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¿Es posible el control de los brotes de hepatitis A en hombres que tienen sexo con hombres? Rev Clin Esp 2020; 220:434-436. [DOI: 10.1016/j.rce.2019.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 10/09/2019] [Indexed: 11/22/2022]
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Can hepatitis A outbreaks in men who have sex with men be controlled? Rev Clin Esp 2020. [DOI: 10.1016/j.rceng.2019.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Nicolay N, Le Bourhis-Zaimi M, Lesourd A, Martel M, Roque-Afonso AM, Erouart S, Etienne M, Ndeikoundam Ngangro N. A description of a hepatitis A outbreak in men who have sex with men and public health measures implemented in Seine-Maritime department, Normandy, France, 2017. BMC Public Health 2020; 20:1441. [PMID: 32962667 PMCID: PMC7510153 DOI: 10.1186/s12889-020-09499-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 09/03/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND In 2016-2017, a European-wide circulation of genotype IA hepatitis A virus was responsible for hepatitis A outbreaks in men who have sex with men (MSM). This study aimed to describe the outbreak investigation in Seine-Maritime department (France) and the control measures implemented accordingly. METHODS Outbreak description used data from mandatory reporting and enhanced surveillance of male cases. Confirmed case was genotype IA isolated, possible cases had no reported genotype information. Targeted control measures included communication on sexual practices at risk of hepatitis A transmission and two vaccination campaigns in April 2017 and January 2018. Characteristics of cases and vaccinees were described. We reported the best communication channel for relaying outbreak information and control measures based on the monitoring of social network activities and feedback from vaccinees. RESULTS During the outbreak period (December 2016 to December 2017), a total of 48 confirmed outbreak cases and 30 possible outbreak cases were notified. Among them, 69 were male (88%). Two epidemic waves were observed. Cases encountered their partners through gay-dating apps (54%) and in one specific sauna (62%). In response to the outbreak, two vaccination campaigns were deployed. A total of 156 MSM were vaccinated, of whom 56 in a truck parked beside the sauna. Most of the vaccinees had been informed about the campaign through dating apps (44%). Community-based organizations involved in sexual health promotion and other gay social media were very proactive in sharing information about the outbreak and promoting the vaccination campaign through their social media account and also on site (gay venues). Vaccinees reported the same sexual practices at risk of hepatitis A transmission as cases. CONCLUSIONS In response to this massive hepatitis A outbreak that affected mostly MSM in Seine-Maritime department, vaccination campaign remained the cornerstone of prevention. Prevention officers from the community-based organization played a key role in vaccination promotion. Gay-dating apps and outdoor sessions of vaccination allowed to effectively reach MSM. Cost-effectiveness studies might analyze the interest of a continuous sexual health promotion including vaccination against hepatitis A in MSM through dating apps and social networks.
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Affiliation(s)
- Nathalie Nicolay
- Santé publique France, French national public health agency, Normandy regional office, 76100, Rouen, France.
- European Centre for Disease Prevention and Control (ECDC), Gustav III:s boulevard 40, 16973, Solna, Sweden.
| | - Maggie Le Bourhis-Zaimi
- Santé publique France, French national public health agency, Normandy regional office, 76100, Rouen, France
| | - Anais Lesourd
- Infectious and Tropical Diseases Department, Rouen University Hospital, 76000, Rouen, France
| | - Mélanie Martel
- Santé publique France, French national public health agency, Normandy regional office, 76100, Rouen, France
| | | | | | - Manuel Etienne
- Infectious and Tropical Diseases Department, Rouen University Hospital, 76000, Rouen, France
- Normandie Univ, UNIROUEN, UNICAEN, GRAM 2.0, 76000, Rouen, France
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Bayesian modelling of a hepatitis A outbreak in men who have sex with men in Sydney, Australia, 1991/1992. Epidemiol Infect 2019; 147:e226. [PMID: 31364583 PMCID: PMC6625190 DOI: 10.1017/s0950268819001109] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
To control hepatitis A spread by vaccination, accurate estimation of transmissibility is vital. Regan et al. (2016) proposed a model of hepatitis A virus (HAV) transmission and used least squares to calibrate model to the 1991/1992 HAV outbreak in men who have sex with men (MSM) in Sydney, Australia. Based on the estimate of R0, they obtained the critical immunity of 70% and showed that when the proportion immune <70%, there is a definite chance for outbreaks to take place. The immunity level from previous surveys ranges from 32% to 64% after 1996 while no outbreaks in Australian MSMs have been reported since 1996. Further noticing the ill-distributed parameters, we argue that their estimate of R0 is not accurate. In this study, we revisited their model by Bayesian inference, which has privilege over least squares. We obtained the appropriate posterior distributions of parameters and the estimate of R0 ranges from 1.38 to 2.89, indicating a critical immunity of 65%. The reduction in critical immunity and outbreak probabilities predicts the absence of outbreaks in Australian MSMs since 1996. Our study shows the importance of using appropriate methods to provide reliable and accurate estimates of the model parameters especially the transmissibility.
