Hepatitis B in Canada: 2020 surveillance data update

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Organization: Public Health Agency of Canada
Published: 2023-03-03

Impact of the COVID-19 pandemic on reported hepatitis B case counts and rates in 2020

The COVID-19 pandemic reduced the demand for and access to services related to sexually transmitted and blood-borne infections, including testingFootnote 1. This likely impacted new hepatitis B diagnosis rates in 2020, by artificially reducing them. As parts of the country experienced different levels of disruptions due to COVID-19 during 2020, comparisons of hepatitis B case counts and rates between the provinces and territories may also be inaccurate.

Hepatitis B

In 2020, 3,004 cases of hepatitis B (acute, chronic, and unspecified cases combined) were reported from 12 provinces and territoriesFootnote 2Footnote 3 for a rate of 8.2 cases per 100,000 people

Acute hepatitis B (infections lasting up to six months)

Figure 1 shows the number and rates of reported acute hepatitis B from 2011 to 2020. The trends in this figure are described below:

Acute hepatitis B by sex and age group

Figure 1 shows the number and rates of reported acute hepatitis B from 2011 to 2020 and Table 4 summarizes the number of cases, rates, and proportions of acute hepatitis B by age and sex reported in 2020. The trends in this figure and in this table are described below:

Note: Acute hepatitis B reporting differed by province and territory from 2011 to 2020. See Appendix B for provincial and territorial acute hepatitis B reporting patterns.

Figure 1. Number of reported cases and rates of acute hepatitis B overall and by sex in Canada, 2011 to 2020
Figure 1. Text version below.
Figure 1 - Text description
Table 1. Number of reported cases and rates of acute hepatitis B in Canada overall and by sex in Canada, 2011 to 2020
Year Total cases Male cases Female cases Total rate
(per 100,000 population of Canada)
Male rate
(per 100,000 males)
Female rate (per 100,000 females)
2011 218 128 88 0.65 0.77 0.52
2012 177 111 66 0.51 0.65 0.38
2013 179 117 62 0.52 0.69 0.36
2014 180 122 57 0.52 0.71 0.33
2015 147 107 40 0.42 0.62 0.23
2016 175 123 52 0.50 0.70 0.29
2017 180 116 64 0.50 0.65 0.36
2018 195 125 69 0.54 0.70 0.38
2019 179 114 64 0.49 0.62 0.34
2020 123 77 46 0.34 0.43 0.25

National annual acute hepatitis B rates were calculated using the number of acute hepatitis B cases from the Canadian Notifiable Disease Surveillance System as numerators and Statistics Canada April 2022 yearly population estimates as denominators. 
The ‘total’ case count and rate includes all males, females and those who did not disclose their sex (unknown sex).
Acute hepatitis B reporting differed by province and territory from 2011 to 2020 (see Appendix B for provincial and territorial hepatitis B reporting patterns).

Acute hepatitis B by province and territory

In 2020, the national reported acute hepatitis B rate was 0.34 cases per 100,000 people. Provinces and territories that had rates of reported acute hepatitis B above the national rate included:

In 2020, provinces and territories with rates of reported acute hepatitis B below the national rate included:

DS: Data not shown where case counts are between one and four, inclusive.

In 2020, Manitoba and Newfoundland and Labrador did not provide acute hepatitis B surveillance data.

Chronic and unspecified hepatitis B (infections lasting longer than six months)

Figure 2 shows the number and rates of reported chronic and unspecified hepatitis B from 2011 to 2020. The trends in this figure are described below:

Chronic and unspecified hepatitis B by sex and age group

Figure 2 shows the number and rates of reported chronic and unspecified hepatitis B from 2011 to 2020 and Table 6 summarizes the number of cases, rates, and proportions of chronic and unspecified hepatitis B by age and sex reported in 2020. The trends in this figure and in this table are described below:

Note: Chronic and unspecified hepatitis B subtype reporting differed by province and territory from 2011 to 2020. See Appendix B for provincial and territorial chronic and unspecified hepatitis B reporting patterns.

Figure 2. Number of reported cases and rates of chronic and unspecified hepatitis B overall and by sex in Canada, 2011 to 2020
Figure 2. Text version below.
Figure 2 - Text description
Table 2. Number of reported cases and rates of chronic and unspecified hepatitis B overall and by sex in Canada, 2011 to 2020
Year Total cases (n) Male cases (n) Female cases (n) Total rate (per 100,000 population of Canada) Male rate (per 100,000 males) Female rate (per 100,000 females)
2011 5404 3015 2379 15.8 17.8 13.8
2012 5500 3088 2406 15.9 18.0 13.8
2013 5527 3065 2458 15.8 17.7 13.9
2014 5193 2769 2415 14.7 15.8 13.6
2015 4861 2757 2089 13.7 15.6 11.6
2016 5029 2854 2165 14.0 16.0 11.9
2017 4951 2822 2119 13.6 15.6 11.5
2018 4835 2672 2144 13.1 14.6 11.5
2019 4877 2698 2136 13.0 14.5 11.3
2020 2881 1608 1240 7.9 8.8 6.7

National annual chronic and unspecified hepatitis B rates were calculated using the number of chronic and unspecified hepatitis B cases reported to the Canadian Notifiable Disease Surveillance System as numerators and Statistics Canada April 2022 yearly population estimates as denominators. 
The ‘total’ case count and the rate includes all males, females and those who did not disclose their sex (unknown sex).
Chronic and unspecified hepatitis B reporting differed by province and territory from 2011 to 2020 (see Appendix B for provincial and territorial hepatitis B reporting patterns).

