Key result
From 1990 to 2017, global HEV age-standardized incidence rates decreased by 0.16% per year, while total incident cases increased by 17.63% to 19.44 million.
Why the study?
Hepatitis E virus infection is an important but long-neglected cause of acute viral hepatitis worldwide, requiring better understanding of global trends and regional differences to tailor prevention strategies.
Observational
Yes
Effect estimate: Average decrease of 0.16% per year (95% CI 0.14-0.17)
Absolute Event Rate: 269.7% vs 279.79%
Despite a slight decrease in global age-standardized incidence rates, the absolute number of HEV cases has increased significantly from 1990 to 2017, highlighting the need for targeted prevention strategies.
Increasing absolute HEV cases despite falling rates may warrant enhanced surveillance; leaves open regional drivers for prospective studies.
BACKGROUND/AIMS: Hepatitis E virus (HEV) infection is an important cause of acute viral hepatitis worldwide, but it is long-neglected. We aimed to understand the global trends and regional differences in the incidence of HEV infection, thereby making global tailored prevention strategies. METHODS: This study is a post-hoc analysis of the data from Global Burden of Disease Study 2017. Annual HEV incident cases and incidence rates from 1990 to 2017 were collected. Changes in incident cases and estimated annual percentage changes (EAPCs) of age-standardized incidence rates (ASRs) were calculated to quantify the temporal trends of HEV infection. RESULTS: Globally, HEV ASRs decreased by an average 0.16% (95% CI: 0.14%-0.17%) per year from 279.79 per 100 000 in 1990 to 269.70 per 100 000 in 2017; however, the number of HEV incident cases increased by 17.63% from 16.53 million in 1990 to 19.44 million in 2017. Against the global trend of ASR falling, an increasing trend was reported in Oceania (EAPC = 0.03; 95% CI: 0.03-0.04) and Western Europe (EAPC = 0.02; 95% CI: 0.01-0.03). The number of HEV incident cases increased remarkably in low (63.07%) and low-middle (37.46%) Socio-Demographic Index (SDI) regions between 1990 and 2017. Additionally, the number of HEV incident cases increased by 4.63% in high SDI regions, mainly in 40 plus age group. Surprisingly, more than 40% of HEV incident cases in Western Europe in 2017 were over 40 years old. CONCLUSIONS: HEV is still pending in hyperendemic regions, and it is emerging in low endemic regions, suggesting more efforts should be done to make targeted prevention strategies.
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Jing et al. (2020) conducted an observational in Hepatitis E virus (HEV) infection. Time period (1990 to 2017) vs. 1990 baseline was evaluated on Age-standardized incidence rates (ASRs) of HEV per 100,000 (Average decrease of 0.16% per year, 95% CI 0.14-0.17). From 1990 to 2017, global HEV age-standardized incidence rates decreased by 0.16% per year, while total incident cases increased by 17.63% to 19.44 million.
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