Unexpectedly high proportion of drug users and men having sex with men who develop chronic hepatitis B infection

Houdt, Robin van; Bruisten, Sylvia M.; Speksnijder, A.G.C.L.; Prins, Maria

doi:10.1016/j.jhep.2012.04.030

Cited by 28 publications

(26 citation statements)

References 17 publications

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“…In France, high rates of hospitalization ( n = 34, 69%) and severe AH (A) ( n = 7, 14%) among MSM were reported . Moreover, the rates of coinfection with HBV or HIV have increased . The rate of HBV is estimated to be 5–10% in the general adult population; an unanticipated high rate of developing chronic HBV infections was found among MSM (26% overall), and 47% were HIV positive .…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of sexually transmitted diseases has recently increased, particularly among men who have sex with men (MSM) . High number of seroprevalence of hepatitis B virus (HBV), hepatitis E virus, and human immunodeficiency virus (HIV) have been reported among MSM . Although there is no specific treatment for HAV, improved sanitation and food safety, as well as immunization, may reduce the frequency of transmission of HAV …”

Section: Introductionmentioning

confidence: 99%

“…16,17 High number of seroprevalence of hepatitis B virus (HBV), hepatitis E virus, and human immunodeficiency virus (HIV) have been reported among MSM. [18][19][20] Although there is no specific treatment for HAV, improved sanitation and food safety, as well as immunization, may reduce the frequency of transmission of HAV. 21 In this study, we compared the characteristics of patients diagnosed with AH (A) before and after 2001 in a hospital in Tokyo, Japan.…”

Section: Introductionmentioning

confidence: 99%

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Characteristics of acute hepatitis A virus infection before and after 2001: A hospital‐based study in Tokyo, Japan

Kogiso

Sagawa

Oda

et al. 2019

J of Gastro and Hepatol

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Background and Aim The incidence of acute hepatitis A [AH (A)] is decreasing because of improvements in hygiene; however, cases of sporadic severe hepatitis are still being reported. We assessed the epidemiology of AH (A) in Japan. Methods This was a hospital‐based retrospective study, in which 126 AH (A) patients (96 men [76%], median age 39 [range, 19–66] years) were enrolled. Patients diagnosed with AH (A) before 2001 (n = 79) and after 2001 (n = 47) were compared. Results The incidence of AH (A) showed peaks in 1990, 1999, and 2018. After 2001, one patient had hepatitis B virus, four had human immunodeficiency virus, and three had syphilis coinfections. Before and after 2001, HAV was transmitted, respectively, by raw oysters (28% and 26%), overseas travel (19% and 28%), and sexual contact (0% and 19%) (P < 0.01). The frequencies of symptoms were appetite loss (51% and 32%), fever (63% and 81%), and diarrhea (3% and 13%) (all P < 0.05), respectively. On admission, the median levels of alanine aminotransferase (1455 and 3069 U/L) and γ‐glutamyl transpeptidase (221 and 345 U/L) were significantly higher (P < 0.01), and the prothrombin time (77.5% and 65.9%) and platelet count (22.7 and 16.4 × 10/μL) were significantly lower after 2001 (P < 0.05). A time to normalization of the bilirubin level ≥ 30 days was associated with older age and a diagnosis of AH (A) after 2001. Conclusions Outbreaks and severe AH (A) cases due to sexual transmission have been reported recently. It is necessary to examine their sexual behavior and other sexual infection.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Characteristics of acute hepatitis A virus infection before and after 2001: A hospital‐based study in Tokyo, Japan

Kogiso

Sagawa

Oda

et al. 2019

J of Gastro and Hepatol

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“…However, during the conduction of the iPrEx no flares were observed among participants with chronic HBV infection [4].…”

Section: Some Of the Strategies In The So Called "Combined Preventionmentioning

confidence: 90%

Prevention of HBV Exposure and Infection among Gay Men and other Men who have Sex with Men (MSM)

