Catharina J Alberts1, Anders Boyd2, Sylvia M Bruisten3, Titia Heijman4, Arjan Hogewoning5, Martijn van Rooijen6, Evelien Siedenburg7, Gerard J B Sonder8. 1. Department of Infectious Diseases, Public Health Service Amsterdam (GGD), Amsterdam, the Netherlands. 2. Department of Infectious Diseases, Public Health Service Amsterdam (GGD), Amsterdam, the Netherlands; INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France. Electronic address: aboyd@ggd.amsterdam.nl. 3. Department of Infectious Diseases, Public Health Service Amsterdam (GGD), Amsterdam, the Netherlands; Amsterdam Infection & Immunity Institute (AI&II), Amsterdam University Medical Center (UMC), Amsterdam, the Netherlands. Electronic address: SBruisten@ggd.amsterdam.nl. 4. Department of Infectious Diseases, Public Health Service Amsterdam (GGD), Amsterdam, the Netherlands. Electronic address: theijman@ggd.amsterdam.nl. 5. Department of Infectious Diseases, Public Health Service Amsterdam (GGD), Amsterdam, the Netherlands; Amsterdam Infection & Immunity Institute (AI&II), Amsterdam University Medical Center (UMC), Amsterdam, the Netherlands. Electronic address: ahogewoning@ggd.amsterdam.nl. 6. Department of Infectious Diseases, Public Health Service Amsterdam (GGD), Amsterdam, the Netherlands. Electronic address: mvrooijen@ggd.amsterdam.nl. 7. Department of Infectious Diseases, Public Health Service Amsterdam (GGD), Amsterdam, the Netherlands. Electronic address: esiedenburg@ggd.amsterdam.nl. 8. Department of Infectious Diseases, Public Health Service Amsterdam (GGD), Amsterdam, the Netherlands; Amsterdam Infection & Immunity Institute (AI&II), Amsterdam University Medical Center (UMC), Amsterdam, the Netherlands. Electronic address: gerardsonder@gmail.com.
Abstract
BACKGROUND: Several outbreaks of Hepatitis A virus (HAV) were recently documented among men who have sex with men (MSM) in Europe. We investigated the HAV incidence among MSM in Amsterdam, the Netherlands; and HAV seroprevalence and HAV vaccination decision among MSM visiting the Sexually Transmitted Infection (STI) clinic in Amsterdam. METHODS: Using surveillance data from 1992 to 2017 of MSM with acute HAV in Amsterdam, we estimated the incidence by calendar year and age. We explored HAV seroprevalence by calendar year and age, determinants for HAV seropositivity, and opting-in/out for HAV vaccination using data collected among MSM that visited the STI clinic between 2006 and 2017 and were included in a nationwide Hepatitis B virus (HBV) vaccination programme. Offering HAV vaccination at the STI clinic differed over three consecutive periods: not offered, offered for free, or offered for 75 euros. Logistic regression analyses were used to explore determinants. RESULTS: HAV incidence increased in 2016/17 after 4 years of absence and peaked in MSM around 35 years of age. Among MSM visiting the STI clinic, HAV seroprevalence was 37% (95%CI = 35-40%), which was constant over the period 2006-2017, and increased with age (p < 0.001). Determinants for HAV seropositivity in multivariable analysis were: older age (p < 0.001), originating from an HAV endemic country (p < 0.001), and being HBV seropositive (p = 0.001). MSM opted-in more frequently when HAV vaccination was offered for free versus paid (89% versus 11%, respectively; p < 0.001). Younger MSM were less inclined to vaccinate when payment was required (p = 0.010). Post-hoc analyses showed that 98% versus 46% of MSM visiting the Amsterdam STI clinic would be protected against HAV infection if HAV vaccination was offered for free or for 75 euros, respectively. CONCLUSIONS: The MSM population of Amsterdam is vulnerable to a new HAV outbreak. We strongly recommend that MSM have access to free hepatitis A vaccination.
BACKGROUND: Several outbreaks of Hepatitis A virus (HAV) were recently documented among men who have sex with men (MSM) in Europe. We investigated the HAV incidence among MSM in Amsterdam, the Netherlands; and HAV seroprevalence and HAV vaccination decision among MSM visiting the Sexually Transmitted Infection (STI) clinic in Amsterdam. METHODS: Using surveillance data from 1992 to 2017 of MSM with acute HAV in Amsterdam, we estimated the incidence by calendar year and age. We explored HAV seroprevalence by calendar year and age, determinants for HAV seropositivity, and opting-in/out for HAV vaccination using data collected among MSM that visited the STI clinic between 2006 and 2017 and were included in a nationwide Hepatitis B virus (HBV) vaccination programme. Offering HAV vaccination at the STI clinic differed over three consecutive periods: not offered, offered for free, or offered for 75 euros. Logistic regression analyses were used to explore determinants. RESULTS:HAV incidence increased in 2016/17 after 4 years of absence and peaked in MSM around 35 years of age. Among MSM visiting the STI clinic, HAV seroprevalence was 37% (95%CI = 35-40%), which was constant over the period 2006-2017, and increased with age (p < 0.001). Determinants for HAV seropositivity in multivariable analysis were: older age (p < 0.001), originating from an HAV endemic country (p < 0.001), and being HBV seropositive (p = 0.001). MSM opted-in more frequently when HAV vaccination was offered for free versus paid (89% versus 11%, respectively; p < 0.001). Younger MSM were less inclined to vaccinate when payment was required (p = 0.010). Post-hoc analyses showed that 98% versus 46% of MSM visiting the Amsterdam STI clinic would be protected against HAVinfection if HAV vaccination was offered for free or for 75 euros, respectively. CONCLUSIONS: The MSM population of Amsterdam is vulnerable to a new HAV outbreak. We strongly recommend that MSM have access to free hepatitis A vaccination.
Authors: Xu-Sheng Zhang; Jason J Ong; Louis Macgregor; Tatiana G Vilaplana; Simone T Heathcock; Miranda Mindlin; Peter Weatherburn; Ford Hickson; Michael Edelstein; Sema Mandal; Peter Vickerman Journal: Lancet Reg Health Eur Date: 2022-06-17