Hepatitis B in Canada: 2021 surveillance data update

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Organization: Public Health Agency of Canada
Type: Infographic
Date published: 2023-12-20

Impact of the COVID-19 pandemic on reported hepatitis B case counts and rates in 2020 and 2021

The COVID-19 pandemic affected the demand for and access to services related to sexually transmitted and blood-borne infections, including testing. This likely contributed to fewer reported cases of hepatitis B casesFootnote 1. As parts of the country experienced various levels of disruptions due to COVID-19 during 2020 and 2021, comparisons of hepatitis B case counts and rates between the provinces and territories may also be inaccurate.

Hepatitis B

In 2021, 3,524 cases of hepatitis B (acute, chronic and unspecified cases combined) were reported from all 13 Canadian provinces and territories for a rate of 9.2 cases per 100,000 people living in Canada.

Reported acute hepatitis B (infections lasting up to six months) case counts and rates in Canada

Figure 1 shows the number and rates of reported acute hepatitis B from 2012 to 2021. The trends in this figure are described below:

Reported acute hepatitis B case counts and rates by age group and sex in Canada

Figure 1 and Table 1 show the number and rates of reported cases of acute hepatitis B overall and by sex from 2012 to 2021. Table 2 summarizes the number of reported acute hepatitis B cases, rates and proportions by age and sex in 2021. The trends in this figure and table are described below:

Note: Acute hepatitis B reporting differed by province and territory from 2012 to 2021. See Table 8 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, 2012 to 2021
Figure 1. Text version below.
Figure 1 – Text description
Table 1. Number of reported cases and rates of acute hepatitis B overall and by sex in Canada, 2012 to 2021
Year Total cases Male cases Female cases Total rate
(per 100,000 population)
Male rate
(per 100,000 males)
Female rate
(per 100,000 females)
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 0.49 0.70 0.29
2017 180 116 64 0.50 0.65 0.35
2018 194 125 68 0.53 0.69 0.37
2019 181 115 66 0.49 0.62 0.35
2020 140 81 58 0.37 0.43 0.31
2021 114 74 40 0.30 0.39 0.21

National 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 July 2022 yearly population estimates as denominators. The "total" case count and rate include all males, females and unspecified sex. Acute hepatitis B reporting differed by province and territory from 2012 to 2021 (see Table 8 for provincial and territorial hepatitis B reporting patterns).

Figure 2. Rates of reported acute hepatitis B cases by age group and sex in Canada, 2021
Figure 2. Text version below.
Figure 2 – Text description
Table 2. Number of reported cases, rates and proportion of acute hepatitis B by age group and sex in Canada, 2021
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 2.7% 2 0.07 5.0% 4 0.07 3.5%
15 to 19 0 0.00 0.0% 0 0.00 0.0% 0 0.00 0.0%
20 to 24 2 0.16 2.7% 1 0.09 2.5% 3 0.12 2.6%
25 to 29 4 0.30 5.4% 3 0.24 7.5% 7 0.27 6.1%
30 to 39 14 0.52 18.9% 8 0.31 20.0% 22 0.42 19.3%
40 to 59 30 0.61 40.5% 13 0.26 32.5% 43 0.44 37.7%
≥60 22 0.49 29.7% 12 0.24 30.0% 34 0.36 29.8%

National acute hepatitis B rates by age and sex and overall in 2021 were calculated using the number of acute hepatitis B cases reported to the Canadian Notifiable Disease Surveillance System as numerators and Statistics Canada July 2022, 2021 population estimates as denominators. The "total" case count and rate include all males, females and unspecified sex. In 2021, all reported cases of hepatitis B were identified as male or female. In 2021, Newfoundland and Labrador did not provide acute hepatitis B data.

Reported acute hepatitis B case counts and rates by province and territory in Canada

In 2021, the national rate of reported acute hepatitis B cases was 0.30 cases per 100,000 people living in Canada. The following provinces and territories that had rates of reported acute hepatitis B above the national rate (Table 6):

In 2021, the following provinces and territories had rates of reported acute hepatitis B below the national rate (Table 6):

Caution should be used when comparing rates across provinces and territories. Reported rates of acute hepatitis B cases may be inflated in provinces and territories with a relatively small population size. To contextualize rates, it is important to look at the case counts per province and territory (Table 6).

