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Canadian Journal of Infectious Diseases
Volume 12 (2001), Issue 6, Pages 345-350
Original Article

Epidemiology of Hepatitis B in Canada

Jun Zhang, Shimian Zou, and Antonio Giulivi

Bloodborne Pathogens Division, Bureau of Infectious Diseases, Centre for Infectious Disease Prevention and Control, Population and Public Health Branch, Health Canada, Ottawa, Ontario, Canada

Received 1 November 2000; Accepted 28 August 2001

Copyright © 2001 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


OBJECTIVE: To provide a current and comprehensive review of the epidemiology of hepatitis B virus (HBV) in Canada.

DATA SOURCES: Published and unpublished epidemiological studies and surveillance reports of the past decade, primarily from Canada were studied. Fifty reports addressing HBV surveillance, incidence and prevalence, transmission-associated risk factors, co-infections, and prevention strategies were reviewed.

DATA SYNTHESIS: HBV infection is an important vaccine-preventable infectious disease in Canada. The incidence rate of clinically recognized, acute HBV infection in 1998/1999 was estimated to be 2.3/100,000 people or approximately 700 cases a year. The prevalence of HBV carriers is estimated to be 0.5% to 1.0% of the population, but varies substantially according to population-specific risk factors. Most acute HBV infections are associated with injection drug use or high risk heterosexual activities, but 20% to 30% of acute cases did not report any identified risk factors. Surveillance activities such as the National Notifiable Disease Reporting system provide information regarding trends and risk factors. The primary preventive strategy for HBV consists of universal immunization for preadolescents and/or infants. Other strategies, such as the universal prenatal screening and postnatal immunization, and the prevention of nosocomial acquistion, are also important. The recently described hepatitis B surface antigen (HBsAg) escape mutants may not be detected by current HBsAg test assays, and the existing HBV vaccines may not protect vaccinees from infections by such mutants.

CONCLUSION: Ongoing surveillance and research are required to assess risk factors for HBV transmission, evaluate the effectiveness of immunization programs and monitor the impact of HBsAg escape mutants.