Hepatitis B in Canada: 2020 surveillance data update

Hepatitis B

In 2020, 3,004 cases of hepatitis B (acute, chronic, and unspecified cases combined) were reported from 12 provinces and territories^{Footnote 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:

• In 2020, a total of 123 acute hepatitis B cases (56 fewer than in 2019) were reported from 11 provinces and territories^{Footnote 2} for a rate of 0.34 cases per 100,000 people
• From 2011 to 2012, the total reported acute hepatitis B rate dropped
• From 2012 to 2019, total reported acute hepatitis B rates were mostly stable
• From 2019 to 2020, the total reported acute hepatitis B rate dropped by 30.6%

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:

• In 2020, 62.6% of reported acute hepatitis B cases were male
• In 2020, the rate of reported acute hepatitis B among males was 0.43 cases per 100,000 males, and the rate among females was 0.25 cases per 100,000 females
• In 2020, among males, those aged 40 to 59 years had the highest reported acute hepatitis B rate at 0.80 cases per 100,000 males 40 to 59 years old
• In 2020, among females, those aged 20 to 24 years had the highest reported acute hepatitis B rate at 0.44 cases per 100,000 females 20 to 24 years old
• In 2020, among males, the largest proportion of reported acute hepatitis B cases was among males aged 40 to 59 years (49.4%)
• In 2020, among females, the largest proportion of reported acute hepatitis B cases was among females aged 40 to 59 years (43.5%)
• From 2011 to 2020, reported acute hepatitis B rates were higher among males than females
• Among males:
  • from 2011 to 2012, rates of reported acute hepatitis B declined
  • from 2012 to 2019, rates of reported acute hepatitis B fluctuated but were stable overall
  • from 2019 to 2020, the reported acute hepatitis B rate dropped by 30.6%
• Among females:
  • from 2011 to 2015, rates of reported acute hepatitis B declined
  • from 2016 to 2018, rates of reported acute hepatitis B increased
  • from 2018 to 2019, the reported acute hepatitis B rate declined slightly by 9.0%
  • from 2019 to 2020, the reported acute hepatitis B rate dropped by 26.5%

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 - 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:

• New Brunswick (1.02 cases per 100,000 population)^{Footnote 4} (eight cases of acute hepatitis B in 2020)
• Ontario (0.52 cases per 100,000 population)
• Nova Scotia (0.51 cases per 100,000 population^{Footnote 4} (five cases of acute hepatitis B in 2020)
• Alberta (0.43 cases per 100,000 population)

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

• Saskatchewan (DS cases per 100,000 population)
• British Columbia (0.14 cases per 100,000 population)
• Quebec (0.06 cases per 100,000 population)
• Prince Edward Island (0.00 cases per 100,000 population)
• Yukon (0.00 cases per 100,000 population)
• Northwest Territories (0.00 cases per 100,000 population)
• Nunavut (0.00 cases per 100,000 population)

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.

• In 2020, the greatest proportion of reported acute hepatitis B cases came from Ontario (62.6%), followed by Alberta (15.4%) and New Brunswick (6.5%)

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:

• In 2020, a total of 2,881 (1,996 fewer than in 2019) chronic and unspecified hepatitis B cases were reported by 12 provinces and territories^{Footnote 3} for a rate of 7.9 cases per 100,000 people
• From 2011 to 2013, the total reported chronic and unspecified hepatitis B rates were stable
• From 2013 to 2015, the total reported chronic and unspecified hepatitis B rates declined
• From 2015 to 2019, the total reported chronic and unspecified hepatitis B rates were stable
• From 2019 to 2020, the total reported chronic and unspecified hepatitis B rate dropped by 39.2%

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:

• In 2020, 55.8% of reported chronic and unspecified hepatitis B cases were male
• In 2020, the rate of reported chronic and unspecified hepatitis B among males was 8.8 cases per 100,000 males, and the rate among females was 6.7 cases per 100,000 females
• In 2020, among males, those aged 30 to 39 years had the highest reported chronic and unspecified hepatitis B rate at 17.8 cases per 100,000 males 30 to 39 years old
• In 2020, among females, those aged 30 to 39 years had the highest reported chronic and unspecified hepatitis B rate at 16.2 cases per 100,000 females 30 to 39 years old
• In 2020, among males, the largest proportion of reported chronic and unspecified hepatitis B cases was among those aged 40 to 59 years (41.7%)
• In 2020, among females, the largest proportion of reported chronic and unspecified hepatitis B cases was among those aged 30 to 39 years (33.2%)
• From 2011 to 2020, reported chronic and unspecified hepatitis B rates were higher among males than females
• Among males:
  • from 2011 to 2013, the rates of reported chronic and unspecified hepatitis B were stable
  • from 2013 to 2014, the rate of reported chronic and unspecified hepatitis B declined
  • from 2014 to 2017, the rates of reported chronic and unspecified hepatitis B were stable
  • from 2017 to 2019, the rates of reported chronic and unspecified hepatitis B declined
  • from 2019 to 2020, the reported chronic and unspecified hepatitis B rate dropped by 39.3%
• Among females:
  • from 2011 to 2014, the rates of reported chronic and unspecified hepatitis B were stable
  • from 2014 to 2015, the rate of reported chronic and unspecified hepatitis B declined
  • from 2015 to 2019, the rates of reported chronic and unspecified hepatitis B were stable
  • from 2019 to 2020, the reported chronic and unspecified hepatitis B rate dropped by 40.7%

