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Abstract
Identification and vaccination of adults at risk for hepatitis B virus acquisition through sexual contact is a key strategy to reduce new hepatitis B virus infections among at-risk adults. Hepatitis C has emerged as a sexually transmitted infection among men with male sex partners (MSM). Several biological and behavioral factors have been linked to hepatitis C virus transmission among MSM, including human immunodeficiency virus coinfection; participation in sexual practices that result in mucosal damage or result in exposure to blood; presence of sexually transmitted diseases (STIs), particularly ulcerative STIs; multiple/casual sex partners; and unprotected anal intercourse.
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Affiliation(s)
- Linda Gorgos
- Special Immunology Associates, El Rio Health Center, 1701 West St Mary's Road, Suite 160, Tucson, AZ 85745, USA.
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2
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Linkins RW, Chonwattana W, Holtz TH, Wasinrapee P, Chaikummao S, Varangrat A, Tongtoyai J, Mock PA, Curlin ME, Sirivongrangson P, van Griensven F, McNicholl JM. Hepatitis A and hepatitis B infection prevalence and associated risk factors in men who have sex with men, Bangkok, 2006-2008. J Med Virol 2013; 85:1499-505. [PMID: 23797893 DOI: 10.1002/jmv.23637] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2013] [Indexed: 01/13/2023]
Abstract
Despite the availability of safe and effective vaccines, little is known about prevalence and risk factors for hepatitis A (HAV) and hepatitis B virus (HBV) infection among Thai men who have sex with men. The prevalence of HAV and HBV infection among men who have sex with men cohort in Bangkok was assessed. Baseline blood specimens were drawn and demographic and behavioral data were collected. Bivariate and multivariate logistic regression analysis was used to analyze risk factors for prevalent HAV and HBV infection. One thousand two hundred ninety-nine Thai men who have sex with men 18 years and older were enrolled. Among those with results, 349/1,291 (27.0%) had evidence of past or current hepatitis A infection. Of the 1,117 (86.5%) men with unambiguous HBV test results, 442 (39.6%) had serologic evidence of past/current infection, 103 (9.2%) were immune due to hepatitis B vaccination, 572 (51.2%) had no evidence of immunological exposure to HBV or vaccine. Of those with past/current HBV infection, 130 (29.4%) were HIV positive. Age >35 years was independently associated with both HAV and HBV infection. University education was protective against both HAV and HBV infection. Increased alcohol consumption, number of lifetime male sexual partners ≥10, and prevalent HIV infection were also independently associated with HBV infection. The prevalence of past/current HAV and HBV infection was high in Bangkok men who have sex with men. Age-cohorts with a higher prevalence of hepatitis B vaccine induced immunity may be expected in the future. Hepatitis A and B vaccination is recommended.
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Affiliation(s)
- Robert W Linkins
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
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3
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Mindel A, Dwyer D, Herring B, Cunningham AL. Global Epidemiology of Sexually Transmitted Diseases. Sex Transm Dis 2013. [DOI: 10.1016/b978-0-12-391059-2.00001-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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4
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Bialek SR, Barry V, Bell BP, Valleroy LA, Behel S, Mackellar DA, Secura G, Thiede H, McFarland W, Ford WL, Bingham TA, Shehan DA, Celentano DD. Seroprevalence and correlates of hepatitis a among HIV-negative American men who have sex with men. Sex Health 2011; 8:343-8. [PMID: 21851774 DOI: 10.1071/sh10162] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2010] [Accepted: 03/11/2011] [Indexed: 12/13/2022]
Abstract
BACKGROUND Hepatitis A outbreaks are well documented among men who have sex with men (MSM). This analysis examines characteristics associated with hepatitis A virus (HAV) infection among a large group of young adult MSM from five USA cities. METHODS The Young Men's Survey was a cross-sectional prevalence study of HIV infection and related behavioural risk factors among MSM aged 15-29 years during 1994-2000. Serum specimens from HIV-negative participants were retrospectively tested for antibodies to HAV (anti-HAV). Data were stratified by ethnicity and analysed with logistic regression. RESULTS Overall anti-HAV prevalence was 18.4% among the 2708 participants, and varied by ethnicity from 6.9 to 45.3% and was highest among Hispanic and Asian men (P < 0.001). Prevalence increased with age across all racial/ethnic groups. Among white men, anti-HAV positivity was associated with having 20 or more lifetime male sex partners for those aged 15-22 years (adjusted odds ratio (AOR)=2.1, 95% confidence interval (CI)=1.0-4.1) and ever having had unprotected anal sex for those aged 23-29 years (AOR=2.4, 95% CI=1.2-4.5). CONCLUSIONS Factors associated with a history of HAV infection among MSM in non-outbreak settings are probably similar to those among non-MSM. MSM are still at risk for HAV infection as a result of outbreaks occurring in MSM communities. Additional studies of hepatitis A vaccination coverage are needed to determine if strategies to vaccinate MSM are adequate.