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Charre C, Ramière C, Roque-Afonso AM, Chidiac C, Zoulim F, Godinot M, Koffi J, Scholtès C, Livrozet JM, Hav Lyon Study Group, Cotte L. Hepatitis A outbreak in HIV-infected MSM and in PrEP-using MSM despite a high level of immunity, Lyon, France, January to June 2017. ACTA ACUST UNITED AC 2018; 22. [PMID: 29208161 PMCID: PMC5725789 DOI: 10.2807/1560-7917.es.2017.22.48.17-00742] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Since 2016, an increase in the number of hepatitis A cases affecting mainly men who have sex with men (MSM) has been reported in low endemic countries in Europe. We calculated the attack rate in Lyon, France, in populations considered at high-risk: HIV-infected MSM and HIV-negative MSM receiving HIV pre-exposure prophylaxis (PrEP). In these populations, high level of immunity did not prevent the outbreak, indicating that vaccination should be reinforced, particularly in younger individuals.
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Affiliation(s)
- Caroline Charre
- Université de Lyon, Lyon, France.,Laboratoire de Virologie, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - Christophe Ramière
- CIRI, International Center for Infectiology Research, Université de Lyon, Lyon, France.,Université de Lyon, Lyon, France.,Laboratoire de Virologie, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - Anne-Marie Roque-Afonso
- National reference centre for hepatitis A virus (Centre national de référence du virus de l'hépatite A), Virologie, Hôpital Paul Brousse, AP-HP, Villejuif, France
| | - Christian Chidiac
- Service de maladie infectieuse et tropicale, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France.,Université de Lyon, Lyon, France
| | - Fabien Zoulim
- INSERM, U871, Lyon, France.,Service d'Hépatologie et de gastroentérologie, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.,Université de Lyon, Lyon, France
| | - Matthieu Godinot
- Service de maladie infectieuse et tropicale, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Joseph Koffi
- Service d'Hépatologie et de gastroentérologie, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.,Service de maladie infectieuse et tropicale, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France
| | - Caroline Scholtès
- INSERM, U871, Lyon, France.,Université de Lyon, Lyon, France.,Laboratoire de Virologie, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - Jean-Michel Livrozet
- Service de maladie infectieuse et tropicale, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | | | - Laurent Cotte
- Service de maladie infectieuse et tropicale, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France
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Jayasundara D, Hui BB, Regan DG, Heywood AE, MacIntyre CR, Wood JG. Quantifying the population effects of vaccination and migration on hepatitis A seroepidemiology in Australia. Vaccine 2017; 35:5228-5234. [PMID: 28823619 DOI: 10.1016/j.vaccine.2017.08.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 08/05/2017] [Accepted: 08/09/2017] [Indexed: 11/24/2022]
Abstract
Since licensure of hepatitis A vaccine in Australia in 1994, infection rates have declined to record lows. Cross-sectional serosurveys conducted over this period meanwhile have shown rising population immunity, particularly in young to middle-aged Australians. In this study, we performed a retrospective birth cohort analysis to estimate the contributions of infection, migration and vaccination towards increased levels of age specific hepatitis A seroprevalence in Australia. When aggregated across age, we find that two-thirds of the increase in population seropositivity (67.04%) between 1994 and 2008 was due to vaccination, just under one-third due to migration, with a negligible contribution from infection (<1%). Comparisons with other data sources reflecting vaccine uptake suggest the magnitude of this effect is realistic. We suggest that these results primarily relate to opportunistic vaccination and indicate the level of population immunity achievable through opportunistic programs providing further evidence for policy considerations around universal hepatitis A vaccine recommendations.
