Hepatitis B in China: the analysis of mortality and burden of disease trends from 2008 to 2021

To characterize mortality patterns and trends, we systematically examined temporal trends and population disparities in hepatitis B mortality and disease burden among Chinese residents from 2008 to 2021. Mortality data for hepatitis B were obtained from the Disease Surveillance Points (DSP) system compiled by the Chinese Center for Disease Control and Prevention (China CDC), covering the period 2008–2021. We used Microsoft Excel to calculate the crude mortality rate (CMR), age-specific mortality rates, age-standardized mortality rate (ASMR), potential years of life lost (PYLL), and the potential years of life lost rate (PYLLR). The Joinpoint software was used to estimate the annual percentage change (APC) for each time period and the average annual percentage change (AAPC) for the entire period. We used R to perform a chi-square (χ²) test and assess the comparability of AAPC between groups. The impact of age, period, and cohort on hepatitis B mortality was assessed using an online age-period-cohort analysis tool. Compared to 2008, the ASMR and PYLLR of hepatitis B in China decreased significantly in 2021, exhibiting a regional pattern of “higher in the west and lower in the east.” Overall, from 2008 to 2021, the national AAPC value for hepatitis B ASMR was − 4.53%, and the national AAPC value for hepatitis B PYLLR was − 4.71%. Gender differences showed that both ASMR and PYLLR were higher in men than in women. Urban-rural differences showed that rural areas consistently had higher values ​​than urban areas. Regional differences showed that the western region > central region > eastern region. In addition, the elderly population and those with earlier birth cohorts had higher ASMR and PYLLR values. From 2008 to 2021, hepatitis B-related mortality and premature mortality burden in China declined substantially, indicating sustained progress in hepatitis B prevention and management. However, marked disparities persist across regions, urban-rural settings, sex, and age groups, highlighting the need for targeted strategies focusing on high-burden populations to further reduce inequalities.