背景:为了监测瑞典在实现世卫组织消除病毒性肝炎目标方面的进展,我们估计了患病率,通知率,以及2015年和2018年诊断的乙型肝炎病毒(HBV)和丙型肝炎病毒(HCV)感染的肝脏相关发病率和死亡率。
方法:我们在国家应报告疾病系统中确定了乙型和丙型肝炎病例,并获得了治疗数据以及该病例是否死亡。我们计算了患病率,每10万人的通报率,以及诊断时新诊断的肝炎合并肝病病例的比例,以及所有死于肝病的死亡病例的比例。我们计算了Poisson95%置信区间(CI)周围的通知率和Wilson95%CI周围的患病率和死亡率估计。
结果:在2015年和2018年,诊断的HBV感染的患病率为0.20%[95%CI:0.19-0.20]和0.21%[0.20-0.21]。每100,000的HBV感染的通知率为13.02[12.32-13.76]和7.71[7.18-8.27]。HBV肝脏相关发病率为2.65%[1.90-3.68]和2.16%[1.35-3.43]。HBV肝脏相关死亡率为20.00%[14.81-26.44]和17.95%[13.20-23.94]。在2015年和2018年,诊断的HCV感染的患病率为0.24%[0.24-0.25]和0.18%[0.18-0.19]。每100,000例HCV感染的通知率为15.92[15.14-16.73]和13.05[12.36-13.77]。HCV肝脏相关发病率为8.14%[6.89-9.60]和3.90%[2.99-5.08]。HCV肝脏相关死亡率分别为27.08%[24.54-29.77]和26.90%[24.12-29.88]。
结论:在2015年至2018年期间,所有指标均下降或保持稳定,表明在消除病毒性肝炎方面取得了进展,尤其是HCV感染。
BACKGROUND: To monitor Sweden\'s progress towards the WHO goal of eliminating viral hepatitis, we estimated the prevalence, notification rate, and liver-related morbidity and mortality for diagnosed hepatitis B virus (HBV) and hepatitis C virus (HCV) infections in 2015 and 2018.
METHODS: We identified cases of hepatitis B and C within the National System for Notifiable Diseases and obtained data on treatment and whether the case was deceased or not. We calculated prevalence, notification rates per 100,000, and proportion of newly diagnosed cases of hepatitis with liver disease at the time of diagnosis, and proportion of all deceased cases who died from liver disease. We calculated Poisson 95% confidence intervals (CIs) around the notification rates and Wilson 95% CIs around prevalence and mortality estimates.
RESULTS: In 2015 and 2018, the prevalence of diagnosed HBV infections was 0.20% [95% CI: 0.19-0.20] and 0.21% [0.20-0.21]. Notification rates per 100,000 for HBV infections were 13.02 [12.32-13.76] and 7.71 [7.18-8.27]. HBV liver-related morbidity was 2.65% [1.90-3.68] and 2.16% [1.35-3.43]. HBV liver-related mortality was 20.00% [14.81-26.44] and 17.95% [13.20-23.94]. In 2015 and 2018, the prevalence of diagnosed HCV-infections was 0.24% [0.24-0.25] and 0.18% [0.18-0.19]. Notification rates per 100,000 for HCV infections were 15.92 [15.14-16.73] and 13.05 [12.36-13.77]. HCV liver-related morbidity was 8.14% [6.89-9.60] and 3.90% [2.99-5.08]. HCV liver-related mortality was 27.08% [24.54-29.77] and 26.90% [24.12-29.88].
CONCLUSIONS: All indicators decreased or remained stable between 2015 and 2018, indicating progress in the elimination of viral hepatitis, especially for HCV infection.