Burden and Long-Term Trends of Viral Hepatitis in China: A National and Provincial Analysis

Viral hepatitis remains a major global health threat, causing approximately 1.3 million deaths in 2022. Despite substantial advances in vaccination and clinical treatment, it continues to impose a heavy disease burden across China. Existing studies have largely focused on single hepatitis subtypes and national epidemiological trends, with limited evidence on provincial heterogeneity. To fill this research gap, this study aimed to conduct a refined, region-specific epidemiological assessment of viral hepatitis in China.

Data were extracted from the Global Burden of Disease Study 2021 (GBD 2021) and the China Public Health Science Data Center to systematically analyze the epidemiological characteristics and spatiotemporal trends of viral hepatitis in China over the past three decades.

The overall burden of viral hepatitis in China decreased substantially over the study period, with obvious regional heterogeneity. Acute hepatitis A, B and E, as well as chronic hepatitis B and C, all presented prominent downward trends. The fastest declines in incidence were observed in acute hepatitis B (estimated annual percentage change [EAPC] = −3.03) and chronic hepatitis B (EAPC = −4.74). Notably, males suffered a higher disease burden for nearly all outcomes, except for HCV-related hepatocellular carcinoma, which predominantly affected females. Furthermore, provincial-level analysis indicated marked regional disparities: Xizang maintained a high incidence rate, while Beijing exhibited low incidence accompanied by strikingly high hepatitis-related mortality, suggesting a notable decoupling between infection prevalence and mortality.

China has achieved remarkable reductions in the overall burden of viral hepatitis, attributable to comprehensive public health interventions such as universal vaccination, standardized screening and improved sanitation conditions. Nevertheless, residual burdens in vulnerable populations and striking regional inequalities warrant targeted prevention and control strategies to reduce disease disparities nationwide.