Trends of infections and mortality due to hepatitis B virus (2005-2022) and the potential impact of the COVID-19 pandemic: a population-based study in Poland

Agnieszka Genowska; Dorota Zarębska-Michaluk; Piotr Tyszko; Birute Strukcinskiene; Anna Moniuszko-Malinowska; Piotr Rzymski; Robert Flisiak

doi:10.5114/ceh.2023.131225

Trends of infections and mortality due to hepatitis B virus (2005-2022) and the potential impact of the COVID-19 pandemic: a population-based study in Poland

Clin Exp Hepatol. 2023 Sep;9(3):286-296. doi: 10.5114/ceh.2023.131225. Epub 2023 Sep 22.

Authors

Agnieszka Genowska¹, Dorota Zarębska-Michaluk², Piotr Tyszko^{3

4}, Birute Strukcinskiene⁵, Anna Moniuszko-Malinowska⁶, Piotr Rzymski⁷, Robert Flisiak⁸

Affiliations

¹ Department of Public Health, Medical University of Bialystok, Bialystok, Poland.
² Department of Infectious Diseases and Allergology, Jan Kochanowski University, Kielce, Poland.
³ Medical University of Warsaw, Warsaw, Poland.
⁴ Institute of Rural Health, Lublin, Poland.
⁵ Faculty of Health Sciences, Klaipeda University, Klaipeda, Lithuania.
⁶ Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, Bialystok, Poland.
⁷ Department of Environmental Medicine, Poznan University of Medical Sciences, Poznań, Poland.
⁸ Department of Infectious Diseases and Hepatology, Medical University of Bialystok, Bialystok, Poland.

Abstract

Aim of the study: To analyze the hepatitis B virus (HBV) infection and mortality in Poland according to sociodemographic characteristics, trends over time, and the impact of the COVID-19 pandemic on hepatitis B epidemiology.

Material and methods: We examined HBV infection cases and deaths reported by national registries and used Joinpoint analysis to estimate time trends in the years 2005-2021. To assess the impact of the COVID-19 pandemic on HBV infection, we used monthly information and compared 2020-2022 with 2019.

Results: The Joinpoint analysis showed that in Poland between 2005 and 2021, there were pronounced decreasing trends of acute HBV infection, and during the pandemic period, acute HBV infection dramatically decreased (annual percent change, APC_2019-2021 for men -57.65%, and women -42.10%, both p_trend < 0.05). There was a fluctuation in trends for chronic HBV infection, shifting from positive to negative in both genders in 2016, and over the pandemic, there were decreasing trends (APC_2019-2021 for men -26.94% and women -28.96%, both p_trend < 0.05). From March to July 2022, the value of the diagnosis rate of HBV infection was lower compared to the respective months in 2019, but from September to December 2022, the rate changes were positive. Mortality due to HBV infection decreased in both genders, mainly within the 2005-2019 period.

Conclusions: During the COVID-19 pandemic, a sharp decrease in HBV diagnosis rates in Poland, especially in acute cases, was observed. However, trends of hepatitis B infection require further monitoring. It is necessary to introduce a national screening program that also encompasses the population of migrants and improve the linkage to care.

Keywords: COVID-19 impact; acute HBV infection; chronic HBV infection; hepatitis epidemiology; time factor.