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Affiliation(s)
- Stephanie R Bialek
- Division of Viral Diseases, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA 30030, USA.
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5
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Rey D, Frick-Michot E, Partisani M, Hess-Kempf G, Cheneau C, Priester M, Bernard-Henry C, de Mautort E, Wendling MJ, Meyer P, Lang JM. Séroprévalence de l'hépatite A chez des patients infectés par le VIH. Med Mal Infect 2005; 35:402-6. [PMID: 16139462 DOI: 10.1016/j.medmal.2005.05.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2005] [Accepted: 05/24/2005] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The authors had for aim to prospectively study the hepatitis A seroprevalence of an HIV-infected population, followed-up in an outpatient clinic (CISIH Strasbourg). DESIGN Blood tests were performed on all patients from September 2003 to March 2004 to screen for hepatitis A (total antibodies with Elisa). RESULTS The overall seroprevalence was 219/514 (56.6%), similar in male and female patients. It increased with age, especially in European patients (P = 0.003). The seroprevalence was lower in European subjects: 46.3% (while it reached 100% in sub-Saharan Africans), the prevalence was similar whatever the HIV risk group (46% in homosexual as well as in heterosexual patients, 44% in intravenous drug users). Hepatitis B or C co-infection did not increase the seroprevalence of hepatitis A. The hepatitis A seroprevalence was similar in various CD4 T cell count categories. CONCLUSIONS Our results stress the utility of hepatitis A serology in HIV-infected patients (more than 50% of European patients are non immune), and the importance of assessing hepatitis A vaccination.
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Affiliation(s)
- D Rey
- Centre d'information et de soins de l'immunodéficience humaine, clinique médicale A, hôpitaux universitaires, 1, place de l'Hôpital, 67091 Strasbourg cedex, France.
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6
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Brunet A, Grabar S, Blanche P, Héripret-Fredouille L, Spiridon G, Calboreanu A, Rollot F, Launay O, Sicard D, Salmon-Céron D, Abad S. Prévalence et facteurs de risque de l'hépatite A au sein d'une population de patients infectés par le virus de l'immunodéficience humaine. Med Mal Infect 2005; 35:73-81. [PMID: 15780896 DOI: 10.1016/j.medmal.2004.09.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2004] [Accepted: 09/07/2004] [Indexed: 11/21/2022]
Abstract
BACKGROUND There are common risk factors between hepatitis A virus (HAV) and human immuno deficiency virus (HIV) infections. OBJECTIVES We tried to evaluate if HIV-infected patients could be at risk for HAV. More over, HAV could worsen prognosis of HIV infection and HAV vaccination was then to be considered. Thus we assessed the prevalence and risk factors of HAV infection in an HIV-infected population. PATIENTS AND METHODS Seroprevalence and risk factors for HAV were studied among 154 HIV-positive patients followed in a Parisian hospital (mean age: 42 years, male patients: 70.8%, female patients: 29.2%). They were screened for HAV antibodies and answered a questionnaire on risk factors for HAV and means of HIV contamination. RESULTS The global prevalence was 72.7% [IC95%: 65.7-79.7]. We excluded patients who were born in highly endemic areas where seroprevalence reached 60% [IC95%: 51.2-70]. The HAV seroprevalence was almost 100% in migrants from highly endemic countries and for those born before 1946. The multivariate analysis showed that risk factors were the geographic origin [OR=20.88; IC95%: 2.40-181], age [OR = 2.33; IC95%: 1.24-4.39], and hemophilia [OR = 13.78; IC95%: 1.34-141]. CONCLUSION Our results suggest that a screening test for HAV antibodies should be performed before vaccination, especially in HIV-infected patients born after 1946 or in non-endemic countries.
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Affiliation(s)
- A Brunet
- Service de médecine interne 2, hôpital Cochin-Saint-Vincent-de-Paul, université René-Descartes, 27, rue du Faubourg-Saint-Jacques, 75679 Paris cedex 14, France
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7
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Abstract
We report the conduct and results of a systematic search for evidence of risk of infection with hepatitis A virus (HAV) among blood transfusion recipients, travellers, the military, healthcare workers, sewage workers, foodhandlers, day care assistants, institutionalised subjects, blood transfusion recipients, drug addicts, homosexuals, prisoners and other risk groups such a liver transplantees. We report our recommendations for the use of the HAV vaccine in these groups.