Mazín

2018

JLRDT

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International organizations, agencies and institutions have made a strong call for early diagnosis of HIV and the prompt -or even immediate-initiation of antiretroviral treatment. It doesn´t happen the same with viral hepatitis. Hepatitis B can´t be cured yet. There is no effective treatment to clear the infection among chronic carriers. Yet, being aware of the condition of chronic carrier allows to make changes in one´s life and to prevent the dissemination of the infection. AbstractIt is a well-known fact that around 20 to 25% of new hepatitis B cases occur among men who have sexual intercourse with other men (MSM), whether they identify as gay or not. This excessive burden is related to several situations that require to be urgently addressed. Among the most important:i. The high viral load of HBV in semen among chronic carriers;ii. The very poor efforts undertaken by health authorities, institutions and organizations to raise awareness about the existence and severity of the problem among MSM populations and groups (gay, bisexual, or self-identified as heterosexuals with sexual intercourse with other men);iii. The possibility of frequent exposure can be associated to greater odds of acquiring HBV and of developing chronic infection and iv. The insufficient commitment and resources allocated to facilitate access to HBV vaccination by MSM.Background: Hepatitis B virus is shed in the semen of chronic surface antigen (HBsAg) carriers as DNA viral particles. Since HBV is a very infectious agent, exposure to this agent may result in an efficient transmission and further spreading of the infection. Although most people who have acquired the infection will clear the virus without any medical intervention, it is estimated that between 5 to 10% will progress to chronic infection. Chronic infection is associated to health conditions that vary in severity from long-term hepatitis to fulminant hepatic failure and/or hepatic cancer. The disproportionate toll of HBV infection MSM echoes the also disproportionate toll of the HIV epidemic among this population that encompasses diverse groups and subpopulations. Given that coinfection with HBV and HIV may result in complex situations with negative public health and clinical outcomes, efforts to promote primary prevention of infection with both agents, reduction of incidence of co-infections, and active detection of the presence of HIV and HBV are of paramount importance [1].While HIV is a rather well-known topic within the MSM communities and groups, there seems to be a diminished awareness about HBV (and other viral hepatitis) infections. Knowledge about HBV infection and strategies and practices to prevent or keep it under clinical control by gay men and other MSM doesn´t seem to have been deeply investigated. At least not in developing countries. In areas where hepatitis A is endemic, many people may assume that other hepatitis can be cleared by the system spontaneously as it does with HAV. Many MSM may even ignore that HAV is transmitted by contact with contaminated feca...

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“…Intriguingly, specific adult populations have exhibited high rates of chronicity . In a previous study of men who have sex with men (MSM) and people who use drugs (PWUD), we observed that about 25% did not clear HBsAg within 6 months after infection and were therefore defined as having chronic infection . Yet whether these infections are truly chronic or simply delayed seroclearers remains unknown.…”

Section: Introductionmentioning

confidence: 96%

Frequent delayed spontaneous seroclearance of hepatitis B virus after incident HBV infection among adult high‐risk groups

Santen

Boyd

Bruisten

et al. 2019

Journal of Viral Hepatitis

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High rates (~25%) of developing chronic hepatitis B virus (HBV) infection (hepatitis B surface antigen (HBsAg)‐positive for > 6 months following infection) have been observed in people who use drugs (PWUD) and men who have sex with men (MSM). We aimed to estimate the frequency of delayed HBsAg seroclearance, along with its determinants, and time to delayed HBsAg seroclearance. Data were used from MSM and PWUD enrolled in the Amsterdam Cohort Studies (1985‐2002) who had anti‐hepatitis B core antibody seroconversion. Potential determinants for standard HBsAg seroclearance, delayed HBsAg seroclearance and chronic HBV were examined using multinominal logistic regression. Time to HBsAg seroclearance was estimated using Kaplan‐Meier curves. A total of 147 incident HBV infections occurred during follow‐up. On initial HBsAg testing after infection (6‐12 months), 42 (29%) were HBsAg‐positive and 105 (71%) were HBsAg‐negative (‘standard HBsAg seroclearance’). Of the 42 initially HBsAg‐positive individuals, 22 subsequently tested HBsAg‐negative (of whom 7 (31.8%) were HBV DNA positive at last visit, suggesting occult HBV). Overall, 15 became HBsAg‐negative and HBV DNA‐negative (‘delayed HBsAg seroclearance’), while 27 remained HBsAg and/or HBV DNA‐positive (‘chronic HBV’). The 5‐year cumulative probability of delayed HBsAg seroclearance was 41.6% for initially HBsAg‐positive individuals. Delayed HBsAg seroclearance and remaining chronically infected were associated with younger age and HIV/hepatitis C virus (HCV)‐co‐infection. In conclusion, delayed HBsAg seroclearance is common in these key adult populations at‐risk for HBV, while proportion developing HBV chronicity (18%) is still higher compared to the general population (~5%). Given the proportion of individuals with occult HBV infection and that HCV direct‐acting antivirals can lead to HBV reactivation, HBV DNA testing in HCV co‐infected MSM/PWUD are warranted prior to treatment initiation.

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Unexpectedly high proportion of drug users and men having sex with men who develop chronic hepatitis B infection

Cited by 28 publications

References 17 publications

Characteristics of acute hepatitis A virus infection before and after 2001: A hospital‐based study in Tokyo, Japan

Characteristics of acute hepatitis A virus infection before and after 2001: A hospital‐based study in Tokyo, Japan

Prevention of HBV Exposure and Infection among Gay Men and other Men who have Sex with Men (MSM)

Frequent delayed spontaneous seroclearance of hepatitis B virus after incident HBV infection among adult high‐risk groups

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