Trends and projections of hepatitis E incidence in Jiangsu Province of eastern China from 2007 to 2021: An analysis based on age-period-cohort models

Objective

This study aims to evaluate Hepatitis E incidence trends by age, period, and birth cohort in Jiangsu Province from 2007 to 2021 and project the future trends.

Methods

Data on Hepatitis E cases in Jiangsu Province were sourced from the National Notifiable Disease Reporting System. Joinpoint regression models analyzed annual percentage changes. Age-period-cohort model decomposed and Bayesian age-period-cohort projected the trends.

Results

Between 2007 and 2021, a total of 46180 cases of Hepatitis E were reported. Both the overall and sex-specific trends revealed a single inflection point, and the average annual percentage change was -3.63% (95% CI: -7.33% ∼ -0.87%, P < 0.05) for male. The net drift value is -5.13%, with -6.28% for males and -2.39% for females. Significant local drift variations were observed, especially in the 20–24 age group (-11.51%). The age curve indicated the peak at 15.94 per 100000 for males in the 25–29 age group and at 4.42 per 100000 for females in the 50–54 age group. The period effect demonstrated the incidence rates for females lagged behind for males. The cohort effect indicated earlier cohorts exhibited higher incidence rates. projected an increase in incidence rates for the 65–69 age group from 2022 to 2031, with a overall incidence rate of 11.31 (95% CI: 2.80 ∼ 31.58) per 100000 in 2031.

Conclusion

Hepatitis E incidence has decreased from 2007 to 2021 for male in Jiangsu Province, and Age-period-cohort analysis revealed sex differences, which may be associated with different exposure routes. Continuous surveillance and timely interventions are essential to 65–69 age group.