BACKGROUND & AIMS: In the Netherlands, transmission of hepatitis B virus occurs mainly within behavioural high-risk groups, such as in men who have sex with men. Therefore, a vaccination programme has targeted these high-risk groups. This study evaluates the impact of the vaccination programme targeting Amsterdam's large population of men who have sex with men from 1998 through 2011. METHODS: We used Amsterdam data from the national database of the vaccination programme for high-risk groups (January 1, 1998 to December 31, 2011). Programme and vaccination coverage were estimated with population statistics. Incidence of acute hepatitis B was analyzed with notification data from the Amsterdam Public Health Service (1992-2011). Mathematical modelling accounting for vaccination data and trends in sexual risk behaviour was used to explore the impact of the programme. RESULTS: At the end of 2011, programme coverage was estimated at 41% and vaccination coverage from 30% to 38%. Most participants (67%) were recruited from the outpatient department for sexually transmitted infections and outreach locations such as saunas and gay bars. Incidence of acute hepatitis B dropped sharply after 2005. The mathematical model in which those who engage most in high-risk sex are vaccinated, best explained the decline in incidence. CONCLUSIONS: Transmission of hepatitis B virus among Amsterdam's men who have sex with men has decreased, despite ongoing high-risk sexual behaviour. Vaccination programmes targeting men who have sex with men do not require full coverage; they may be effective when those who engage most in high-risk sex are reached.
BACKGROUND & AIMS: In the Netherlands, transmission of hepatitis B virus occurs mainly within behavioural high-risk groups, such as in men who have sex with men. Therefore, a vaccination programme has targeted these high-risk groups. This study evaluates the impact of the vaccination programme targeting Amsterdam's large population of men who have sex with men from 1998 through 2011. METHODS: We used Amsterdam data from the national database of the vaccination programme for high-risk groups (January 1, 1998 to December 31, 2011). Programme and vaccination coverage were estimated with population statistics. Incidence of acute hepatitis B was analyzed with notification data from the Amsterdam Public Health Service (1992-2011). Mathematical modelling accounting for vaccination data and trends in sexual risk behaviour was used to explore the impact of the programme. RESULTS: At the end of 2011, programme coverage was estimated at 41% and vaccination coverage from 30% to 38%. Most participants (67%) were recruited from the outpatient department for sexually transmitted infections and outreach locations such as saunas and gay bars. Incidence of acute hepatitis B dropped sharply after 2005. The mathematical model in which those who engage most in high-risk sex are vaccinated, best explained the decline in incidence. CONCLUSIONS: Transmission of hepatitis B virus among Amsterdam's men who have sex with men has decreased, despite ongoing high-risk sexual behaviour. Vaccination programmes targeting men who have sex with men do not require full coverage; they may be effective when those who engage most in high-risk sex are reached.
Keywords:
95% CI; 95% confidence interval; APC; HBV; HbsAg; Hepatitis B; IQR; MSM; Men who have sex with men; PHS; Prevention; Public Health Service; RR; Risk group; STI-OPD; UAI; Vaccination programme; age-period-cohort; anti-HBc; antibodies against hepatitis B core antigen; hepatitis B surface antigen; hepatitis B virus; incidence rate ratios; interquartile range; men who have sex with men; outpatient department for sexually transmitted infections; unprotected anal intercourse
Authors: Sumathi Ramachandran; Michael A Purdy; Guo-liang Xia; David S Campo; Zoya E Dimitrova; Eyasu H Teshale; Chong Gee Teo; Yury E Khudyakov Journal: J Virol Date: 2014-09-03 Impact factor: 5.103
Authors: Loes C Soetens; Birgit H B van Benthem; Anouk Urbanus; Jeroen Cremer; Kimberly S M Benschop; Ariene Rietveld; Erik I van Dijk; Susan J M Hahné Journal: PLoS One Date: 2015-02-23 Impact factor: 3.240
Authors: Gudrun S Freidl; Gerard Jb Sonder; Lian Pmj Bovée; Ingrid Hm Friesema; Gini Gc van Rijckevorsel; Wilhelmina Lm Ruijs; Frank van Schie; Evelien C Siedenburg; Jyh-Yuan Yang; Harry Vennema Journal: Euro Surveill Date: 2017-02-23