Reported chronic and unspecified hepatitis B by province and territory

In 2020, the national rate of chronic and unspecified hepatitis B was 7.9 cases per 100,000 people. Provinces and territories that had rates of chronic and unspecified hepatitis B above the national rate included:

In 2020, provinces and territories with rates of chronic and unspecified hepatitis B below the national rate included:

DS: Data not shown where case counts are between one and four, inclusive.

In 2020, Manitoba did not provide chronic and unspecified hepatitis B data.

In 2020, the greatest proportion of reported chronic and unspecified hepatitis B cases came from Ontario (35.1%), followed by British Columbia (27.0%) and Quebec (21.1%).

Hepatitis B public health messaging

Appendix A: Data tables corresponding to described hepatitis B information

Table 3. Number of cases and rates of reported hepatitis B overall and by infection status, 2020
Hepatitis B disease status Number of cases Rate per 100,000 population
Acute 123 0.34
Chronic 2,375 6.6
Unspecified 506 2.4
Total 3,004 8.2

National annual rates of reported acute, chronic, and unspecified hepatitis B were computed using the number of acute, chronic, and unspecified hepatitis B cases from the Canadian Notifiable Disease Surveillance System as numerators and Statistics Canada April 2022, 2020, population estimates as denominators. 
In 2020, Manitoba and Newfoundland and Labrador did not provide acute hepatitis B data.
In 2020, Manitoba did not provide chronic and unspecified hepatitis B data.

Table 4. Number of reported cases, rates, and proportion of acute hepatitis B by sex and age group in Canada, 2020
Age group (years) Males Females Total
Cases (n) Rate (per 100,000 males) Proportion of all male cases Cases (n) Rate (per 100,000 females) Proportion of all female cases Cases (n) Rate (per 100,000 population) Proportion of all reported cases
<15 2 0.07 2.6% 0 0.00 0.0% 2 0.04 1.6%
15 to 19 1 0.10 1.3% 1 0.10 2.2% 2 0.10 1.6%
20 to 24 4 0.32 5.2% 5 0.44 10.9% 9 0.38 7.3%
25 to 29 3 0.23 3.9% 3 0.24 6.5% 6 0.24 4.9%
30 to 39 12 0.47 15.6% 6 0.24 13.0% 18 0.36 14.6%
40 to 59 38 0.80 49.4% 20 0.41 43.5% 58 0.61 47.2%
≥60 17 0.41 22.1% 11 0.23 23.9% 28 0.32 22.8%

National reported acute hepatitis B age rates by sex and overall were computed using the number of acute hepatitis B cases reported to the Canadian Notifiable Disease Surveillance System as numerators and Statistics Canada April 2022, 2020, population estimates as denominators.
The ‘total’ case count and the rate includes all males, females and those who did not disclose their sex (unknown sex). In 2020, all acute hepatitis B cases had sex data. In 2020, Manitoba and Newfoundland and Labrador did not provide acute hepatitis B data.

Table 5. Number of reported cases, rates, and proportion of acute hepatitis B cases by province and territory, 2020
Jurisdiction Cases (n) Rate (per 100,000 population) Proportion of all reported acute hepatitis B cases
Canada 123 0.34 100.0%
British Columbia 7 0.14 5.7%
Alberta 19 0.43 15.4%
Saskatchewan DS DS DS
Manitoba NA NA NA
Ontario 77 0.52 62.6%
Quebec 5 0.06 4.1%
Newfoundland and Labrador NA NA NA
Prince Edward Island 0 0.00 0.0%
Nova Scotia 5 0.51 4.1%
New Brunswick 8 1.02 6.5%
Yukon 0 0.00 0.0%
Northwest Territories 0 0.00 0.0%
Nunavut 0 0.00 0.0%

Provincial and territorial annual acute hepatitis B rates were calculated using the number of acute hepatitis B cases reported to the Canadian Notifiable Disease Surveillance System as numerators and Statistics Canada April 2022, 2020, population estimates as denominators. 
NA: In 2020, Manitoba and Newfoundland and Labrador did not provide acute hepatitis B data.
DS: Data not shown where case counts are between one and four, inclusively.

