Factors associated with susceptibility to hepatitis A virus among men who have sex with men taking HIV pre-exposure prophylaxis in Northeast Brazil: a cross-sectional study
Hepatitis A virus, men who have sex with men, preexposure prophylaxis, epidemiology
Background
Hepatitis A virus (HAV) infection has disproportionately affected more men who have sex with men (MSM), occurring in outbreaks, despite being potentially vaccine-preventable. We determined the prevalence of MSM taking HIV pre-exposure prophylaxis (PrEP) that are HAV susceptible and the factors associated with HAV susceptibility.
Methods
From August 2021 to June 2023, 282 PrEP-using cisgender MSM were enrolled in this cross-sectional study. Sociodemographic and clinical information was collected. Blood samples were collected for screening of sexually transmitted infections (STIs) and serum samples were tested for IgM and total anti-HAV antibodies.
Results
Non-reagent results of total anti-HAV antibodies were found in 37.6% of subjects. Factors associated with HAV susceptibility included age ≤30 years (adjusted prevalence ratio, 2.02 [95% confidence interval, 1.61-2.53]), having health insurance (1.39 [1.19-1.64]), sex only with cisgender men (1.52 [1.23-1.89]), non-steady partner (1.20 [1.01-1.43]) and no history of STIs (1.25 [1.03-1.53]).
Conclusions
A high proportion of PrEP-using cisgender MSM were HAV susceptible. Young age, better socioeconomic status and sexual characteristics related to partnerships and medical history of STIs were associated with HAV susceptibility in this population. Understanding the epidemiology of HAV infection in key populations is essential to development of preventive strategies, especially following the recent hepatitis A outbreak in Brazil.