Regional and age related variations in hepatitis A virus incidence in China 2004 to 2018: a descriptive epidemiological study

Hepatitis A virus (HAV), mainly transmitted through the fecal-oral route, is a leading trigger of acute viral hepatitis globally. Our study aims to analyze the distribution of HAV in China, highlighting differences across regions and age groups from 2004 to 2018. We obtained HAV incidence and fatality information from the China Public Health Science Data Center to analyze the incidence of HAV and associated deaths in 31 Chinese regions during the years 2004 to 2018. Statistical analysis was performed using SPSS 18, while line graphs and histograms were generated using GraphPad Prism 5. The geographic distribution was mapped using Adobe Illustrator CS 6. The geographic distribution analysis revealed significantly higher HAV incidence in Sichuan Province (average number of cases > 4,000 per year). No significant differences in HAV-related deaths were observed among different regions (average number of cases 0 to 1.93 per year). From 2004 to 2018, both HAV incidence and HAV-associated mortality in China showed a decreasing trend: 7.1997 and 0.0031 per 100,000 in 2004, 2.6430 and 0.0003 per 100,000 in 2010, and 1.1659 and 0.0002 per 100,000 in 2018, respectively (p < 0.01). Additionally, the rate of HAV infections was higher in children (0-10 years old) compared to the elderly (> 50 years old) (p < 0.01). In China, HAV is more common in the western regions. Greater attention should be given to preventing HAV transmission among children and adolescents.