Hepatitis A outbreak in HIV-infected MSM and in PrEP-using MSM despite a high level of immunity, Lyon, France, January to June 2017

Abstract

Since 2016, an increase in the number of hepatitis A cases affecting mainly men who have sex with men (MSM) has been reported in low endemic countries in Europe. We calculated the attack rate in Lyon, France, in populations considered at high-risk: HIV-infected MSM and HIV-negative MSM receiving HIV pre-exposure prophylaxis (PrEP). In these populations, high level of immunity did not prevent the outbreak, indicating that vaccination should be reinforced, particularly in younger individuals.

Hepatitis A outbreak disproportionately affecting men who have sex with men (MSM) in the European Union and European Economic Area, June 2016 to May 2017

“…The last reported European HA outbreak among MSM in 2008–09 involved a high proportion of HIV-positive MSM [ 4 , 6 - 8 ]. HAV and HIV infections among MSM share overlapping risk factors such as casual sex with multiple partners, which often involves injecting drug use and unprotected sexual intercourse [ 9 ]. Furthermore, HIV co-infection can exacerbate HAV-associated liver abnormalities and prolong the faecal excretion of HAV [ 10 ].…”

Spillover of a hepatitis A outbreak among men who have sex with men (MSM) to the general population, the Netherlands, 2017

“…Hepatitis A outbreaks among MSM are ongoing in Europe and the rest of the world [ 1 - 10 ]. Genetic sequencing of these outbreaks revealed three independent strains (VRD_521_2016 (UK/Spain), RIVM-HAV16–090 (EuroPride) and V16_25801 (Germany)) circulating within the outbreaks, all of which were genotype IA [ 1 , 2 , 4 , 5 , 9 ]. Between September and December 2016, the first eight Dutch MSM outbreak–related cases were reported [ 4 ].…”

Hepatitis A Virus in men who have sex with men: Need for awareness and vaccination

“…Up to December 18, 2017, the European Centre for Disease Prevention and Control collected 3813 cases confirmed by viral sequencing; in the January‐November 2017 interval, laboratory‐confirmed cases have been 15 040, significantly more than 4226 cases observed in the same time period between 2012 and 2015 . Published reports from UK, France, the Netherlands, Italy, Germany and Israel described cases involving mainly MSM, as depicted by a general male/female ratio of 3.6. Other similar outbreaks have been reported also in North and South America, and in Australia (Victoria) .…”