Trends and future projections of alcohol-attributable hepatitis B burden in women of childbearing age (1990-2040): a global analysis.

Introduction: Chronic hepatitis B virus (HBV) infection affects over 254 million people globally, with women of childbearing age (WCBA) facing dual risks of vertical transmission and alcohol-exacerbated disease progression. This study quantifies the alcohol-attributable burden of HBV among WCBA across 204 countries from 1990 to 2021 and projects trends to 2040. Methods: Data on deaths and Disability-Adjusted Life Years (DALYs) were extracted from the Global Burden of Diseases (GBD) Study 2021. Joinpoint regression and decomposition analyses were used to assess historical trends, while Bayesian Age-Period-Cohort (BAPC) analysis predicted future trends. Results: Between 1990 and 2021, global deaths showed a significant increase to 1,551.98 (95% UI: 700.34 to 2,707.01), accompanied by a rise in DALYs reaching 80,616.03 (95% UI: 37,268.53 to 139,146.25). This growth trajectory was primarily driven by population expansion. While age-standardized death and DALY rates exhibited a declining trend overall, epidemiological analysis revealed a transient rebound in DALYs between 1999 and 2005. Current projections using BAPC modeling suggest continued challenges, with deaths and DALYs anticipated to rise by 2040 under current intervention patterns. Conclusion: Despite declining age-standardized rates, population growth and alcohol exposure necessitate region-specific interventions. These findings underscore the urgent need for WHO alcohol control policies and HBV birth-dose vaccination in low-SDI regions, particularly sub-Saharan Africa and South Asia, to achieve 2030 elimination targets.