A changing landscape: Tracking and analysis of the international HDV epidemiology 1999-2020.
A changing landscape: Tracking and analysis of the international HDV epidemiology 1999-2020.
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DOI：
10.1371/journal.pgph.0000790
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发表时间：
2023
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由于对这种罕见传染病的积极监测有限，很难准确估计丁型肝炎病毒（HDV）的国际流行病学。先前的HDV流行病学研究依赖于汇总和静态数据集的荟萃分析。这些限制限制了主动发现HDV诊断发病率低水平和/或地理分散变化的能力。本研究旨在为跟踪和分析国际HDV流行病学提供资源。总体分析的数据集包括1999-2020年间报告的70万例HBV和9000例HDV病例。从政府出版物中挖掘的数据集被确定为阿根廷、澳大利亚、奥地利、巴西、保加利亚、加拿大、芬兰、德国、澳门、荷兰、新西兰、挪威、瑞典、台湾、泰国、英国和美国。时间序列分析包括Mann-Kendall （MK）趋势检验、贝叶斯信息准则（BIC）和层次聚类，以表征HDV时间线的趋势。确定的总患病率为2,560 HDV/ hbv10万例（95% CI 180-4940）或2.56% HDV/HBV病例，从加拿大的0.26%到美国的20%不等。在2002年、2012年和2017年发现了HDV发病时间线的结构性断裂，2013-2017年期间出现了显著增加。报告的HDV和HBV病例分别在47%和24%的数据集中观察到显著增加趋势。对HDV发病时间线的分析确定了四个不同的时间聚类，包括聚类I（澳门、台湾）、聚类II（阿根廷、巴西、德国、泰国）、聚类III（保加利亚、荷兰、新西兰、英国、美国）和聚类IV（澳大利亚、奥地利、加拿大、芬兰、挪威、瑞典）。在国际范围内跟踪HDV和HBV病例对于确定病毒性肝炎的全球影响至关重要。已确定HDV和HBV流行病学的重大中断。有必要加强对HDV的监测，以进一步确定最近国际HDV发病率断点的病因。
The international epidemiology of Hepatitis Delta Virus (HDV) is challenging to accurately estimate due to limited active surveillance for this rare infectious disease. Prior HDV epidemiological studies have relied on meta-analysis of aggregated and static datasets. These limitations restrict the capacity to actively detect low-level and/or geographically dispersed changes in the incidence of HDV diagnoses. This study was designed to provide a resource to track and analyze the international HDV epidemiology. Datasets analyzed collectively consisted of >700,000 HBV and >9,000 HDV reported cases ranging between 1999–2020. Datasets mined from government publications were identified for Argentina, Australia, Austria, Brazil, Bulgaria, Canada, Finland, Germany, Macao, Netherlands, New Zealand, Norway, Sweden, Taiwan, Thailand, United Kingdom, and United States. Time series analyses, including Mann-Kendall (MK) trend test, Bayesian Information Criterion (BIC), and hierarchal clustering, were performed to characterize trends in the HDV timelines. An aggregated prevalence of 2,560 HDV/HBV100,000 cases (95% CI 180–4940) or 2.56% HDV/HBV cases was identified, ranging from 0.26% in Canada to 20% in the United States. Structural breaks in the timeline of HDV incidence were identified in 2002, 2012, and 2017, with a significant increase occurring between 2013–2017. Significant increasing trends in reported HDV and HBV cases were observed in 47% and 24% of datasets, respectively. Analyses of the HDV incidence timeline identified four distinct temporal clusters, including Cluster I (Macao, Taiwan), Cluster II (Argentina, Brazil, Germany, Thailand), Cluster III (Bulgaria, Netherlands, New Zealand, United Kingdom, United States) and Cluster IV (Australia, Austria, Canada, Finland, Norway, Sweden). Tracking of HDV and HBV cases on an international scale is essential in defining the global impact of viral hepatitis. Significant disruptions of HDV and HBV epidemiology have been identified. Increased surveillance of HDV is warranted to further define the etiology of the recent breakpoints in the international HDV incidence.