Factors associated with hepatitis A virus infection among HIV-positive patients before and after implementation of a hepatitis A virus vaccination program at a medical centre in central Taiwan

Sexual Health ◽  
2020 ◽  
Vol 17 (3) ◽  
pp. 239
Author(s):  
Jia-Juen Lin ◽  
Yuan-Ti Lee ◽  
Hao-Jan Yang
Keyword(s):  
Hepatitis A ◽  
Cox Regression ◽  
Hepatitis A Virus ◽  
Preventive Measure ◽  
Risk Groups ◽  
Vaccination Rate ◽  
Hiv Positive ◽  
Adjusted Relative Risk ◽  
Vaccination Policy ◽  
Central Taiwan

Background Taiwan government has promoted the administration of a hepatitis A vaccine at public expense for high-risk groups as a preventive measure after the outbreak of hepatitis A virus (HAV) infections in 2015. The aim of this study was to evaluate the efficacy of such vaccination policy in patients with human immunodeficiency virus (HIV). Methods: From January 2016 to July 2017, we enrolled 658 HIV-positive male participants. Participants were stratified into anti-HAV-positive (n = 165) and anti-HAV-negative (n = 493) groups. A total of 364 anti-HAV-negative patients received vaccination against HAV and were followed up for 1.5 years. A Cox regression model was used to estimate the effects of factors predicting positive anti-HAV detection after vaccination. Results: Patients with HIV had an anti-HAV-positive prevalence of 25.1% before vaccination. Of the 364 patients inoculated with the first dose of vaccine, 58.0% received the second dose. Seroresponse rates were 50.0% and 80.6%, respectively. Antibody production was 30.0% lower in patients with a CD4 T-cell count <200 cells/µL (adjusted relative risk (ARR) = 0.7; 95% confidence interval (CI) = 0.5–0.9) compared with those with 500 cells/µL. Hepatitis C co-infection reduced the production of antibodies by 50.0% (ARR = 0.5; 95% CI = 0.2–0.8). Conclusion: This study suggests that vaccination against hepatitis A be administered when the immunity of an HIV-positive patient is strong. The promotion of the current vaccination policy against hepatitis A in Taiwan has improved the vaccination rate; the response rate for receiving one dose of the vaccine doubled.

scholarly journals Comparative hepatitis A seroepidemiology in 10 European countries

2012 ◽  
Vol 140 (12) ◽  
pp. 2172-2181 ◽  
Author(s):  
S. KURKELA ◽  
R. PEBODY ◽  
G. KAFATOS ◽  
N. ANDREWS ◽  
C. BARBARA ◽  
...  
Keyword(s):  
Disease Burden ◽  
Hepatitis A ◽  
Hepatitis A Virus ◽  
Age Groups ◽  
Risk Groups ◽  
Vaccination Policy ◽  
Laboratory Results ◽  
Children And Young Adults ◽  
Middle Aged Adults ◽  
Local Laboratory

SUMMARYThe WHO recommends hepatitis A virus (HAV) immunization according to level of transmission and disease burden. We aimed to identify susceptible age groups by standardized serosurveys to inform HAV vaccination policy in participating countries: Belgium, Czech Republic, England, Finland, Germany, Italy, Lithuania, Malta, Romania, and Slovakia. Each country tested national serum banks (n = 1854–6748), collected during 1996–2004, for anti-HAV antibodies. Local laboratory results were standardized to common units. Forty-one per cent of those aged <30 years and 6% of those aged ⩾30 years were susceptible to HAV in Romania; compared to 70–94% and 26–71%, respectively, elsewhere. Romania reported high HAV incidence in children and young adults. Other countries reported HAV disease primarily in older risk groups. The results suggest low level of HAV transmission in most of Europe. Romania, however, appeared as an area with intermediate transmission. Vaccination of risk groups in countries with high susceptibility of young and middle-aged adults needs to be continued.

scholarly journals Susceptibility to Hepatitis A Virus Infection in the United States, 2007–2016

2020 ◽  
Vol 71 (10) ◽  
pp. e571-e579 ◽  
Author(s):  
Shaoman Yin ◽  
Laurie Barker ◽  
Kathleen N Ly ◽  
Greta Kilmer ◽  
Monique A Foster ◽  
...  
Keyword(s):  
United States ◽  
Hepatitis A ◽  
Hepatitis A Virus ◽  
Risk Groups ◽  
The United States ◽  
Poverty Level ◽  
Health And Nutrition ◽  
National Immunization ◽  
Vaccination Recommendations ◽  
Sex With Men