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Affiliation(s)
- Elisabetta Franco
- Department of Public Health, University of Rome Tor Vergata, Via Montpellier 1, Rome 00133, Italy.
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8
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Abstract
Hepatitis A infection is known since the ancient Chinese, Greek and Roman civilizations but the first documented report was published in the eighteenth century. The hepatovirus belongs to the Picornaviridae family, and carries a single strand RNA. There are 7 genotypes. Antibodies of the IgM and IgA classes, during natural infections, appear early in the serum, together with the first clinical manifestations of the disease, but they may also appear at the end of the first week of infection. There is a spectrum of clinical presentation: asymptomatic infection, symptomatic without jaundice and symptomatic jaundiced. A rare fatal form of hepatitis has been described. Diagnosis of the hepatitis A infection is confirmed by the finding of IgM anti-HAV antibodies, routinely performed using an ELISA test. Treatment is supportive. Intramuscular anti-A gamma globulin is used for passive immune prophylaxis, and there is an efficient vaccine for active immune prophylaxis.
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Affiliation(s)
- Fausto E L Pereira
- Núcleo de Doenças Infecciosas, Departamento de Clínica Médica do Centro Biomédico, Universidade Federal do Espírito Santo, Vitória, ES, Brasil.
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9
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Kahn J. Preventing hepatitis A and hepatitis B virus infections among men who have sex with men. Clin Infect Dis 2002; 35:1382-7. [PMID: 12439802 DOI: 10.1086/343044] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2002] [Accepted: 07/01/2002] [Indexed: 11/03/2022] Open
Abstract
Hepatitis A and hepatitis B are 2 common sexually transmitted diseases that are preventable by vaccination. Men who have sex with men (MSM) are at increased risk of acquiring hepatitis A virus and hepatitis B virus through sexual exposure. Current guidelines from the Centers for Disease Control and Prevention recommend that MSM receive immunizations against hepatitis A and hepatitis B. Many health care providers and most MSM are unaware of the risks and the potentially dangerous consequences posed by hepatitis A and B virus infection, and the MSM thus remain unvaccinated and unprotected from exposure to these viruses. It is important for health care providers to educate and vaccinate their at-risk male patients against hepatitis A and hepatitis B virus infections.
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Affiliation(s)
- James Kahn
- Department of Medicine, Positive Health Program, University of California, San Francisco, and San Francisco General Hospital, San Francisco, CA 94110, USA.
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de Almeida LM, Amaku M, Azevedo RS, Cairncross S, Massad E. The intensity of transmission of hepatitis A and heterogeneities in socio-environmental risk factors in Rio de Janeiro, Brazil. Trans R Soc Trop Med Hyg 2002; 96:605-10. [PMID: 12625132 DOI: 10.1016/s0035-9203(02)90325-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
The objective of this work was to assess the intensity of transmission of hepatitis A in Rio de Janeiro, Brazil. We also used the estimation of the parameters of a deterministic model to study the effects of risk factors. Age-specific seroprevalence of antibodies against hepatitis A virus (HAV) was obtained from a survey screening in a city of the metropolitan area of Rio de Janeiro, in 1997. From the seroprevalence data, we estimated the age-dependent force of infection (lambda) and the average age of first infection (A), using a deterministic model. To evaluate the influence of the environmental risk factors, we estimated the same parameters stratifying the sample for the selected socio-environmental risk factors: the number of years of schooling of the female responsible for the house, crowding within the bedroom, number of water taps and fittings, and the presence of sewage in front of the house. For the whole sample, the maximum force of infection estimated was 0.12/year and the average age of infection was 10.1 years. This last parameter decreased as the number of persons per bedroom increased, and also when the number of water taps and the number of years of schooling of the woman responsible for the house decreased. The proposed environmental interventions may lead to a decrease in the intensity of transmission of HAV and an increase in the average age of first infection in the next few years. This may have public health implications, since hepatitis A is more severe in adults. In this context, specific vaccination programmes may be necessary, as in developed countries.
