What is it about?
Between June 2015 and December 2016, a total of 1,268 acute hepatitis A (AHA) cases were documented, and 601 cases were co-infected with HIV; the majority of whom were men who have sex with men (MSM). Over the past 3 years, outbreaks of AHA among MSM have been recently reported in Spain, France, Germany, Italy, Poland and New York City. These outbreaks were characterized by urban population and seemed to have disproportionately affected MSM who had HIV infection, any history of sexually transmitted infections (STIs), or engagement in casual sex.
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Why is it important?
HAV outbreaks among MSM in Asia have been only reported in Taiwan and Hong Kong; both outbreaks were first identified in 2015. One of the major circulating HAV strains (RIVM_HAV_16_090) in the 2016–2017 MSM-associated outbreaks in European countries was found to be identical with the 2015 outbreak strain in Taiwan, indicating possibilities of intercontinental HAV spread through social or sexual networks among MSM.
Perspectives
AHA outbreak among HIV-infected men was characterized by virologically suppressed younger urban MSM, and HIV-infected MSM with a recent history of sexually transmitted diseases might have contributed to HAV transmission but nonsexual exposures such as social networks might have also played a role. Hence, we recommend surveillance of associated behavioral and virologic characteristics and HAV counseling and testing, and preventive measures, such as education of safer sex and mass hepatitis A immunization program towards young HIV-infected men with recent syphilis, are urgently needed for outbreak control.
chien-yu cheng
Taoyuan General Hospital
Read the Original
This page is a summary of: Epidemiological characteristics and associated factors of acute hepatitis A outbreak among HIV-coinfected men who have sex with men in Taiwan, June 2015-December 2016, Journal of Viral Hepatitis, June 2018, Wiley,
DOI: 10.1111/jvh.12926.
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