Abstract Background Despite national immunization efforts, including universal childhood hepatitis A (HepA) vaccination recommendations in 2006, hepatitis A virus (HAV)–associated outbreaks have increased in the United States. Unvaccinated or previously uninfected persons are susceptible to HAV infection, yet the susceptibility in the US population is not well known. Methods Using National Health and Nutrition Examination Survey 2007–2016 data, we estimated HAV susceptibility prevalence (total HAV antibody negative) among persons aged ≥2 years. Among US-born adults aged ≥20 years, we examined prevalence, predictors, and age-adjusted trends of HAV susceptibility by sociodemographic characteristics. We assessed HAV susceptibility and self-reported nonvaccination to HepA among risk groups and the “immunization cohort” (those born in or after 2004). Results Among US-born adults aged ≥20 years, HAV susceptibility prevalence was 74.1% (95% confidence interval, 72.9–75.3%) during 2007–2016. Predictors of HAV susceptibility were age group 30–49 years, non-Hispanic white/black, 130% above the poverty level, and no health insurance. Prevalences of HAV susceptibility and nonvaccination to HepA, respectively, were 72.9% and 73.1% among persons who reported injection drug use, 67.5% and 65.2% among men who had sex with men, 55.2% and 75.1% among persons with hepatitis B or hepatitis C, and 22.6% and 25.9% among the immunization cohort. Susceptibility and nonvaccination decreased over time among the immunization cohort but remained stable among risk groups. Conclusions During 2007–2016, approximately three-fourths of US-born adults remained HAV susceptible. Enhanced vaccination efforts are critically needed, particularly targeting adults at highest risk for HAV infection, to mitigate the current outbreaks.

scholarly journals Naturally acquired hepatitis A antibodies after haematopoetic stem cell transplantation

2010 ◽  
Vol 139 (5) ◽  
pp. 683-687 ◽  
Author(s):  
S. S. YALÇIN ◽  
M. KONDOLOT ◽  
H. GÖKER ◽  
B. KUŞKONMAZ ◽  
Y. KARACAN ◽  
...  
Keyword(s):  
Stem Cell ◽  
Hepatitis A ◽  
Cox Regression ◽  
Hepatitis A Virus ◽  
Haematopoietic Stem Cell ◽  
Immune Memory ◽  
Cell Transplant ◽  
Natural Immunity ◽  
Endemic Region ◽  
Rank Analysis

SUMMARYHaematopoietic stem cell transplant (HSCT) recipients lose immune memory of exposure to infectious agents and vaccines accumulated throughout their lifetime and therefore need to be revaccinated. We aimed to evaluate the influence of different factors on hepatitis A virus (HAV) immunity in both child and adult HSCT recipients living in an intermediate endemic region, Turkey. Eighty patients (age range 2·5–57 years) who had HAV serology prior to HSCT were evaluated. The prevalence of HAV seropositivity was 85% (n=68) before HSCT. There was no history of HAV vaccination before HSCT in children and HAV vaccine was not available in Turkey 10 years ago, so it was assumed that all seropositive patients reflected natural immunity. After the exclusion of six patients with autologous HSCT, the remaining 62 seropositive and allogeneic patients were included in this retrospective study. The duration of HAV seropositivity was estimated using the Kaplan–Meier method, log-rank analysis and Cox regression models. Estimated mean time to loss of HAV seropositivity was 48·6 months after transplantation. Patients who were older (⩾18 years) at transplantation and who had older (⩾18 years) donors became seronegative later (P<0·05). Cox backward-stepwise regression confirmed that older age of recipient at transplantation was the only significant parameter for HAV seropositivity (P<0·05). HAV-inactivated vaccine might be recommended later to older HSCT recipients in intermediate endemic regions.

