Background: Human immunodeficiency virus (HIV) is a global public health issue, with an estimated 36.9 million people living with HIV in 2017. HIV has been reportable in Canada since 1985 and the Public Health Agency of Canada (PHAC) continues to monitor trends in new HIV diagnoses. Objective: The objective of this surveillance report is to provide an overview of the epidemiology of all reported diagnoses of HIV in Canada since 1985 with a focus on 2018 overall, and by geographic location, age group, sex, and exposure category. Methods: PHAC monitors HIV through the national HIV/AIDS Surveillance System, a passive, case-based system that collates nonnominal data that is voluntarily submitted by all Canadian provinces and territories. Descriptive epidemiological analyses were conducted on national data and those relating to specific populations provided by Immigration, Refugees and Citizenship Canada and the Canadian Perinatal HIV Surveillance Program. Results: In 2018, a total of 2,561 HIV diagnoses were reported in Canada, an increase of 8.2% compared with 2017. The national diagnosis rate increased to 6.9 per 100,000 population in 2018 from 6.5 per 100,000 population in 2017. Saskatchewan reported the highest provincial diagnosis rate at 14.9 per 100,000 population. The 30-39 year age group continued to have the highest HIV diagnosis rate at 15.4 per 100,000 population. Overall, the diagnosis rate for males continued to be higher than that of females (9.8 versus 4.0 per 100,000 population, respectively); however, females experienced a larger increase in reported cases and diagnosis rate. The gay, bisexual and other men who have sex with men (gbMSM) exposure category continued to represent the highest proportion of all reported adult cases (41.4%), though the proportion has decreased over time. Five perinatal HIV transmissions were documented, three where related to the mother not receiving perinatal antiretroviral therapy prophylaxis. Conclusion: The number and rate of reported HIV cases in Canada increased in 2018, gbMSM continued to account for the largest exposure category and the number and rate of reported HIV cases among women increased. PHAC will continue to work with its national partners to refine the collection, analysis and publication of national data to better understand the burden of HIV in Canada.

Background: Human immunodeficiency virus (HIV) continues to be a global public health concern, with 2.1 million people newly infected in 2015. Although many high-income countries have noted decreasing rates of HIV, between 2013 and 2015 Canada's rates had stabilized at 5.8 per 100,000 population.

Background: Tuberculosis (TB) is a major global health problem that affected an estimated 10.4 million people worldwide in 2016. The Public Health Agency of Canada (PHAC) monitors active TB disease through a national surveillance system, which is a collaborative effort with the provinces and territories. Objective: This article presents an epidemiological summary of the active TB disease cases reported from 2006 to 2016, with a focus on 2016. Treatment outcomes for cases diagnosed in 2015 are also presented. Methods: The Canadian Tuberculosis Reporting System (CTBRS) is a case-based surveillance system that maintains non-nominal data on people diagnosed with active TB disease in Canada. Data are collected annually from the provinces and territories, analyzed by PHAC and validated by each province and territory. Results: The number of active TB disease cases increased from 1,642 in 2015 to 1,737 in 2016, corresponding to an increase in incidence rate from 4.6 to 4.8 per 100,000 population. Foreign born individuals continued to make up the majority of cases reported (70%) and the incidence rate remained highest among Canadian born Indigenous people (23.5 per 100,000 population) and was particularly high within the Inuit population (170.1 per 100,000 population). Over the past decade, there was a slight decrease in the number of cases among children and the proportion of re-treatment cases declined from 8.3% of cases in 2006 to 5.4% of cases in 2016. Conclusion: Although tuberculosis incidence rates in Canada are low in the global context and have been relatively stable over the last decade, there has been a slight increase in rates over the last three years, especially in the foreign born population which accounts for the majority of cases. The decrease in cases among children suggests less active transmission and the low proportion of re-treatment cases suggests effective treatment and adherence.

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Background: Drug-resistant strains of tuberculosis (TB) pose a serious threat to TB prevention and control efforts. The Canadian Tuberculosis Laboratory Surveillance System (CTBLSS) was created in 1998 to monitor emerging trends and patterns in TB drug resistance in Canada. Objective: To present a descriptive overview of TB drug resistance data collected through the CTBLSS for the years 2006 to 2016 in Canada, with a focus on 2016. Methods: The CTBLSS is an isolate-based surveillance system designed to collect data on TB drug resistance across Canada. Each year, data are collected and analyzed by the Public Health Agency of Canada (PHAC) and then validated by the submitting laboratory. Results: In 2016, anti-tuberculosis drug susceptibility test results were reported for 1,452 isolates. The proportion of TB drug-resistant strains remained relatively stable with 108 (7.4%) of the isolates classified as monoresistant, five (0.3%) isolates as polyresistant and 17 (1.2%) as multidrug-resistant TB (MDR-TB) strains. In 2016, there were no extensively drug-resistant TB (XDR-TB) isolates identified. Males accounted for 792 (54.5%) of all reported isolates and 64 (49.2%) of the resistant strains and females accounted for 11 (64.7%) of the MDR-TB strains. Between 2006 and 2016, individuals between 15 and 44 years of age comprised 47.4% of all reported isolates, 54.0% of isolates showing any resistance and 72.3% of MDR-TB strains. Conclusion: TB drug resistance levels have been relatively low and stable over the past 11 years and have remained below the global average since national surveillance began. However, with growing worldwide concern about drug resistance and the emergence of XDR-TB, the CTBLSS will remain vital to the monitoring of TB drug resistance in Canada.