Hepatitis C in Canada: 2020 surveillance data update

Hepatitis C

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

• In 2020, a total of 6,736 cases of hepatitis C (acute, chronic, and unspecified combined) were reported from 12 provinces and territories, for a rate of 18.4 cases per 100,000 people. Of these, there were:
  • 186 reported acute cases from six^{Footnote 2} provinces and territories for a rate of 1.0 cases per 100,000 people
  • 2,012 reported chronic cases from five^{Footnote 3} provinces and territories for a rate of 18.6 cases per 100,000 people
  • 4,538 reported unspecified cases from ten^{Footnote 4} provinces and territories for a rate of 14.4 cases per 100,0000 people
• From 2011 to 2018, total reported hepatitis C rates increased slightly
• From 2018 to 2019, the total reported hepatitis C rate decreased by 9.9%. Whether this decrease observed in 2019 represents a trend remains to be confirmed.
• From 2019 to 2020, the total reported hepatitis C rate dropped by 39.9%

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

Hepatitis C by sex and age group

Figure 1 shows the number and rates of reported hepatitis C from 2011 to 2020 and Table 3 summarizes the number of cases, rates, and proportions of hepatitis C by sex and age group reported in 2020. The trends in this figure and in this table are described below:

• In 2020, 62.3% of reported hepatitis C cases were male
• In 2020, the rate of reported hepatitis C among males was 22.9 cases per 100,000 males, and the rate among females was 13.7 cases per 100,000 females
• In 2020, among males, those aged 30 to 39 years had the highest reported hepatitis C rate at 43.1 cases per 100,000 males 30 to 39 years old
• In 2020, among females, those aged 25 to 29 years had the highest reported hepatitis C rate at 32.3 cases per 100,000 females 25 to 29 years old
• In 2020, among males, the largest proportion of reported hepatitis C cases was among males aged 40 to 59 years (35.7%)
• In 2020, among females, the largest proportion of reported cases was among females aged 40 to 59 years (27.8%)
• From 2011 to 2020, reported hepatitis C rates were higher among males than females
• Among males:
  • from 2011 to 2014, rates of reported hepatitis C fluctuated but were stable overall
  • from 2014 to 2018, rates of reported hepatitis C increased
  • from 2018 to 2019, the reported hepatitis C rate decreased by 9.7%
  • from 2019 to 2020, the reported hepatitis C rate dropped by 39.0%
• Among females:
  • from 2011 to 2014, rates of reported hepatitis C fluctuated but were stable overall
  • from 2014 to 2018, rates of reported hepatitis C increased
  • from 2018 to 2019, the reported hepatitis C rate decreased by 10.4%
  • from 2019 to 2020, the reported hepatitis C rate dropped by 41.0%

Figure 1 - Text description

Table 1. Number of reported cases and rates of hepatitis C 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	10,113	6,365	3,657	29.5	37.5	21.2
2012	10,205	6,345	3,767	29.5	37.0	21.6
2013	10,366	6,527	3,751	29.7	37.7	21.3
2014	10,496	6,603	3,829	29.7	37.7	21.5
2015	10,920	6,767	4,088	30.7	38.3	22.8
2016	11,338	7,081	4,235	31.5	39.7	23.4
2017	11,837	7,215	4,565	32.5	40.0	24.9
2018	12,560	7,665	4,847	34.0	41.9	26.1
2019	11,470	7,021	4,400	30.6	37.8	23.4
2020	6,736	4,173	2,528	18.4	22.9	13.7
National annual hepatitis C rates were calculated using the number of hepatitis C 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 include all males, females and those who did not disclose their sex (unknown sex). Hepatitis C reporting differed by province and territory from 2011 to 2020 (see Appendix B for provincial and territorial hepatitis C reporting patterns).

Hepatitis C by province and territory

In 2020, the national reported hepatitis C rate was 18.4 cases per 100,000 people. Provinces and territories that had rates of reported hepatitis C above the national rate included:

• Saskatchewan (38.5 cases per 100,000 population)
• British Columbia (27.8 cases per 100,000 population)
• Yukon Territory (26.1 cases per 100,000 population)^{Footnote 5}
• Newfoundland and Labrador (26.0 cases per 100,000 population)^{Footnote 5}
• Nova Scotia (25.2 cases per 100,000 population)^{Footnote 5}
• New Brunswick (23.9 cases per 100,000 population)^{Footnote 5}
• Prince Edward Island (19.9 cases per 100,000 population)^{Footnote 5}
• Ontario (19.2 cases per 100,000 population)

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

• Alberta (13.6 cases per 100,000 population)
• Quebec (9.2 cases per 100,000 population)
• Nunavut (DS cases per 100,000 population)
• Northwest Territories (DS cases per 100,000 population)

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

In 2020, Manitoba did not provide hepatitis C surveillance data.

