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

Lin, Kuan‐Yin; Hsieh, Shu‐Ching; Sun, Hsin‐Yun; Lo, Yi‐Chun; Sheng, Wang‐Huei; Chuang, Yi‐Fang; Cheng, Aristine; Pan, Sung‐Ching; Chen, Guan‐Jhou; Hung, Chien‐Ching; Chang, Shan‐Chwen

doi:10.1002/hep.29780

Cited by 24 publications

(31 citation statements)

References 23 publications

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“…Before the outbreak, only toddlers in townships with a high HAV endemicity underwent routine HAV vaccination. In response to the outbreak, an HAV vaccination campaign was initially launched at designated hospitals for HIV care, and, thereafter, the Taiwan Centers for Disease Control (CDC) implemented an HAV vaccination program targeting individuals who were HIV positive or newly diagnosed with syphilis or gonorrhea …”

Section: Methodsmentioning

confidence: 99%

“…In countries with low HAV endemicity, HAV infection has a predilection for at‐risk populations, such as men who have sex with men (MSM) and illicit drug users . Beginning in 2015‐2016, large outbreaks of acute hepatitis A predominantly affecting MSM reemerged in Asia, Europe, and America, in which oral‐anal sexual contact among at‐risk individuals might have contributed to HAV transmission . On the other hand, HEV infection that caused approximately 44,000 deaths in 2015 has become a significant public health issue given that autochthonous cases are increasingly reported .…”

mentioning

confidence: 99%

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Hepatitis E Virus Infections Among Human Immunodeficiency Virus–Positive Individuals During an Outbreak of Acute Hepatitis A in Taiwan

Lin

Sun

et al. 2019

Hepatology

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Hepatitis A virus (HAV) and hepatitis E virus (HEV) share the similar fecal‐oral transmission route. During an outbreak of sexually transmitted acute hepatitis A among men who have sex with men (MSM) worldwide between 2015 and 2017, we investigated the possibility of sexual transmission and related morbidity of HEV infection among human immunodeficiency virus (HIV)‐positive patients. From March 1, 2015 to August 31, 2017, anti‐HEV immunoglobulin G was retrospectively determined among 3,293 HIV‐positive patients, who were mainly MSM (87.6%) with a median CD4 count of 575 cells/μL. Prevalence and incidence of HEV infection were 3.7% (123 of 3,293) and 4.35 per 1,000 person‐years of follow‐up (PYFU), respectively, which were significantly lower compared with those of HAV infection (31.1% [996 of 3,204] and 12.61 per 1,000 PYFU, respectively). The number of patients with HEV infection did not increase with the hepatitis A epidemic. The factor associated with prevalent HEV infection was older age (per 1‐year increase, adjusted odds ratio, 1.07; 95% confidence interval, 1.05‐1.09), but neither sexual orientation nor acquisition of sexually transmitted infections was related to prevalent or incident HEV infection. Among 23 patients with incident HEV infection, 22 patients had viremia caused by HEV genotype 4. No patients had prolonged HEV viremia or clinical symptoms, and only a mild elevation of serum aminotransferase, ranging from 34 to 77 IU/L, was noted. Although 4 patients had hepatitis for a prolonged duration of between 8 and 17 months, no abdominal imaging revealed liver fibrosis or cirrhosis. Conclusion: HEV endemicity remained low among HIV‐positive patients in Taiwan during the outbreak of acute hepatitis A. Our data suggest that sexual transmission of HEV with significant morbidity of HEV infection, if any, is rare in this population.

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Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

Hepatitis E Virus Infections Among Human Immunodeficiency Virus–Positive Individuals During an Outbreak of Acute Hepatitis A in Taiwan

Lin

Sun

et al. 2019

Hepatology

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“…In Taiwan, an unprecedented outbreak of AHA occurred among MSM between June 2015 and December 2017 . To control the outbreak, an HAV vaccination campaign was launched in September 2015 and a subsidized HAV vaccination program was implemented in October 2016 among HIV‐positive patients and those with sexually transmitted diseases . Following this large‐scale HAV vaccination program among at‐risk populations, high serological response rates to HAV vaccination were observed and HAV vaccination was effective in preventing AHA .…”

Section: Participants and Methodsmentioning

confidence: 99%

“…In response to the outbreak of HAV in Taiwan since June 2015, HIV‐positive patients who sought care in these hospitals were screened for anti‐HAV antibodies and those who were seronegative were advised to receive two doses of HAV vaccine administered at 6 months apart . After vaccination, anti‐HAV antibodies were determined at 4‐24 weeks after the first dose and the second dose . For patients who successfully seroconverted following vaccination, anti‐HAV antibodies were monitored every 6 months to evaluate durability of seroprotection following two doses of HAV vaccination.…”

Section: Participants and Methodsmentioning

confidence: 99%

“…(20,21) To control the outbreak, an HAV vaccination campaign was launched in September 2015 and a subsidized HAV vaccination program was implemented in October 2016 among HIV-positive patients and those with sexually transmitted diseases. (22,23) Following this large-scale HAV vaccination program among at-risk populations, high serological response rates to HAV vaccination were observed and HAV vaccination was effective in preventing AHA. (22,23) Because of the supply shortage of HAVRIX 1440 enzyme-linked immunosorbent assay units (GlaxoSmithKline, Biologicals, Rixensart, Belgium) during the outbreak, it was gradually substituted by VAQTA 50 units (Merck and Co., Inc., West Point, PA) in the participating hospitals between May and October 2016.…”

Section: Study Settingmentioning

confidence: 99%

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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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Poor increase on HAV vaccination coverage among people living with HIV after an immunization-based intervention

Corma-Gómez

Real

Fernández‐Fuertes

et al. 2023

Enfermedades Infecciosas y Microbiología Clínica

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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

Cited by 24 publications

References 23 publications

Hepatitis E Virus Infections Among Human Immunodeficiency Virus–Positive Individuals During an Outbreak of Acute Hepatitis A in Taiwan

Hepatitis E Virus Infections Among Human Immunodeficiency Virus–Positive Individuals During an Outbreak of Acute Hepatitis A in Taiwan

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

Poor increase on HAV vaccination coverage among people living with HIV after an immunization-based intervention

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