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RESEARCH ARTICLE

Hepatitis A and B infection and vaccination in a cohort of homosexual men in Sydney

Fengyi Jin A D , Garrett P. Prestage A , Catherine M. Pell B , Basil Donovan B , Paul G. Van de Ven C , Susan C. Kippax C , John M. Kaldor A and Andrew E. Grulich A
+ Author Affiliations
- Author Affiliations

A National Centre in HIV Epidemiology and Clinical Research, the University of New South Wales, Sydney, NSW 2010, Australia.

B Sydney Sexual Health Centre, Nightingale Wing, Sydney Hospital, Macquarie Street, Sydney, NSW 2001, Australia.

C National Centre in HIV Social Research, the University of New South Wales, Sydney, NSW 2010, Australia.

D Corresponding author. Email: jjin@nchecr.unsw.edu.au

Sexual Health 1(4) 227-237 https://doi.org/10.1071/SH04022
Submitted: 8 July 2004  Accepted: 11 November 2004   Published: 21 December 2004

Abstract

Objectives: To determine the prevalence and incidence of hepatitis A (HAV) and B (HBV) infection and vaccination in HIV-negative homosexual men in Sydney, and associated risk factors. Methods: An open prospective cohort study was conducted among a community-based sample of HIV-negative homosexual men in Sydney in 2001–02. Participants underwent a face-to-face interview, regarding demographics, sexual behavioural risk factors and sexually transmitted infections, and blood samples were collected. They were followed annually. Results: Nine hundred and three men completed a baseline interview by the end of 2002. Among them, 68% were seropositive to hepatitis A. The seroprevalence of prior hepatitis B infection was 19%, and 53% had serological evidence of HBV vaccination. Younger men were much more likely to be seronegative, with 48% and 46% of <25-year-olds being seronegative to HAV and HBV respectively. In multivariate analysis HAV and HBV infection were associated with increasing age, greater number of lifetime sex partners and HBV infection was also associated with previous sexually transmitted infections. HAV vaccination was associated with increasing age, greater number of lifetime sex partners, overseas travel in the last year and self-reported anogenital warts. HBV vaccination was associated with higher occupational status, greater lifetime number of sex partners and previous sexually transmitted infections. Conclusion: Substantial proportions of gay community attached young homosexual men are still at risk of HAV and HBV infection. This study points to a need for vaccination strategies which ensure high levels of hepatitis A and B immunity in young sexually active gay men.

Additional keywords: hepatitis A, hepatitis B, homosexuality, male.


References


[1] Christopher PJ,  Crewe EB,  Mailer PT,  Murphy AM. Hepatitis B infection among STD clinic patients in Sydney. Aust N Z J Med 1984; 14 491–4.
PubMed |

[2] Gilson RJ,  de Ruiter A,  Waite J,  Ross E,  Loveday C,  Howell DR, et al. Hepatitis B virus infection in patients attending a genitourinary medicine clinic: risk factors and vaccine coverage. Sex Transm Infect 1998; 74 110–5.
PubMed |

[3] Ochnio JJ,  Patrick D,  Ho M,  Talling DN,  Dobson SR. Past infection with hepatitis A virus among Vancouver street youth, injection drug users and men who have sex with men: implications for vaccination programs. Can Med Assoc J 2001; 165 293–7.


[4] Villano SA,  Nelson KE,  Vlahov D,  Purcell RH,  Saah AJ,  Thomas DL. Hepatitis A among homosexual men and injection drug users: more evidence for vaccination. Clin Infect Dis 1997; 25 726–8.
PubMed |

[5] Brook MG. Sexually acquired hepatitis. Sex Transm Infect 2002; 78 235–40.
CrossRef | PubMed |

[6] Ferson MJ,  Young LC,  Stokes ML. Changing epidemiology of hepatitis A in the 1990s in Sydney, Australia. Epidemiol Infect 1998; 121 631–6.
CrossRef | PubMed |

[7] Stewart T,  Crofts N. An outbreak of hepatitis A among homosexual men in Melbourne. Med J Aust 1993; 158 519–21.
PubMed |

[8] Centers for Disease Control and Prevention. Hepatitis A among homosexual men — United States, Canada, and Australia. MMWR 2002; 41 161–4.