Changing risk profile of hepatitis A in The Netherlands: a comparison of seroprevalence in 1995–1996 and 2006–2007

2011 ◽  
Vol 139 (8) ◽  
pp. 1172-1180 ◽  
Author(s):  
L. VERHOEF ◽  
H. J. BOOT ◽  
M. KOOPMANS ◽  
L. MOLLEMA ◽  
F. VAN DER KLIS ◽  
...  
Keyword(s):  
The Netherlands ◽  
Hepatitis A ◽  
Hepatitis A Virus ◽  
Risk Groups ◽  
Second World War ◽  
World War ◽  
Susceptible Population ◽  
Prophylactic Vaccination ◽  
The Cost ◽  
Second World

SUMMARYThe prevalence of antibodies to hepatitis A virus (HAV) was assessed in a nationwide sample (n=6229) in The Netherlands in 2006–2007, and compared to the seroprevalence in a similar study in 1995–1996 (n=7376). The overall seroprevalence increased from 34% in 1995–1996 to 39% in 2006–2007, mainly due to vaccination of travellers and an increased immigrant population. Risk factors remain travelling to, and originating from, endemic regions, and vaccination is targeted currently at these risk groups. Our results show a trend of increasing age of the susceptible population. These people would also benefit from HAV vaccination because they are likely to develop clinically serious symptoms after infection, and are increasingly at risk of exposure through imported viruses through foods or travellers. The cost-effectiveness of adding elderly people born after the Second World War as a target group for prophylactic vaccination to reduce morbidity and mortality after HAV infection should be assessed.

scholarly journals Estimating the critical immunity threshold for preventing hepatitis A outbreaks in men who have sex with men

2015 ◽  
Vol 144 (7) ◽  
pp. 1528-1537 ◽  
Author(s):  
D. G. REGAN ◽  
J. G. WOOD ◽  
C. BENEVENT ◽  
H. ALI ◽  
L. WATCHIRS SMITH ◽  
...  
Keyword(s):  
High Risk ◽  
Hepatitis A ◽  
Hepatitis A Virus ◽  
Reproduction Number ◽  
Vaccine Coverage ◽  
Risk Groups ◽  
Developed Countries ◽  
Population Immunity ◽  
Sex With Men ◽  
The Basic Reproduction Number

SUMMARYSeveral outbreaks of hepatitis A in men who have sex with men (MSM) were reported in the 1980s and 1990s in Australia and other countries. An effective hepatitis A virus (HAV) vaccine has been available in Australia since 1994 and is recommended for high-risk groups including MSM. No outbreaks of hepatitis A in Australian MSM have been reported since 1996. In this study, we aimed to estimate HAV transmissibility in MSM populations in order to inform targets for vaccine coverage in such populations. We used mathematical models of HAV transmission in a MSM population to estimate the basic reproduction number (R0) and the probability of an HAV epidemic occurring as a function of the immune proportion. We estimated a plausible range forR0of 1·71–3·67 for HAV in MSM and that sustained epidemics cannot occur once the proportion immune to HAV is greater than ~70%. To our knowledge this is the first estimate ofR0and the critical population immunity threshold for HAV transmission in MSM. As HAV is no longer endemic in Australia or in most other developed countries, vaccination is the only means of maintaining population immunity >70%. Our findings provide impetus to promote HAV vaccination in high-risk groups such as MSM.

scholarly journals Immunization strategies to control a community-wide hepatitis A epidemic

2001 ◽  
Vol 127 (3) ◽  
pp. 461-467 ◽  
Author(s):  
K. M. THORBURN ◽  
R. BOHORQUES ◽  
P. STEPAK ◽  
L. L. SMITH ◽  
C. JOBB ◽  
...  
Keyword(s):  
High Risk ◽  
Injection Drug Users ◽  
Drug Users ◽  
Hepatitis A ◽  
Illicit Drug ◽  
Hepatitis A Virus ◽  
Risk Groups ◽  
Jail Inmates ◽  
Illicit Drug Users ◽  
Immunization Strategies

One fifth of 527 cases of hepatitis A occurred in self-identified injection drug users during a community-wide epidemic in Spokane County (Washington) in 1997–8. We hypothesized that an immunization campaign targeted at illicit drug users could control the epidemic. Starting in May 1998, hepatitis A vaccine was provided to individuals in jails and other sites frequented by illicit drug users. Volunteers at vaccination sites were surveyed about risk. Serial convenience samples of jail inmates who denied previous vaccination were anonymously tested for hepatitis A virus (HAV) immunoglobulin G (IgG). From May to December 1998, 2765 high-risk individuals were vaccinated against hepatitis A. The proportion of HAV IgG seropositive inmates increased from 30% to more than 50%. Our findings suggest that vaccination along with naturally occurring infection increased the rate of hepatitis A immunity among illicit drug users during the final months of the epidemic. This supports the hypothesis that targeted immunization of high risk groups may shorten the natural history of a community-wide epidemic.

