age curves. Longitudinal age-specific rates are expected age-specific rates in the reference cohort (1988–1992), adjusted for period effects; (d, e, f) Period rate ratios (RRs) and the corresponding 95% confidence intervals. The RRs of each period compared with the reference period (2008–2012) adjusted for age and non-linear cohort effects. (g, h, i) Cohort rate ratios (RRs) and the corresponding 95% confidence intervals. The RRs of each cohort compared with the reference cohorts (1988–1992) adjusted for age and non-linear period effects.
Figure 4
Figure 4
The age, period, and cohort effects on acute HB incidence by sex and by region; (a, b, c) Longitudinal age curves. Longitudinal age-specific rates are expected age-specific rates in the reference cohort (1988–1992), adjusted for period effects; (d, e, f) Period rate ratios (RRs) and the corresponding 95% confidence intervals. The RRs of each period compared with the reference period (2008–2012) adjusted for age and non-linear cohort effects. (g, h, i) Cohort rate ratios (RRs) and the corresponding 95% confidence intervals. The RRs of each cohort compared with the reference cohorts (1988–1992) adjusted for age and non-linear period effects.

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