Global, regional and national burden of chronic hepatitis B-related cirrhosis from 1990 to 2021 and projections to 2050: a finding from the Global Burden of Disease Study 2021

Background: Chronic hepatitis B (CHB) is a widespread liver infection caused by Hepatitis B virus (HBV), affecting 296 million people globally. The disease often progresses to severe conditions like cirrhosis, hepatocellular carcinoma, and liver failure. This study aimed to evaluate the global, regional, and national burden of chronic hepatitis B-related cirrhosis from 1990 to 2021 and projected the disease development from 2022-2050. Methods: This study utilized data from the GBD 2021 database to analyze the global burden of CHB-related cirrhosis. Metrics such as incidence, prevalence, deaths, DALYs, YLDs, and YLLs were examined. Descriptive analysis explored the burden distribution by gender, age, sociodemographic Index (SDI) levels and country in 1990 and 2021. Trend analysis used Estimated Annual Percentage Change (EAPC) to assess changes in age-standardized rates over time. The Auto-Regressive Integrated Moving Average (ARIMA) model and the Exponential Smoothing (ES) model were applied to predict future trends. Results: In 2021, CHB-related cirrhosis caused 4.8 million incident cases, 432,000 deaths, and 13.9 million DALYs globally, with decreasing trends in age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), and age-standardized DALYs rate (ASDR) since 1990. Males exhibited higher burdens than females. Age-specific analysis revealed the highest ASIR in those <5 years and the highest ASMR in the 85-89 age group. Regionally, the greatest burden was observed in low SDI areas, with Sierra Leone and Egypt showing the highest rates. Projections indicate stable mortality but declining incidence and slightly increasing DALYs globally by 2050, with minor sex-specific variations. Conclusion: The 2021 Global Burden of Disease Study highlights progress in reducing CHB-related cirrhosis. Targeted efforts and lessons from successful interventions are essential to further alleviate this burden and improve outcomes worldwide.