Global Temporal Trends in Mother-to-Child Transmission Disease Incidence Among Women of Child-Bearing Age: An Analysis of Global Burden of Disease Study 2021 Data

Abstract

Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS), syphilis, hepatitis B and hepatitis C are the four major Mother-to-child transmission (MTCT) diseases, represent a significant public health challenge worldwide. Understanding the disease burden among women of child-bearing age (WCBA) helps to implement effective screening and treatment programs to control the MTCT diseases globally. Data on HIV/AIDS, syphilis, hepatitis B, and hepatitis C was collected from the Global Burden of Disease (GBD) 2021 database spanning 1992–2021. We analyzed the temporal trends of four MTCT diseases with joinpoint regression and further evaluated age-period-cohort effects using the age-period-cohort model. The age-standardized incidence rates per 100,000 population for HIV/AIDS, syphilis, hepatitis B, and hepatitis C in 2021 were 34.73 (95% uncertainty interval [UI]: 30.03, 40.54), 279.19 (95% UI: 174.59, 459.54), 908.39 (95% UI: 494.99, 1640.44), and 77.44 (95% UI: 41.57, 126.12). Joinpoint regression revealed ongoing declines in HIV/AIDS and hepatitis B rates among WCBA, contrasting with increasing trends for hepatitis C and syphilis post-2012. Age effects for HIV/AIDS, syphilis, and hepatitis B peaked in the 15–29 age group, while hepatitis C peaked in the 45–49 age group. Period effects showed increased incidence rates for syphilis and hepatitis C since 2012, peaking between 2017–2021, while HIV/AIDS and hepatitis B showed a general decline. Cohort effects for all four diseases generally followed a fluctuating downward trend. For hepatitis B, the incidence rate is declining in all 21 GBD regions. At national level, only the United Kingdom and Greece have seen a slight increase in incidence rates compared to 30 years ago, but the increase is minimal. For other MTCT diseases, Eastern Europe has the highest increase in incidence rates of HIV/AIDS and hepatitis C among WCBA, which requires special attention. Tropical Latin America is the region with the greatest increase in syphilis incidence rates. Specifically, at the national level, the countries with the highest increase in incidence rates for HIV/AIDS, syphilis, and hepatitis C are Pakistan, Greece, and Ukraine, respectively. Globally, while HIV/AIDS and hepatitis B incidence in WCBA has decreased, negative age, period, and cohort effects persist in certain countries. Post-2012, hepatitis C and syphilis incidence in WCBA has risen, underscoring the need to refine management strategies against MTCT diseases.