• In 2020, the greatest proportion of reported hepatitis C cases came from Ontario (42.1%), followed by British Columbia (21.3%) and Quebec (11.8%)

Acute hepatitis C in Canada, 2020

• In 2020, 186 cases of acute hepatitis C were reported by six provinces and territories (British Columbia, Alberta, Saskatchewan, Quebec, Nunavut, and Yukon Territories) for a rate of 1.0 case per 100,000 people
• In 2020, individuals aged 25 to 29 years had the highest reported acute hepatitis rate C rate (2.8 cases per 100,000 25 to 29-year-olds), followed by individuals aged 30 to 39 years (2.5 cases per 100,000 30 to 39-year-olds)
• In 2020, the largest proportion of reported acute hepatitis C cases was among people aged 30 to 39 years (37.1%)

Acute hepatitis C by sex and age group, 2020

• In 2020, 58.7% of reported acute hepatitis C cases were male
• In 2020, the rate of reported acute hepatitis C among males was 1.1 cases per 100,000 males and among females was 0.8 cases per 100,000 females
• In 2020, among males, those aged 30 to 39 years had the highest reported acute hepatitis C rate (3.1 cases per 100,000 males 30 to 39 years old)
• In 2020, among females, those aged 25 to 29 years had the highest reported acute hepatitis C rate (3.1 cases per 100,000 females 25 to 29 years old)
• In 2020, among males, the largest proportion of reported acute hepatitis C cases was among 30 to 39-year-old males (40.7%)
• In 2020, among females, the largest proportion of reported acute hepatitis C cases was among 30 to 39-year-old females (31.6%)

Hepatitis C continues to be a public health concern

• In 2019, it was estimated that one in four people in Canada who ever had hepatitis C were not aware of their current or past infection and could benefit from testing^{Footnote 6}
• Hepatitis C disproportionately affects certain populations and communities in Canada, including people who inject drugs; people who are incarcerated; First Nations, Inuit, and Métis people; gay, bisexual, and other men who have sex with men; immigrant populations; and the 1945-1975 birth cohort^{Footnote 7}
• Hepatitis C is curable
• Early diagnosis and treatment leads to better health outcomes

Appendix A: Data tables corresponding to described hepatitis C information

Table 2. Number of reported cases and rates of reported hepatitis C overall and by infection status, 2020

Hepatitis C disease status	Number of cases	Rate per 100,000 population
AcuteFootnote 2	186	1.0
ChronicFootnote 3	2,012	18.6
UnspecifiedFootnote 4	4,538	14.4
Total	6,736	18.4
National annual rates of reported acuteFootnote 2, chronicFootnote 3 and unspecifiedFootnote 4 hepatitis C were computed using cases reported to the Canadian Notifiable Disease Surveillance System as numerators and Statistics Canada April 2022, 2020, population estimates as denominators.

Table 3. Number of reported cases, rates, and proportion of hepatitis C by sex and age group in Canada, 2020

Males				Females			Total
Age group (years)	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 popula-tion)	Proportion of all reported cases
<15	12	0.4	0.3%	20	0.7	0.8%	32	0.6	0.5%
15 to 19	22	2.1	0.5%	43	4.3	1.7%	66	3.2	1.0%
20 to 24	203	16.2	4.9%	224	19.5	8.9%	428	17.8	6.4%
25 to 29	444	33.6	10.7%	401	32.3	15.9%	849	33.1	12.6%
30 to 39	1,103	43.1	26.5%	681	26.9	26.9%	1795	35.3	26.7%
40 to 59	1,486	30.8	35.7%	702	14.3	27.8%	2198	22.6	32.7%
>60	896	21.1	21.5%	456	9.5	18.0%	1358	15.0	20.2%
National hepatitis C (including acuteFootnote 2, chronicFootnote 3 and unspecifiedFootnote 4 reported hepatitis C cases) age rates by sex and overall were computed using 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 rate include all males, females and those who did not disclose their sex (unknown sex). There were 35 unknown sex hepatitis C cases in 2020.

Table 4. Number of reported cases, rates, and proportion of hepatitis C cases by province and territory, 2020

Jurisdiction	Cases (n)	Rate (per 100,000 population)	Proportion of all reported hepatitis C cases
Canada	6,736	18.4	100.0%
British Columbia	1,433	27.8	21.3%
Alberta	601	13.6	8.9%
Saskatchewan	455	38.5	6.8%
Manitoba	NA	NA	NA
Ontario	2,833	19.2	42.1%
Quebec	795	9.2	11.8%
New Brunswick	187	23.9	2.8%
Nova Scotia	247	25.2	3.7%
Newfoundland and Labrador	136	26.0	2.0%
Prince Edward Island	32	19.9	0.5%
Yukon Territories	11	26.1	0.2%
Northwest Territories	DS	DS	DS
Nunavut	DS	DS	DS
Provincial and territorial 2020 hepatitis C rates were calculated using the number of hepatitis C cases reported to the Canadian Notifiable Disease Surveillance System as numerators and Statistics Canada April 2022, 2020, population estimates as denominators.  NA: In 2020, hepatitis C data were not provided by Manitoba. DS: Data are not shown where case counts were between one and four, inclusive.

