hepatitis A

EuroSurveillance, 2024; 29(45):pii=2400100 (doi: 10.2807/1560- 7917.ES.2024.29.45.2400100).

Authors: Michael Brandl, Axel J Schmidt, Ulrich Marcus, Erika Duffell, Ettore Severi, Antons Mozalevskis, Anda Kivite-Urtane, Matthias an der Heiden, Sandra Dudareva.

Abstract

Background. Hepatitis A and B vaccinations are recommended for men who have sex with men (MSM), given their increased risk of infection. However, data on vaccination programmes are scarce.

Aim. To use information on vaccination recommendations and vaccine uptake among MSM in the WHO European Region to guide prevention.

Methods. From a large pan-European MSM Internet Survey (EMIS-2017), we analysed data on self-reported hepatitis A and B vaccination status by age, education, financial coping, settlement size, outness (disclosure of sexual behaviour), migration history and diagnosis with hepatitis C or HIV, using multivariable logistic regression. Additionally, we collected information on national hepatitis A and B vaccination recommendations.

Results. We present data of 113,884 MSM, median age 36 years (IQR: 27–47). Vaccination for hepatitis A and B was recommended and free for MSM in 7 and 18 of 43 countries, respectively. Of all respondents, 48% (n = 50,966) reported ever being vaccinated against hepatitis A, and 53% (n = 56,889) against hepatitis B. Odds for being vaccinated against hepatitis A increased with outness (‘out to (almost) all’ aOR: 1.78, 95% CI: 1.72–1.85 vs ‘out to none’) and were higher in countries where vaccination was recommended and free for MSM (aOR:2.22, 95% CI: 1.29–3.82 vs ‘no recommendation’). Results for hepatitis B were similar (outness: aOR:1.81, 95%CI:1.75–1.88 and MSM-specific vaccination recommendation: aOR: 2.44, 95% CI: 1.54–3.85).

Conclusion. Large proportions of MSM in Europe remain vulnerable to hepatitis A and B, despite available vaccination. Implementation of MSM-specific vaccination recommendations and greater efforts to improve the societal climate for MSM are needed to address gaps in vaccine coverage.

Available online

EuroSurveillance, 2024; 29(45):pii=2400099 (doi: 10.2807/1560-7917.ES.2024.29.45.2400099).

Authors: Sofia Burdi, Michael Brandl, Ulrich Marcus, Erika Duffell, Ettore Severi, Antons Mozalevskis, Kristi Rüütel, Achim Dörre, Axel J Schmidt*, Sandra Dudareva*.

Abstract

Background. Recent hepatitis A virus outbreaks in Europe affecting men who have sex with men (MSM) and ongoing hepatitis B virus transmission among MSM underscore the ongoing need for viral hepatitis prevention in this population.

Aim. To describe viral hepatitis knowledge and associated factors among MSM in the WHO European Region to inform targeted prevention.

Methods. In the European MSM Internet Survey (EMIS-2017), basic knowledge was defined as correctly identifying at least 4 of 5 statements about viral hepatitis and vaccination. We described basic knowledge by country. In a multilevel logistic regression model, we estimated adjusted odds ratios (aOR) with 95% confidence intervals (CI) for having basic knowledge and explanatory variables: sociodemographic characteristics, history of hepatitis C and/or HIV diagnosis, sexual orientation disclosure at last sexually transmitted infections (STI) test and outness..

Results. Of 113,884 participants across 43 WHO European Region countries, 68% demonstrated basic knowledge, ranging from 50% in Israel to 80% in the Netherlands. Basic knowledge was significantly associated with older age (≥ 40 years vs < 25 years, aOR: 2.9, 95% CI: 2.7–3.0), a history of hepatitis C and/or HIV diagnosis (aOR:1.8, 95% CI: 1.7–1.9) and sexual orientation disclosure at last STI test (aOR: 1.3, 95% CI: 1.2– 1.3), among other factors.

Conclusion. We found a knowledge disparity regard- ing viral hepatitis and hepatitis vaccination aware- ness among MSM across Europe, highlighting a need to address these gaps. A non-judgemental, accept- ing climate that allows individuals attending medical services to safely disclose their sexual orientation is fundamental to enable healthcare professionals to target information and preventative measures more effectively.

Available online