In 2021, the greatest proportion of reported acute hepatitis B cases came from Ontario (78 cases; 68.4%) followed by Manitoba (8 cases; 7.0%)

Reported chronic and unspecified hepatitis B (infections lasting longer than six months) case counts and rates in Canada

Figure 3 shows the number and rates of reported chronic and unspecified hepatitis B from 2012 to 2021. The trends in this figure are described below:

Reported chronic and unspecified hepatitis B case counts and rates by age group and sex in Canada

Figure 3 and Table 3 show the number and rates of reported chronic and unspecified hepatitis B overall and sex from 2012 to 2021. Table 4 summarizes the number of reported chronic and unspecified hepatitis B cases, rates and proportions by age and sex in 2021. The trends in the figure and tables are described below:

Note: Chronic and unspecified hepatitis B subtype reporting differed by province and territory from 2012 to 2021. See Table 8 for provincial and territorial chronic and unspecified hepatitis B reporting patterns.

Figure 3. Number of reported cases and rates of chronic and unspecified hepatitis B overall and by sex in Canada, 2012 to 2021
Figure 3. Text version below.
Figure 3 – Text description
Table 3: Number of reported cases and rates of chronic and unspecified hepatitis B overall and by sex in Canada, 2012 to 2021
Year Total cases Male cases Female cases Total rate
(per 100,000 population)
Male rate
(per 100,000 males)
Female rate
(per 100,000 females)
2012 5,500 3,088 2,406 15.8 17.9 13.7
2013 5,527 3,065 2,458 15.8 17.6 13.9
2014 5,193 2,769 2,415 14.7 15.7 13.5
2015 4,861 2,757 2,089 13.6 15.6 11.6
2016 5,029 2,854 2,165 13.9 15.9 11.9
2017 4,951 2,822 2,119 13.5 15.6 11.5
2018 4,877 2,698 2,161 13.2 14.7 11.6
2019 4,876 2,704 2,141 13.0 14.5 11.3
2020 3,141 1,768 1,352 8.3 9.4 7.1
2021 3,410 1,879 1,517 8.9 9.9 7.9

National annual acute 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 July 2022 yearly population estimates as denominators. The "total" case count and rate include all males, females and unspecified sex. Acute hepatitis B reporting differed by province and territory from 2012 to 2021 (see Table 8 for provincial and territorial hepatitis B reporting patterns).

Figure 4. Rates of reported chronic and unspecified hepatitis B cases by age group and sex in Canada, 2021
Figure 4. Text version below.
Figure 4 – Text description
Table 4. Number of reported cases, rates and proportions of chronic and unspecified hepatitis B by age group and sex in Canada, 2021
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 0.6% 8 0.3 0.5% 19 0.3 0.6%
15 to 19 18 1.7 1.0% 12 1.2 0.8% 30 1.5 0.9%
20 to 24 65 5.1 3.5% 66 5.6 4.4% 132 5.4 3.9%
25 to 29 125 9.2 6.7% 154 12.1 10.2% 281 10.7 8.2%
30 to 39 514 19.0 27.4% 435 16.4 28.7% 951 17.8 27.9%
40 to 59 760 15.3 40.4% 522 10.3 34.4% 1,285 12.8 37.7%
≥60 371 8.2 19.7% 307 6.0 20.2% 682 7.0 20.0%

National chronic and unspecified hepatitis B age rates by sex and overall, in 2021, were calculated using cases reported to the Canadian Notifiable Disease Surveillance System as numerators and Statistics Canada July 2022, 2021 population estimates as denominators. The "total" case count and rate include all males, females and unspecified sex. In 2021, 14 chronic and unspecified hepatitis B cases did not have sex data.

Reported chronic and unspecified hepatitis B case counts and rates by province and territory in Canada

In 2021, the national rate of chronic and unspecified hepatitis B was 8.9 cases per 100,000 people living in Canada. The following provinces and territories had rates of reported chronic and unspecified hepatitis B cases above the national rate (Table 7):

In 2021, the following provinces and territories had rates of reported chronic and unspecified hepatitis B cases below the national rate (Table 7):

Caution should be used when comparing rates across provinces and territories. Reported rates of chronic and unspecified hepatitis B may be inflated in provinces and territories with a relatively small population size. To contextualize rates, it is important to look at the case counts per province and territory (Table 7).

In 2021, the greatest proportion of reported chronic and unspecified hepatitis B cases came from Ontario (1,075 cases; 31.5%), followed by British Columbia (845 cases; 24.8%) and Quebec (794 cases; 23.3%).