Table 5. Number of reported cases, rates, and proportion of acute hepatitis C by sex and age group in Canada, 2020

Males				Females			Total
Age group (years)	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 popula-tion)	Proportion of all reported cases
<15	0	0	0%	0	0	0%	0	0	0.0%
15 to 19	0	0	0%	5	1.0	6.6%	5	0.5	2.7%
20 to 24	5	0.8	4.6%	11	1.9	14.5%	16	1.3	8.6%
25 to 29	18	2.6	16.7%	20	3.1	26.3%	38	2.8	20.4%
30 to 39	44	3.1	40.7%	24	1.8	31.6%	69	2.5	37.1%
40 to 59	35	1.4	32.4%	13	0.5	17.1%	48	0.9	25.8%
>60	6	0.3	5.6%	3	0.1	3.9%	10	0.2	5.4%
National acute hepatitis C age rates by sex and overall were computed using acuteFootnote 2 hepatitis C 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 rate include all males, females and those who did not disclose their sex (unknown sex). There were two unknown sex acute hepatitis C cases in 2020. In 2020, six provinces and territories (British Columbia, Alberta, Saskatchewan, Quebec, Nunavut, and Yukon Territories) provided reported acute hepatitis C case data.

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

Acute, chronic and unspecified hepatitis C reporting patterns by province and territory, 2011 to 2020

PT	2011	2012	2013	2014	2015	2016	2017	2018	2019	2020
BC	Unspecified	Acute and Chronic/UnspecifiedFootnote 8
AB	Unspecified	Acute, Chronic and Unspecified
SK	Unspecified									Acute, Chronic and Unspecified
MB	Unspecified							Acute, Chronic and Unspecified		Not reported
ON	Unspecified
QC	Unspecified	Acute and Unspecified
NB	Unspecified
NS	Unspecified
PE	Unspecified
NL	Unspecified
YT	Unspecified	Acute, Chronic and Unspecified		Acute and Chronic					Acute, Chronic and Unspecified	Acute and Chronic
NT	Unspecified
NU	Unspecified						Acute, Chronic and 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 C 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: 

• Table 1. Hepatitis C number of reported cases and rates per 100,000 people in Canada, from 2011 to 2020
• Figure 1. Annual percent change in rates of hepatitis C by sex in Canada, 2011 to 2020
• Figure 2. Hepatitis C rates by sex and age group (15 years and older) in Canada, 2011 to 2020
• Table 2. Hepatitis C rates per 100,000 people by sex and age group (15 years and older) in Canada, 2011 to 2020
• Figure 3. Percent change in hepatitis C rates by sex and age group in Canada, 2019 to 2020
• Table 3. Hepatitis C number of reported cases and rates per 100,000 people in 2019 and 2020 and hepatitis C prevent change in rate (%) from 2019 to 2020, by sex and age group in Canada
• Table 4. Number of reported cases of hepatitis C by age group in Canada, 2011 to 2020
• Table 5. Rates per 100,000 people of hepatitis C by age group in Canada, 2011 to 2020
• Table 6. Hepatitis C number of reported cases among males by province and territory in Canada, 2011 to 2020
• Table 7. Hepatitis C rates (per 100,000 population) among males by province and territory in Canada, 2011 to 2020
• Table 8. Hepatitis C number of reported cases among females by province and territory in Canada, 2011 to 2020
• Table 9. Hepatitis C rates (per 100,000 population) among females by province and territory in Canada, 2011 to 2020
• Figure 4. Percent change in rates of hepatitis C by province or territory in Canada, from 2019 to 2020
• Table 10:  Hepatitis C number of reported cases and rates (per 100,000 population) in 2019 and 2020 and hepatitis C percent change in rate (%) from 2019 to 2020, by province and territory in Canada
• Figure 5. Reported rates of hepatitis C cases in Canada by region, province and territory, 2011 to 2020
• Table 11:  Hepatitis C number of reported cases and rates per 100,000 population in the western provinces of Canada, 2011 to 2020.
• Table 12:  Hepatitis C number of reported cases and rates per 100,000 population in central Canada, 2011 to 2020
• Table 13:  Hepatitis C number of reported cases and rates per 100,000 population in the Atlantic region of Canada, 2011 to 2020
• Table 14:  Hepatitis C number of reported cases and rates per 100,000 population in the Northern Territories of Canada, 2011 to 2020
• Table 15. Hepatitis C number of reported cases and proportion (%) by age group (years) in Canada, 2011 to 2020
• Figure 6. Number of reported cases and rates of acute hepatitis C by sex and age group (years) in Canada, 2020
• Table 16. Acute hepatitis C number of reported cases and rates per 100,000 people by sex and age group in Canada, 2020
• Table 17:  Acute hepatitis C number of reported cases and rates per 100,000 population by province and territory in Canada, 2020

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.