Hepatitis B in Homosexual Men: Prevalence of Infection and Factors Related to Transmission

Abstract

Of 3,816 homosexual men examined in five sexually transmitted disease clinics in the United States, 6.1% had hepatitis B surface antigen, 52.4% had antibody to hepatitis B surface antigen, and 3.0% of the men who had no other indicator of infection with hepatitis B virus (HBV) had antibody to hepatitis B core antigen. The rate of seropositivity for HBV indicated by the presence of one or more of these serologic markers was 61.5%; seropositivity was significantly related to the duration of regular homosexual activity and to the number of nonsteady male sexual contacts in the four months before the patients were interviewed. Anal-genital intercourse, oral-anal intercourse, and rectal douching were significantly related to evidence of HBV infection, but oral-oral contact and oral-genital contact were not. Trauma to the rectal mucosa is a feature common to the practices that were significantly related to seropositivity for HBV.

Two decades after vaccine license: hepatitis B immunization and infection among young men who have sex with men

“…The prevalence of infection increased significantly by age and risk behavior, corroborating findings that sexual behavior is the predominant mode of HBV transmission among MSM. [18][19][20][21][22] As reported for the general population, rates of HBV infection were higher for MSM of Asian, Black, or mixed race than for White MSM. 26 As we expected, young MSM who used a regular source of health care were more likely to have been immunized than those who did not have a regular source of health care or did not use health care services.…”

“…From these, we constructed a risk hierarchy (low, moderate, high) based on factors known to be associated with HBV infection among MSM. [18][19][20][21][22] We defined low risk as having never engaged in anal sex and having 5 or fewer lifetime male sex partners. High risk was defined as having ever engaged in anal sex and meeting 1 or more of the following criteria: having had 20 or more male sex partners; having ever exchanged sex for money, food, or drugs; having, or having had, a STD; having ever engaged in anal fisting; and having ever shared needles or equipment to inject drugs.…”

“…Because of the substantial literature on behavioral risk factors associated with HBV infection among MSM, we evaluated HBV infection by a single risk hierarchy rather than by multiple risk behaviors. [18][19][20][21][22] We used logistic regression to identify independent predictors of immunization. 24 We entered into the model all variables that were found to be associated or that we reasoned could be associated with immunization.…”

Association of hepatitis B virus infection with other sexually transmitted infections in homosexual men. Omega Study Group

“…Since associations observed in such studies may be markers for other associations, studies that collected demographic and riskrelated data (e.g., on sexual practices and past STDs) and used multivariate analysis to adjust for possible confounding are of particular interest. Both the duration of homosexual activity 17,18 and the number of male sexual partners 5,17,19,21 were independently associated with HBV infection in studies carried out in Canada, the United States, and Europe. Receptive anal intercourse was identified in at least 3 studies 5,17,18 and insertive anal intercourse in 1 study.…”

Prevalence of Hepatitis B Antigen amongst the voluntary blood donors in a tertiary care institution

“…(Table 3, One case showed positive history of contact with a jaundice patient in the family, suggesting that other modes of transmission also operate. Various studies showed that risks with this route is found in 28% 37 , in 40% of spouses and household members of HBs Ag carriers 9 , 22% 38 and 29% 6 .…”