scholarly journals Spillover of a hepatitis A outbreak among men who have sex with men (MSM) to the general population, the Netherlands, 2017

2018 ◽  
Vol 23 (23) ◽  
Author(s):  
Ingrid HM Friesema ◽  
Gerard JB Sonder ◽  
Mariska WF Petrignani ◽  
Annemarie E Meiberg ◽  
Gini GC van Rijckevorsel ◽  
...  
Keyword(s):  
Sequence Analysis ◽  
General Population ◽  
The Netherlands ◽  
Hepatitis A ◽  
Hepatitis A Virus ◽  
Epidemiological Data ◽  
Risk Groups ◽  
Virus Genotypes ◽  
Sex With Men ◽  
The Impact

Since 2015, outbreaks of hepatitis A among men who have sex with men (MSM) have been reported worldwide. To examine the impact of these MSM outbreaks in the Netherlands, we combined notification and epidemiological data with sequence analysis. Our results show the hazards of outbreaks within risk-groups spilling over into the largely susceptible general population. One third of the outbreak-related hepatitis A virus genotypes were detected in non-MSM cases.

Hepatitis A virus infection in an HIV-positive man with previously confirmed immunity against hepatitis A virus

2020 ◽  
Vol 13 (5) ◽  
pp. 844-846
Author(s):  
Yukihiro Yoshimura ◽  
Hiroshi Horiuchi ◽  
Nobuyuki Miyata ◽  
Makiko Kondo ◽  
Natsuo Tachikawa
Keyword(s):  
Virus Infection ◽  
Hepatitis A ◽  
Hepatitis A Virus ◽  
Hiv Positive

A case of hepatitis a vaccination failure in an HIV-positive man who had sex with men in Israel

2012 ◽  
Vol 23 (7) ◽  
pp. 529-530 ◽  
Author(s):  
Z Mor ◽  
Y Lurie ◽  
E Katchman
Keyword(s):  
Hepatitis A ◽  
Hepatitis A Virus ◽  
Transmitted Disease ◽  
Cd4 Count ◽  
Response Alternative ◽  
Hiv Positive ◽  
Vaccine Failure ◽  
Increased Risk ◽  
Sex With Men ◽  
Susceptible Populations

Hepatitis A virus (HAV) vaccination is recommended for men who have sex with men (MSM) and other susceptible populations, who are at increased risk for HAV infection, such as HIV-positive persons. Vaccines failures are uncommon, and in HIV-positive individuals whose CD4 count is ≥500 cells/mm2, seroconversion is achieved in 73–94% of vaccinees following the second dose. Data were retrieved from the patient's file at the sexually transmitted disease clinic and the AIDS clinic describing this rare case of vaccine failure. A 35-year-old, HIV-positive MSM was vaccinated against HAV on 2007, while his CD4 count was 551 cells/mm2. Two years later, he was hospitalized due to acute HAV. The patient's serum drawn two months prior to the onset of acute HAV was retrospectively tested and showed no response to the vaccine. The source of the HAV infection was not identified. The patient's partner who was HIV-negative and had been vaccinated simultaneously with the same batch developed protective antibodies. In conclusion, HIV-positive patients and their providers should be informed about HAV vaccine failure, and post-immunization serologies to hepatitis should be considered to evaluate immunization response. Alternative approaches to develop immunity are needed for non-responders.

scholarly journals Seroprevalence of Helicobacter pylori and Hepatitis A Virus among Children in Rural Central Taiwan

2015 ◽  
Vol 68 (6) ◽  
pp. 494-503 ◽  
Author(s):  
Meng-Che Wu ◽  
Chia-Hsing Sung ◽  
Yu-Chuan Chang ◽  
Chi-Lin Ho ◽  
Chih-Chiang Wu ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Hepatitis A ◽  
Hepatitis A Virus ◽  
Central Taiwan
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