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Affiliation(s)
- Duleepa Jayasundara
- School of Public Health and Community Medicine, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia.
| | - Ben B Hui
- The Kirby Institute, University of New South Wales, Sydney, NSW 2052, Australia
| | - David G Regan
- The Kirby Institute, University of New South Wales, Sydney, NSW 2052, Australia
| | - Anita E Heywood
- School of Public Health and Community Medicine, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
| | - C Raina MacIntyre
- School of Public Health and Community Medicine, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
| | - James G Wood
- School of Public Health and Community Medicine, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
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Lin KY, Chen GJ, Lee YL, Huang YC, Cheng A, Sun HY, Chang SY, Liu CE, Hung CC. Hepatitis A virus infection and hepatitis A vaccination in human immunodeficiency virus-positive patients: A review. World J Gastroenterol 2017; 23:3589-3606. [PMID: 28611512 PMCID: PMC5449416 DOI: 10.3748/wjg.v23.i20.3589] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2017] [Revised: 03/31/2017] [Accepted: 05/04/2017] [Indexed: 02/06/2023] Open
Abstract
Hepatitis A virus (HAV) is one of the most common infectious etiologies of acute hepatitis worldwide. The virus is known to be transmitted fecal-orally, resulting in symptoms ranging from asymptomatic infection to fulminant hepatitis. HAV can also be transmitted through oral-anal sex. Residents from regions of low endemicity for HAV infection often remain susceptible in their adulthood. Therefore, clustered HAV infections or outbreaks of acute hepatitis A among men who have sex with men and injecting drug users have been reported in countries of low endemicity for HAV infection. The duration of HAV viremia and stool shedding of HAV may be longer in human immunodeficiency virus (HIV)-positive individuals compared to HIV-negative individuals with acute hepatitis A. Current guidelines recommend HAV vaccination for individuals with increased risks of exposure to HAV (such as from injecting drug use, oral-anal sex, travel to or residence in endemic areas, frequent clotting factor or blood transfusions) or with increased risks of fulminant disease (such as those with chronic hepatitis). The seroconversion rates following the recommended standard adult dosing schedule (2 doses of HAVRIX 1440 U or VAQTA 50 U administered 6-12 mo apart) are lower among HIV-positive individuals compared to HIV-negative individuals. While the response rates may be augmented by adding a booster dose at week 4 sandwiched between the first dose and the 6-mo dose, the need of booster vaccination remain less clear among HIV-positive individuals who have lost anti-HAV antibodies.
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REGAN DG, WOOD JG, BENEVENT C, ALI H, SMITH LWATCHIRS, ROBERTSON PW, FERSON MJ, FAIRLEY CK, DONOVAN B, LAW MG. Estimating the critical immunity threshold for preventing hepatitis A outbreaks in men who have sex with men. Epidemiol Infect 2016; 144:1528-37. [PMID: 26566273 PMCID: PMC9150569 DOI: 10.1017/s0950268815002605] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Revised: 09/17/2015] [Accepted: 10/07/2015] [Indexed: 01/17/2023] Open
Abstract
Several 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 (R 0) and the probability of an HAV epidemic occurring as a function of the immune proportion. We estimated a plausible range for R 0 of 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 of R 0 and 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.
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Affiliation(s)
- D. G. REGAN
- The Kirby Institute, UNSW Australia, Sydney, NSW, Australia
| | - J. G. WOOD
- The School of Public Health and Community Medicine, UNSW Australia, Sydney, NSW, Australia
| | - C. BENEVENT
- École Nationale Supérieure de Techniques Avanceés, Palaiseau Cedex, France
| | - H. ALI
- The Kirby Institute, UNSW Australia, Sydney, NSW, Australia
| | | | - P. W. ROBERTSON
- South Eastern Area Laboratory Services, Prince of Wales Hospital, Sydney, NSW, Australia
| | - M. J. FERSON
- The School of Public Health and Community Medicine, UNSW Australia, Sydney, NSW, Australia
- Public Health Unit, South Eastern Sydney Local Health District, Sydney, NSW, Australia
| | - C. K. FAIRLEY
- Central Clinical School, Monash University, Melbourne, VIC, Australia
- Melbourne Sexual Health Centre, Melbourne, VIC, Australia
| | - B. DONOVAN
- The Kirby Institute, UNSW Australia, Sydney, NSW, Australia
- Sydney Sexual Health Centre, Sydney Hospital, Sydney, NSW, Australia
| | - M. G. LAW
- The Kirby Institute, UNSW Australia, Sydney, NSW, Australia
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