Canadian Association for the Study of the Liver
 
 

Epidemiology of Hepatitis B in Canada


 

The prevalence of hepatitis B (HBV) infection varies considerably across Canada because of the heterogeneity of the Canadian population. If the Canadian population can be described by three groups - Native/Inuit, Immigrant and Non-immigrant then the estimated prevalence and number of cases in Canada are shown in Table 1 (1-6)
 
Table 1

 
 
Prevalence of HBsAg+
Estimated number of cases in Canada
Native/Inuit
4%
1640
Immigrant
4.3%
154,160

Non-immigrant

0.2% - 0.5%

49,862 – 124,655
Total
  
206,000 to 280,000

Immigrants constitute the largest group of HBV carriers, particularly those from regions with high endemic rates of HBV, such as Asia. The proportion of HBV infected patients who are HBeAg-positive also varies amongst the different groups (1). HBeAg-positivity ranges from <9% in the Inuit population, to <15% for non-immigrants, to 46% for Asian immigrants and 55% for Indochinese immigrants. The majority of HBeAg-positive cases occur in the young immigrant population.

Following acute HBV infection, the percentage of infected patients who become carriers varies with age. The risk is greatest in the very young and in the elderly (natural history). Although acute hepatitis B continues to be an important clinical problem in Canada the majority of acute cases will resolve and clear HBsAg spontaneously. Chronic HBV infection, established when HBsAg is detectable for longer than 6 months with or without continuing liver enzyme abnormalities, accounts for the greatest burden of disease.

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