Hepatitis B public health messaging

Appendix A: Data tables corresponding to described hepatitis B information

Table 5. Number of cases and rates of reported hepatitis B overall and by infection status, 2021
Hepatitis B infection status Number of cases Rate per 100,000 population
Acute 114 0.3
Chronic 2,833 7.5
Unspecified 577 2.7
Total 3,524 9.2

National annual rates of reported acute, chronic and unspecified hepatitis B were calculated using the number of acute, chronic and unspecified hepatitis B cases reported to Canadian Notifiable Disease Surveillance System as numerators and Statistics Canada July 2022, 2021 yearly population estimates as denominators. The "total" case count and rate include all males, females and unspecified sex. In 2021, Newfoundland and Labrador did not provide acute hepatitis B data.

Table 6 Number of reported cases, rates and proportion of acute hepatitis B cases by province and territory, 2021
Jurisdiction Cases (n) Rate (per 100,000 population) Proportion of all reported acute hepatitis B cases
Canada 114 0.30 100.0%
British Columbia 6 0.12 5.3%
Alberta 5 0.11 4.4%
Saskatchewan DNS DNS DNS
Manitoba 8 0.57 7.0%
Ontario 78 0.53 68.4%
Quebec 5 0.06 4.4%
Newfoundland and Labrador NA NA NA
Prince Edward Island 0 0.00 0.0%
Nova Scotia DNS DNS DNS
New Brunswick 6 0.76 5.3%
Yukon 0 0.00 0.0%
Northwest Territories DNS DNS DNS
Nunavut 0 0.00 0.0%

Provincial and territorial 2021 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 July 2022, 2021 population estimates as denominators.
NA: Not applicable. In 2021, Newfoundland and Labrador did not provide acute hepatitis B data.
DNS: Data not shown to reduce the risk of identifying individuals.

Table 7. Number of reported cases, rates and proportion of chronic and unspecified hepatitis B cases by province and territory, 2021
Jurisdiction Cases (n) Rate (per 100,000 population) Proportion of all reported chronic and unspecified hepatitis B cases
Canada 3,410 8.9 100.0%
British Columbia 845 16.2 24.8%
Alberta 309 7.0 9.1%
Saskatchewan 82 6.9 2.4%
Manitoba 209 15.0 6.1%
Ontario 1,075 7.3 31.5%
Quebec 794 9.2 23.3%
Newfoundland and Labrador 5 1.0 0.1%
Prince Edward Island 16 9.7 0.5%
Nova Scotia 20 2.0 0.6%
New Brunswick 44 5.6 1.3%
Yukon 6 13.9 0.2%
Northwest Territories 0 0.0 0.0%
Nunavut 5 12.6 0.1%

Provincial and territorial 2021 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 July 2022, 2021 population estimates as denominators.

Table 8. Acute, chronic and unspecified hepatitis B reporting patterns by province and territory, 2012 to 2021
PT 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021
B.C. Acute, Chronic, Unspecified
Man. Acute, Chronic, Unspecified
Que. Acute, Chronic, Unspecified
Y.T. Acute, Chronic, Unspecified
N.B. Acute, Chronic
Ont. Acute, Chronic
N.W.T Acute, Unspecified
Alta. Acute, Chronic Acute, Chronic, Unspecified
N.L. Acute, Chronic, Unspecified Unspecified
N.S. Acute, Chronic, Unspecified Acute, Chronic Acute, Chronic, Unspecified Acute, Chronic Acute, Chronic, Unspecified
Nun. Unspecified Acute, Chronic, Unspecified Acute, Unspecified Unspecified Acute, Chronic, Unspecified
P.E.I. Unspecified Acute, Chronic, Unspecified
Sask. Acute, Chronic Acute, Chronic, Unspecified Acute, Chronic

PT=province or territory, B.C.=British Columbia, Que.=Quebec, Y.T.=Yukon, Alta.=Alberta, Man.=Manitoba, Nun.=Nunavut, N.S.=Nova Scotia, Ont.=Ontario, N.B.=New Brunswick, Sask.=Saskatchewan, N.W.T.=Northwest Territories, N.L.=Newfoundland and Labrador, P.E.I.=Prince Edward Island

Appendix B: List of supplementary tables

Due to the impact of the COVID-19 pandemic on the number of reported hepatitis B cases, a 2021 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.

Hepatitis B

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. Also, percent changes in rates were calculated using non-rounded numbers.

Related links

Footnotes

Footnote 1

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 2021, Newfoundland and Labrador did not provide acute hepatitis B surveillance data.

Return to footnote 2 referrer

Footnote 3

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 3 referrer

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