<i>Notes from the Field:</i> Increase in Reported Hepatitis A Infections Among Men Who Have Sex with Men — New York City, January–August 2017

Latash, Julia; Dorsinville, Marie; Rosso, Paula Del; Antwi, Mike; Reddy, Vasudha; Waechter, HaeNa; Lawler, Jacqueline; Boss, Heather; Kurpiel, Philip; Backenson, P. Bryon; Gonzalez, Charles J.; Rowe, Shannon; Poissant, Tasha; Lin, Yulin; Xia, Guoliang; Balter, Sharon

doi:10.15585/mmwr.mm6637a7

Cited by 45 publications

(41 citation statements)

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“…While most outbreaks were traced to contaminated foods, several outbreaks have been reported among men who have sex with men (MSM) and injecting drug users (IDUs) who were engaged in oral–anal sex and use of contaminated illicit drugs, respectively . Outbreaks of acute hepatitis A among those at‐risk populations have been described since the 1980s and have reemerged across the Asia‐Pacific region, the United States, and several European countries since 2015 . In Taiwan, an unprecedented outbreak with more than 1,000 indigenous cases of acute hepatitis A occurred in 2015‐2016, which was characterized by a high proportion of MSM and human immunodeficiency virus (HIV)–positive individuals .…”

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confidence: 99%

“…(4) Outbreaks of acute hepatitis A among those at-risk populations have been described since the 1980s and have reemerged across the Asia-Pacific region, the United States, and several European countries since 2015. (4)(5)(6)(7) In Taiwan, an unprecedented outbreak with more than 1,000 indigenous cases of acute hepatitis A occurred in 2015-2016, which was characterized by a high proportion of MSM and human immunodeficiency virus (HIV)-positive individuals. (8)(9)(10) Furthermore, phylogenetic analysis demonstrated that the outbreak strains in Taiwan and The Netherlands were identical, suggesting that HAV might have been transmitted through sexual networks and international travel.…”

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Serologic responses and effectiveness of hepatitis A vaccination among human immunodeficiency virus–positive individuals during the outbreak of acute hepatitis A

et al. 2018

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Serologic responses and effectiveness of hepatitis A vaccination among human immunodeficiency virus–positive individuals during the outbreak of acute hepatitis A

et al. 2018

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“…Hepatitis A virus (HAV) is an important cause of viral hepatitis worldwide . Although commonly perceived as a food‐borne, self‐limited infection, recent outbreaks of acute hepatitis A (AHA) involving more than 4,000 patients who were mostly men who have sex with men (MSM) in Europe and the Americas highlighted its potential as a contagious sexually transmitted disease in high‐income countries . In the United States, a recent large outbreak of AHA centered in homeless people and injecting drug users and resulted in 1,521 cases, 1,073 admissions, and 41 deaths .…”

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confidence: 99%

“…(MSM) in Europe and the Americas highlighted its potential as a contagious sexually transmitted disease in high-income countries. (2)(3)(4) In the United States, a recent large outbreak of AHA centered in homeless people and injecting drug users and resulted in 1,521 cases, 1,073 admissions, and 41 deaths. (5) In addition to the public health threats to the at-risk populations, the economic losses from AHA outbreaks could also be substantial.…”

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confidence: 99%

Early Seroreversion After 2 Doses of Hepatitis A Vaccination in Human Immunodeficiency Virus–Positive Patients: Incidence and Associated Factors

Huang

Wang

et al. 2019

Hepatology

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Serological responses (Seroresponse) and durability of hepatitis A virus (HAV) vaccination are reduced among human immunodeficiency virus (HIV)‐positive patients. Incidence of and associated factors with early seroreversion (loss of seroresponse) among HIV‐positive patients who have achieved seroresponses after two doses of HAV vaccination remain unclear. In this multicenter study, we followed HIV‐positive adults who had mounted seroresponses after completing two doses of HAV vaccination during a recent outbreak of acute hepatitis A between 2015 and 2017, a 1:4 case‐control study was conducted to identify factors associated with seroreversion. Case patients were those with seroreversion, and controls were those with similar follow‐up durations who were able to maintain seroresponses. During the study period, 49 of the 1,256 patients (3.9%) seroreverted after a median follow‐up of 611 days. In a case‐control study, seroreversion was more likely to occur in patients with a higher weight (adjusted odds ratio [aOR], 1.703; 95% confidence interval [CI], 1.292‐2.323, per 10‐kg increment) and HIV viremia at the time of vaccination (aOR, 2.922; 95% CI, 1.067‐7.924), whereas positive seroresponse at 6 months of HAV vaccination and higher CD4 lymphocyte counts at vaccination were inversely associated with early seroreversion with an aOR of 0.059 (95% CI, 0.020‐0.154) and 0.837 (95% CI, 0.704‐0.979, per 100‐cell/mm3 increment), respectively, in multivariable analyses. Conclusion: During an outbreak setting, early seroreversion following two‐dose HAV vaccination occurred in 3.9% of HIV‐positive patients. Lower and delayed seroresponses to HAV vaccination, a higher weight, and HIV viremia and lower CD4 lymphocyte counts at the time of HAV vaccination were associated with early seroreversion. Regular monitoring of seroresponse and booster vaccination might be warranted, especially in HIV‐positive adults with predictors of early seroreversion.

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“…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. [9][10][11] To our knowledge, HAV outbreaks among MSM in Asia have been only reported in Taiwan and Hong Kong; both outbreaks were first identified in 2015. 12,13 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.…”

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confidence: 99%

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

Cheng

Zou

et al. 2018

Journal of Viral Hepatitis

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In Taiwan, an outbreak of acute hepatitis A (AHA) infection has been identified since June 2015. Approximately half of the cases occurred in HIV-infected men who have sex with men (MSM). We used the Taiwan Centers for Disease Control (TCDC)-operated National Disease Surveillance Systems (NDSS) to identify the incidence of AHA during 2011-2016. Between June 2015 and December 2016, a total of 1268 AHA cases were documented, and 601 cases (47.4%) were co-infected with HIV; the majority of whom were MSM (98.4%). Each AHA case was matched to two HIV-infected controls without AHA reported in the NDSS on age (± 5 years), risk factor of HIV infection, HIV diagnosis date (± 30 days) and county/city of residence at HIV diagnosis. Three hundred forty-three HIV/AHA cases were matched to 686 controls. In multivariable conditional logistic regression analysis, a previous gonorrhoea (adjusted OR=1.77, 95% CI 1.16-2.70) and recent (aOR=6.77, 95% CI 4.34-10.55) or remote syphilis report (aOR=3.56, 95% CI 2.48-5.13) were independently associated with AHA. The epidemic persisted till December 2016, and the cases with a new diagnosis of HIV infection after AHA (28/301, 9.3%) increased after July 2016 (P = .001). HIV/AHA cases were centralized in northern and central metropolitan areas and HIV-infected MSM with a recent history of sexually transmitted diseases in Taiwan. We recommend surveillance of associated behavioural and virologic characteristics and HAV counselling and testing for HIV-infected men.

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Notes from the Field: Increase in Reported Hepatitis A Infections Among Men Who Have Sex with Men — New York City, January–August 2017

Cited by 45 publications

References 1 publication

Serologic responses and effectiveness of hepatitis A vaccination among human immunodeficiency virus–positive individuals during the outbreak of acute hepatitis A

Serologic responses and effectiveness of hepatitis A vaccination among human immunodeficiency virus–positive individuals during the outbreak of acute hepatitis A

Early Seroreversion After 2 Doses of Hepatitis A Vaccination in Human Immunodeficiency Virus–Positive Patients: Incidence and Associated Factors

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

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