[9] Kani J,  Nandwani R,  Gilson RJ,  Johnson AM,  Maguire HC,  Tedder RS. Hepatitis A virus infection among homosexual men. BMJ 1991; 302 1399.
PubMed |

[10] Newell A,  Asboe D,  Azadian B. Outbreak of hepatitis A in homosexual men in Riverside. Sex Transm Infect 1998; 74 304–5.
PubMed |

[11] Leentvaar-Kuijpers A,  Kool JL,  Veugelers PJ,  Coutinho RA,  van Griensven GJ. An outbreak of hepatitis A among homosexual men in Amsterdam, 1991–1993. Int J Epidemiol 1995; 24 218–22.
PubMed |

[12] Iwarson S. New target groups for vaccination against hepatitis A: homosexual men, injecting drug users and patients with chronic hepatitis. Scand J Infect Dis 1998; 30 316–8.
CrossRef | PubMed |

[13] MacKellar DA,  Valleroy LA,  Secura GM,  McFarland W,  Shehan D,  Ford W, et al. Two decades after vaccine license: hepatitis B immunization and infection among young men who have sex with men. Am J Public Health 2001; 91 965–71.
PubMed |

[14] Anderson B,  Bodsworth NJ,  Rohrsheim RA,  Donovan BJ. Hepatitis B virus infection and vaccination status of high risk people in Sydney: 1982 and 1991. Med J Aust 1994; 161 368–71.
PubMed |

[15] Brook MG. Sexual transmission and prevention of the hepatitis viruses A-E and G. Sex Transm Infect 1998; 74 395–8.
PubMed |

[16] Coutinho RA,  Schut BJ,  Albrecht-Van Lent NA,  Reerink-Brongers EE,  Jesdijk LS. Hepatitis B among homosexual men in The Netherlands. Sex Transm Dis 1981; 8 333–5.
PubMed |

[17] Shah N,  Ostrow D,  Altman N,  Baker AL. Evolution of acute hepatitis B in homosexual men to chronic hepatitis B. Prospective study of placebo recipients in a hepatitis B vaccine trial. Arch Intern Med 1985; 145 881–2.
CrossRef | PubMed |

[18] Alter MJ,  Hadler SC,  Margolis HS,  Alexander WJ,  Hu PY,  Judson FN, et al. The changing epidemiology of hepatitis B in the United States. Need for alternative vaccination strategies. JAMA 1990; 263 1218–22.
CrossRef | PubMed |

[19] Centers for Disease Control and Prevention. Prevention of hepatitis A through active or passive immunization. MMWR 2002; 48
PubMed |

[R20] , (2000) Prevention of hepatitis A through active or passive immunization. The Australian immunisation handbook.  106–33.

[21] Centers for Disease Control and Prevention Undervaccination for Hepatitis B among young men who have sex with men — San Francisco and Berkeley, California, 1992–1993. MMWR 1996; 45 215–7.
PubMed |

[22] Friedman MS,  Blake PA,  Koehler JE,  Hutwagner LC,  Toomey KE. Factors influencing a communitywide campaign to administer hepatitis A vaccine to men who have sex with men. Am J Public Health 2000; 90 1942–6.
PubMed |

[23] Prestage G,  Van de Ven P,  Mao L,  Grulich AE,  Kippax SC,  Kaldor JM. Contexts for last occasions of unprotected anal intercourse among HIV-negative gay men in Sydney: the Health in Men (HIM) cohort. AIDS Care in press;


[24] Van Herck K,  Beutels P,  Van Damme P,  Beutels M,  Van den DJ,  Briantais P, et al. Mathematical models for assessment of long-term persistence of antibodies after vaccination with two inactivated hepatitis A vaccines. J Med Virol 2000; 60 1–7.
CrossRef | PubMed |

[25] Van Herck K,  Van Damme P. Inactivated hepatitis A vaccine-induced antibodies: follow-up and estimates of long-term persistence. J Med Virol 2001; 63 1–7.
PubMed |

[26] Amin J,  Gilbert GL,  Escott RG,  Heath TC,  Burgess MA. Hepatitis A epidemiology in Australia: national seroprevalence and notifications. Med J Aust 2001; 174 338–41.
PubMed |

[27] Communicable diseases. NSW: March 2002. N S W Public Health Bull 2002; 13 59–63.
PubMed |

[28] Remis RS,  Dufour A,  Alary M,  Vincelette J,  Otis J,  Masse B, et al. Association of hepatitis B virus infection with other sexually transmitted infections in homosexual men. Omega Study Group. Am J Public Health 2000; 90 1570–4.
PubMed |

[29] Corona R,  Stroffolini T,  Giglio A,  Cotichini R,  Tosti ME,  Prignano G, et al. Lack of evidence for increased risk of hepatitis A infection in homosexual men. Epidemiol Infect 1999; 123 89–93.
CrossRef | PubMed |

[30] Donovan B,  Anderson B,  Rohrsheim R,  Bodsworth N. Cost as a disincentive to hepatitis B vaccination. Venereology 1995; 8 177.


[31] Jin FY,  Prestage G,  Law MG,  Kippax S,  Van den V,  Rawstorne P, et al. Predictors of recent HIV testing in homosexual men in Australia. HIV Med 2002; 3 271–6.
CrossRef | PubMed |

[32] National Centre in HIV Social Research Facts and figures: 2000 Male Out Survey. Sydney: Sydney: NCHSR, The University of New South Wales; 2001 

[33] Australian Government Department of Health and Ageing Australian immunisation handbook 8th edn.Canberra: Australian Government Publishing Service; 2003 



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