Cargando…
Hepatitis a among men who have sex with men in Barcelona, 1989-2010: insufficient control and need for new approaches
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...
Autores principales: | , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2012
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3282664/ https://www.ncbi.nlm.nih.gov/pubmed/22264382 http://dx.doi.org/10.1186/1471-2334-12-11 |
_version_ | 1782224098589409280 |
---|---|
author | Tortajada, Cecilia de Olalla, Patricia G Diez, Elia Pinto, Rosa M Bosch, Albert Perez, Unai Sanz, Milagros Caylà, Joan A |
author_facet | Tortajada, Cecilia de Olalla, Patricia G Diez, Elia Pinto, Rosa M Bosch, Albert Perez, Unai Sanz, Milagros Caylà, Joan A |
author_sort | Tortajada, Cecilia |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-3282664 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2012 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-32826642012-02-21 Hepatitis a among men who have sex with men in Barcelona, 1989-2010: insufficient control and need for new approaches Tortajada, Cecilia de Olalla, Patricia G Diez, Elia Pinto, Rosa M Bosch, Albert Perez, Unai Sanz, Milagros Caylà, Joan A BMC Infect Dis Research Article 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. BioMed Central 2012-01-20 /pmc/articles/PMC3282664/ /pubmed/22264382 http://dx.doi.org/10.1186/1471-2334-12-11 Text en Copyright ©2012 Tortajada et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Tortajada, Cecilia de Olalla, Patricia G Diez, Elia Pinto, Rosa M Bosch, Albert Perez, Unai Sanz, Milagros Caylà, Joan A Hepatitis a among men who have sex with men in Barcelona, 1989-2010: insufficient control and need for new approaches |
title | Hepatitis a among men who have sex with men in Barcelona, 1989-2010: insufficient control and need for new approaches |
title_full | Hepatitis a among men who have sex with men in Barcelona, 1989-2010: insufficient control and need for new approaches |
title_fullStr | Hepatitis a among men who have sex with men in Barcelona, 1989-2010: insufficient control and need for new approaches |
title_full_unstemmed | Hepatitis a among men who have sex with men in Barcelona, 1989-2010: insufficient control and need for new approaches |
title_short | Hepatitis a among men who have sex with men in Barcelona, 1989-2010: insufficient control and need for new approaches |
title_sort | hepatitis a among men who have sex with men in barcelona, 1989-2010: insufficient control and need for new approaches |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3282664/ https://www.ncbi.nlm.nih.gov/pubmed/22264382 http://dx.doi.org/10.1186/1471-2334-12-11 |
work_keys_str_mv | AT tortajadacecilia hepatitisaamongmenwhohavesexwithmeninbarcelona19892010insufficientcontrolandneedfornewapproaches AT deolallapatriciag hepatitisaamongmenwhohavesexwithmeninbarcelona19892010insufficientcontrolandneedfornewapproaches AT diezelia hepatitisaamongmenwhohavesexwithmeninbarcelona19892010insufficientcontrolandneedfornewapproaches AT pintorosam hepatitisaamongmenwhohavesexwithmeninbarcelona19892010insufficientcontrolandneedfornewapproaches AT boschalbert hepatitisaamongmenwhohavesexwithmeninbarcelona19892010insufficientcontrolandneedfornewapproaches AT perezunai hepatitisaamongmenwhohavesexwithmeninbarcelona19892010insufficientcontrolandneedfornewapproaches AT sanzmilagros hepatitisaamongmenwhohavesexwithmeninbarcelona19892010insufficientcontrolandneedfornewapproaches AT caylajoana hepatitisaamongmenwhohavesexwithmeninbarcelona19892010insufficientcontrolandneedfornewapproaches |