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Estimated prevalence of hepatitis B and C among immigrants in Canada
Laurence Campeau1, Janelle Elliott1, Anson Williams1
1Public Health Agency of Canada, Ottawa, ON.
Insights
Viral hepatitis, including hepatitis B (HBV) and hepatitis C (HCV), is more prevalent among immigrants in Canada than the general population. This study provides the first national estimates, highlighting the need for targeted care and treatment strategies.
Area of Science:
- Public Health
- Infectious Diseases
- Epidemiology
Background:
- Canada's STBBI Action Plan emphasizes people-centered healthcare.
- Immigrants are disproportionately affected by viral hepatitis.
- Limited data exists on viral hepatitis burden among immigrants in Canada.
Purpose of the Study:
- To estimate the national prevalence of hepatitis B (HBV) and hepatitis C (HCV) among immigrants in Canada.
- To address the gap in evidence regarding viral hepatitis burden in this key population.
- To inform public health strategies for viral hepatitis prevention and care.
Main Methods:
- Utilized country- and region-specific prevalence data for HBV and HCV.
- Multiplied immigrant population data (Statistics Canada 2021 Census) by origin-specific prevalence rates.
- Categorized countries by viral hepatitis prevalence (low <2% vs. intermediate-to-high ≥2%) and stratified estimates by time period where possible.
Main Results:
- In 2021, estimated viral hepatitis prevalence among all immigrants was 4.03% for chronic HBV (CHB), 1.43% for HCV antibodies, and 0.78% for chronic HCV (CHC).
- Prevalence was higher among immigrants from intermediate-to-high prevalence countries (CHB 5.57%, HCV antibodies 4.04%, CHC 2.20%) compared to low prevalence countries (CHB 0.91%, HCV antibodies 0.96%, CHC 0.52%).
Conclusions:
- This is the first national-level study on HBV and HCV burden among immigrants in Canada.
- Viral hepatitis prevalence is higher in immigrant populations than the general Canadian population.
- Understanding variations in hepatitis prevalence among immigrants is crucial for effective care and treatment linkage.
Background:
Canada's Sexually Transmitted and Blood-borne Infections (STBBI) Action Plan and the Global Health Sector Strategies on STBBI highlight the importance of putting people at the centre of the health system response. Several key populations are disproportionately affected by viral hepatitis, including immigrants. However, there is a limited body of evidence on the burden of viral hepatitis among immigrants in Canada. We seek to address this gap by estimating the prevalence of hepatitis B (HBV) and C (HCV) infections among immigrants in Canada.
Methods:
Using country- and region-specific publicly available data on the prevalence of HBV and HCV, we estimated the number of immigrants with chronic HBV (CHB), HCV antibodies, and chronic HCV (CHC) by multiplying the number of immigrants from Statistics Canada's 2021 census of population data by the corresponding publicly available country or region-of-origin prevalence, including lower and upper bounds. Each country was categorized as low (<2%) or intermediate-to-high (≥2%) based on published prevalence. To capture changes over time, estimates were stratified by time-period, where possible.
Results:
In 2021, the estimated prevalence of viral hepatitis among all immigrants was 4.03% for CHB, 1.43% for HCV antibodies, and 0.78% for CHC. The estimated prevalence of CHB, HCV antibodies, and CHC was 0.91%, 0.96% and 0.52%, respectively, among immigrants from low-prevalence countries (<2%). It was 5.57%, 4.04%, and 2.20%, respectively, among immigrants from intermediate-to-high-prevalence countries (≥2%).
Conclusion:
This is the first study to estimate the burden of HBV and HCV among immigrants at the national level in Canada. The results show that the prevalence of viral hepatitis among immigrants is higher than the general Canadian population. However, grouping all immigrants into one category masks important variation, and potentially over-estimates the burden of HBV and HCV among immigrants. Strengthening our understanding of hepatitis prevalence among immigrants can improve our ability to connect those in need to care and treatment services.
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