Table 6. Number of reported cases, rates, and proportions of chronic and unspecified hepatitis B by sex and age group in Canada, 2020
Age group (years) Males Females Total
Cases (n) Rate (per 100,000 males) Proportion of all male cases Cases (n) Rate (per 100,000 females) Proportion of all female cases Cases (n) Rate (per 100,000 population) Proportion of all reported cases
<15 11 0.4 0.7% 8 0.3 0.6% 19 0.3 0.7%
15 to 19 17 1.6 1.1% 10 1.0 0.8% 27 1.3 0.9%
20 to 24 50 4.0 3.1% 56 4.9 4.5% 109 4.5 3.8%
25 to 29 122 9.2 7.6% 118 9.5 9.6% 243 9.5 8.5%
30 to 39 456 17.8 28.4% 409 16.2 33.2% 873 17.2 30.4%
40 to 59 670 13.9 41.7% 401 8.2 32.6% 1086 11.2 37.9%
≥60 279 6.6 17.4% 229 4.8 18.6% 511 5.7 17.8%

National reported chronic and unspecified hepatitis B age rates by sex and overall were computed using the number of chronic and unspecified hepatitis B cases reported to the Canadian Notifiable Disease Surveillance System as numerators and Statistics Canada April 2022, 2020, population estimates as denominators.
The ‘total’ case count and the rate includes all males, females and those who did not disclose their sex (unknown sex). In 2020, 33 chronic and unspecified hepatitis B cases did not have sex data.

Table 7. Number of reported cases, rates and proportion of chronic and unspecified hepatitis B cases by province and territory, 2020
Jurisdiction Cases (n) Rate per 100,000 population Proportion of all reported chronic and unspecified hepatitis B cases
Canada 2881 7.9 100.0%
British Columbia 779 15.1 27.0%
Alberta 301 6.8 10.4%
Saskatchewan 88 7.5 3.1%
Manitoba NA NA NA
Ontario 1012 6.9 35.1%
Quebec 609 7.1 21.1%
Newfoundland and Labrador 10 1.9 0.3%
Prince Edward Island 17 10.6 0.6%
Nova Scotia 15 1.5 0.5%
New Brunswick 38 4.9 1.3%
Yukon DS DS DS
Northwest Territories 0 0.0 0.0%
Nunavut 10 25.7 0.3%

Provincial and territorial annual chronic and unspecified hepatitis B rates were calculated using the number of chronic and unspecified hepatitis B cases reported to the Canadian Notifiable Disease Surveillance System as numerators and Statistics Canada April 2022, 2020, population estimates as denominators. 
NA: In 2020, Manitoba did not provide reported chronic and unspecified hepatitis B data.
DS: Data not shown where case counts are between one and four.

Appendix B: Acute, chronic, and unspecified hepatitis B reporting patterns by province and territory, 2011 to 2020

Acute, chronic, and unspecified hepatitis B reporting patterns by province and territory, 2011 to 2020
PT 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
BC Acute, chronic, and unspecified
QC Acute, chronic, and unspecified
YT Acute, chronic, and unspecified
AB Acute and chronic Acute, chronic, and unspecified
MB Acute and unspecified Acute, chronic, and unspecified Did not provide data
NU Unspecified Acute, chronic, and unspecified Acute and unspecified Unspecified Acute, chronic, and unspecified
NS Acute, chronic, and unspecified Acute and chronic Acute, chronic, and unspecified Acute and chronic Acute, chronic, and unspecified
SK Acute and chronic Acute, chronic, and unspecified
ON Acute and chronic
NB Acute and chronic
NT Acute, chronic, and unspecified Acute and unspecified
PE Unspecified Acute, chronic, and unspecified
NL Unspecified Acute, chronic, and unspecified Unspecified

PT=province or territory, BC=British Columbia, QC=Quebec, YT=Yukon Territories, AB=Alberta, MB=Manitoba, NU=Nunavut, NS=Nova Scotia, ON=Ontario, NB=New Brunswick, SK=Saskatchewan, NT=Northwest Territories, NL=Newfoundland and Labrador, PE=Prince Edward Island

Appendix C: List of supplementary tables

Due to the impact of the COVID-19 pandemic on the number of reported hepatitis B cases, a 2020 hepatitis B and C in Canada surveillance report was not prepared by the Public Health Agency of Canada. However, the supplementary tables described below are available upon request via sti-hep-its@phac-aspc.gc.ca.

List of supplementary tables and figures:

Notes

Observed differences in the data published here and the data published in provincial and territorial surveillance products may be due to reporting delays, differences in the date data were extracted from the provincial and territorial surveillance databases or other reporting variations. Where such differences are noted, it is recommended that data and results from provincial and territorial products be used.

Footnotes

Footnote 1

Public Health Agency of Canada. Survey on the impact of COVID-19 on the delivery of STBBI prevention, testing and treatment, including harm reduction services, in Canada. Ottawa, ON: Public Health Agency of Canada; 2022. Pub.: 210294

Return to footnote 1 referrer

Footnote 2

In 2020, Manitoba and Newfoundland and Labrador did not provide acute hepatitis B surveillance data.

Return to footnote 2 referrer

Footnote 3

In 2020, Manitoba did not provide chronic and unspecified hepatitis B surveillance data.

Return to footnote 3 referrer

Footnote 4

Interpret rate with caution since it was calculated as the number of cases among a smaller population. In such instances, it is best to consider the number of cases reported for the jurisdiction.

Return to footnote 4 referrer

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