Author information

¹Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Palo Alto, California, USA.

²Gastroenterology Section Veterans Affairs Palo Alto Healthcare System, Palo Alto, California, USA.

³Toronto Centre for Liver Disease, University Health Network, Toronto, Ontario, Canada.

⁴S Wong Consulting, LLC, Mountain View, California, USA.

⁵Department of Medicine, Epidemiology and Biostatistics, University of California, San Francisco, California, USA.

⁶Department of Medicine, Aga Khan University, Karachi, Pakistan.

⁷Hepatitis B Foundation, Doylestown, Pennsylvania, USA.

⁸Coalition for Global Hepatitis Elimination, Task Force for Global Health, Decatur, Georgia, USA.

⁹Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany.

¹⁰Department of Gastroenterology and Hepatology, Koç University School of Medicine, Istanbul, Turkey.

Abstract

Foreign-born (FB) persons represent a large proportion of adults with chronic hepatitis B (CHB) in Canada due to higher prevalence rates in countries of birth for FB persons. Suboptimal awareness and low rates of hepatitis delta virus (HDV) testing contribute to underdiagnosis and gaps in accurate estimates of Canada HDV prevalence. We aim to provide an assessment of CHB and HDV prevalence in Canada using a comprehensive literature review and meta-analysis. A comprehensive literature review of articles reporting HBsAg seroprevalence and anti-HDV prevalence was conducted to calculate country-specific rates and pooled prevalence of CHB and HDV using meta-analyses. Country-specific CHB and HDV rate estimates were combined with number of FB persons in Canada in 2021 from Statistics Canada to estimate total numbers of FB with CHB and HDV, respectively. These estimates were combined with estimates of Canada-born persons with CHB and HDV to yield the total number of persons with CHB and HDV. In 2021, we estimated 0.550 million (M) (95% CI 0.488-0.615) persons with CHB; 0.344 M (95% CI 0.288-0.401) were FB and 0.206 M (95% CI: 0.200-0.214) were Canada-born. The weighted average HDV prevalence among FB persons in Canada was 5.19% (17,848 [95% CI 9611-26,052] persons), among whom 50% emigrated from Asia and 31% from Africa. When combined with estimates of Canada-born persons with HDV, we estimate 35,059 (95% CI: 18,744-52,083) persons with HDV in Canada. In conclusion, we estimate 0.550 M and 35,059 persons living with CHB and HDV, respectively, in Canada in 2021.