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Affiliation(s)
- Liz Maria de Almeida
- Núcleo de Estudos de Saúde Coletiva, Universidade Federal do Rio de Janeiro, Av. Brig. Trompowski, s/n, HUCFF, 5o andar/Ala Sul, sala 25, Ilha do Fundão, 21941-590 Rio de Janeiro, RJ, Brazil
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Ross JDC, Ghanem M, Tariq A, Gilleran G, Winter AJ. Seroprevalence of hepatitis A immunity in male genitourinary medicine clinic attenders: a case control study of heterosexual and homosexual men. Sex Transm Infect 2002; 78:174-9. [PMID: 12238647 PMCID: PMC1744479 DOI: 10.1136/sti.78.3.174] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To compare the seroprevalence of hepatitis A in homosexual and heterosexual men to determine their susceptibility to infection and provide guidance for a policy on vaccination. METHODS A case-control study design was utilised to compare the risk factors associated with hepatitis A in homosexual and heterosexual men attending a city centre genitourinary medicine clinic. Demographic and sexual behavioural characteristics were included in univariate and multivariate models. RESULTS The overall seropositivity rate was 29% with no significant difference between homosexual and heterosexual men. Ethnicity and age were strongly associated with hepatitis A seropositivity in both homosexuals and heterosexuals. A history of sex in a sauna in homosexual men, and being born outside the United Kingdom for heterosexual men, was associated with hepatitis A seropositivity. CONCLUSIONS Targeted hepatitis A screening and vaccination of homosexual men attending UK genitourinary medicine clinics is not supported by the results of this study.
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12
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Abstract
The hepatitis A virus (HAV), a picornavirus, is a common cause of hepatitis worldwide. Spread of infection is generally person to person or by oral intake after fecal contamination of skin or mucous membranes; less commonly, there is fecal contamination of food or water. Hepatitis A is endemic in developing countries, and most residents are exposed in childhood. In contrast, the adult population in developed countries demonstrates falling rates of exposure with improvements in hygiene and sanitation. The export of food that cannot be sterilized, from countries of high endemicity to areas with low rates of infection, is a potentially important source of infection. After ingestion and uptake from the gastrointestinal tract, the virus replicates in the liver and is excreted into the bile. Cellular immune responses to the virus lead to destruction of infected hepatocytes with consequent development of symptoms and signs of disease. Humoral immune responses are the basis for diagnostic serologic assays. Acute HAV infection is clinically indistinguishable from other causes of acute viral hepatitis. In young children the disease is often asymptomatic, whereas in older children and adults there may be a range of clinical manifestations from mild, anicteric infection to fulminant hepatic failure. Clinical variants include prolonged, relapsing, and cholestatic forms. Management of the acute illness is supportive, and complete recovery without sequelae is the usual outcome. Research efforts during World War II led to the development of passive immunoprophylaxis. Pooled immune serum globulin is efficacious in the prevention and attenuation of disease in exposed individuals. More recently, active immunoprophylaxis by vaccination has been accomplished. Future eradication of this disease can now be contemplated.
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Affiliation(s)
- J A Cuthbert
- Department of Internal Medicine, UT Southwestern Medical Center at Dallas, Dallas, Texas 75390-9151, USA.
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Dal-R� R, Garc�a-Corbeira P, Garc�a-de-Lomas J. A large percentage of the Spanish population under 30 years of age is not protected against hepatitis A. J Med Virol 2000. [DOI: 10.1002/(sici)1096-9071(200004)60:4<363::aid-jmv1>3.0.co;2-l] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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14
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GLOBAL EPIDEMIOLOGY OF SEXUALLY TRANSMITTED DISEASES. Sex Transm Dis 2000. [DOI: 10.1016/b978-012663330-6/50002-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register]
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15
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Abstract
OBJECTIVES To assess current knowledge about the potential for sexual transmission of the hepatitis viruses A-E and G and how to prevent any such transmission. METHOD A search of published literature identified through Medline 1966-June 1998 (Ovid v 3.0), the Cochrane Library and reference lists taken from each article obtained. Textword and MeSH searches for hepatitis A, B, C, D, E, G, delta, GB virus, GBV-C were linked to searches under the textword terms sex$, vaccine$, prevent$, and MeSH subheadings, epidemiology, transmission, prevention, and control. CONCLUSIONS There is evidence for heterosexual transmission of hepatitis B, C, D, and G and homosexual transmission of hepatitis A-D and G. Condoms are an effective method for preventing transmission by penetrative vaginal or anal sex although spread of types A and B are linked also to oro-anal sex. Hepatitis types A and B can be prevented by pre- and post-exposure active or passive immunisation. There is still some uncertainty about appropriate target groups for pre-exposure vaccination, particularly against hepatitis A.
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Affiliation(s)
- M G Brook
- Patrick Clements Clinic, Central Middlesex Hospital, London
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