Hepatitis a among men who have sex with men in Barcelona, 1989-2010 : Insufficient control and need for new approaches
Tortajada, Cecilia (Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública)
García de Olalla, Patricia (Institut d'Investigació Biomèdica Sant Pau)
Diez, Elia (Institut d'Investigació Biomèdica Sant Pau)
Pinto, Rosa M. (Universitat de Barcelona)
Bosch, Albert (Universitat de Barcelona)
Perez, Unai (Universitat de Barcelona)
Sanz, Milagros (Agència de Salut Pública de Barcelona)
Caylà, Joan A. (Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública)
Universitat Autònoma de Barcelona

Data:	2012
Resum:	Background: Men who have sex with men (MSM) are a known group at risk for hepatitis A and outbreaks among this group are frequent. In Barcelona, vaccination for MSM has been recommended since 1994. In 1998 a vaccination campaign among preadolescents was implemented and an immunization program in gay bathhouses began in 2004. Objective: to asses the incidence of hepatitis A in adults in Barcelona from 1989 to 2010 and to evaluate the outbreaks among MSM including all genotypes involved. Methods: All cases of acute hepatitis A among young adults notified to the Public Health Agency of Barcelona from 1989 to 2010 were included for analyses. We calculated the annual incidence rate and the incidence ratio male-to-female (M:F) as a marker for MSM. Spearman's coefficient was used to evaluate trends. We also evaluated the outbreaks among MSM and compared their characteristics using Chi-squared and ANOVA test. Fragment amplification of the VP1/P2A region was used for genetic analysis. Results: The median annual incidence for the period of study was 4. 7/100000 among females and 11. 7/100000 among males. The rate of hepatitis A for adult woman decreased over time (Spearman' coefficient = -0. 63, p = 0. 002), whereas there was no decrease for adult men (Spearman' coefficient = 0. 097, p = 0. 67). During the study period the M:F ratio increased (Spearman' coefficient = 0. 73, p < 0. 001). Three large outbreaks among MSM were detected. When comparing outbreaks, there was a decrease in the percentage of bathhouse users (from 47% to 19%, p = 0. 0001) and sex workers (from 6. 5% to 0%) while the percentage of HIV infected individuals did not change significantly (range: 21%-28%, p = 0. 36). The isolated strains were closely related to those circulating in Europe. Conclusions: Annual incidences remain high among MSM without tendency to decrease. More strategies which effectively reach the whole MSM community are needed. © 2012 Tortajada et al; licensee BioMed Central Ltd.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Publicat a:	BMC Infectious diseases, Vol. 12 (20 2012) , p. 11, ISSN 1471-2334

DOI: 10.1186/1471-2334-12-11
PMID: 22264382

5 p, 189.9 KB

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