Epidemiological trends of hepatitis in mainland China: 2004–2019

Abstract Hepatitis, caused by five main viral strains (A, B, C, D, and E), is a major global health issue in animals and humans. Hepatitis B virus (HBV) and hepatitis C virus (HCV) are particularly concerning and can lead to chronic diseases, cirrhosis, liver cancer, and death. Recent WHO data indicate a rise in hepatitis-related deaths from 1.1 million (2019) to 1.3 million (2022), predominantly attributed to HBV. China bears a substantial global burden of HBV and HCV due to its large population. Data on hepatitis A, B, C, E, and unclassified hepatitis from 2004–2019 were obtained from the Chinese Center for Disease Control and Prevention. Joinpoint, ArcGIS, and SaTScan were used to analyze trends, spatial‒temporal distributions, and correlations. From 2004–2019, the overall incidence and mortality of viral hepatitis in China declined. Although hepatitis C and E showed an initial increase until 2012 before stabilizing. Hepatitis B remains the most common strain, with peaks in spring, particularly in the southeastern provinces (Jiangsu, Zhejiang, Fujian). Farmers and workers were the most affected groups due to their living and hygiene conditions. Spatial analysis revealed higher concentrations of cases in rapidly urbanizing and mobile regions. Enhanced prevention and control strategies targeting high-risk populations and regions are critical for reducing hepatitis transmission and improving public health in China.