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 - 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:

• Nunavut (25.7 cases per 100,000 population)^{Footnote 4} (there were ten cases)
• British Columbia (15.1 cases per 100,000 population)
• Prince Edward Island (10.6 cases per 100,000 population)^{Footnote 4} (there were 17 cases)

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

• Saskatchewan (7.5 cases per 100,000 population)
• Quebec (7.1 cases per 100,000 population)
• Ontario (6.9 cases per 100,000 population)
• Alberta (6.8 cases per 100,000 population)
• New Brunswick (4.9 cases per 100,000 population)
• Yukon (DS per 100,000 population)
• Nova Scotia (1.5 cases per 100,000 population)
• Newfoundland and Labrador (1.9 cases per 100,000 population)
• Northwest Territories (0.0 cases per 100,000 population)

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

• Hepatitis B is preventable through vaccination
• Testing for hepatitis B is recommended in the presence of risk factors, during pregnancy, and for people who are immunocompromised (see Primary Care Management of Hepatitis B – Quick Reference (HBV-QR) - Canada.ca)

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:

• Table 1. Number of reported acute hepatitis B cases among males by age group in Canada, 2011 to 2020
• Table 2. Number of reported acute hepatitis B cases among females by age group in Canada, 2011 to 2020
• Table 3. Reported acute hepatitis B rates (per 100,000 males living in Canada) among males by age group in Canada, 2011 to 2020
• Table 4. Reported acute hepatitis B rates (per 100,000 females living in Canada) among females by age group in Canada, 2011 to 2020
• Table 5. Number of reported acute hepatitis B cases by province or territory in Canada, 2011 to 2020
• Table 6. Reported acute hepatitis B rates (per 100,000 population) by province or territory in Canada, 2011 to 2020
• Table 7. Number of reported acute hepatitis B cases among males by province or territory in Canada, 2011 to 2020
• Table 8. Number of reported acute hepatitis B cases among females by province or territory in Canada, 2011 to 2020
• Table 9. Reported acute hepatitis B rates (per 100,000 population) among males by province or territory in Canada, 2011 to 2020
• Table 10. Reported acute hepatitis B rates (per 100,000 population) among females by province or territory in Canada, 2011 to 2020
• Table 11. Number of reported chronic and unspecified hepatitis B cases among males by age group in Canada, 2011 to 2020 
• Table 12. Number of reported chronic and unspecified hepatitis B cases among females by age group in Canada, 2011 to 2020 
• Table 13. Reported chronic and unspecified hepatitis B rates (per 100,000 males) among males by age group in Canada, 2011 to 2020 
• Table 14. Reported chronic and unspecified hepatitis B rates (per 100,000 females) among females by age group in Canada, 2011 to 2020 
• Table 15. Number of reported chronic and unspecified hepatitis B cases by province or territory in Canada, 2011 to 2020 
• Table 16. Reported chronic and unspecified hepatitis B rates (per 100,000 population) by province or territory in Canada, 2011 to 2020 
• Table 17. Number of reported chronic and unspecified hepatitis B cases among males by province or territory in Canada, 2011 to 2020 
• Table 18. Number of reported chronic and unspecified hepatitis B cases among females by province or territory in Canada, 2011 to 2020 
• Table 19. Reported chronic and unspecified hepatitis B rates (per 100,000 population) among males by province or territory in Canada, 2011 to 2020
• Table 20. Reported chronic and unspecified hepatitis B rates (per 100,000 population) among females by province or territory in Canada, 2011 to 2020 
• Figure 1. Number of reported cases and rates of acute hepatitis B by sex and age group (years) in Canada, 2020
• Figure 2. Number of reported cases and rates of chronic and unspecified hepatitis B by sex and age group (years) in Canada, 2020
• Figure 3. Reported chronic and unspecified hepatitis B rates by sex and age group in Canada, 2011 to 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.