Hepatitis A virus infection and hepatitis A vaccination in human immunodeficiency virus-positive patients: A review

Table 2 Outbreaks of acute hepatitis A in the men who have sex with men population

Ref.	Location	Study period	Case number	Male	MSM	HIV-positive patients	Age (yr)	Risk factors1 and comments
	Europe
Høybye et al[43]	Copenhagen, Denmark	1977-1978	45	45	21	NA	29
Christenson et al[44]	Stockholm, Sweden	1979-1980	145	145	145	NA	NA	Multiple partners and oral-anal sexual contact
Mindel et al[45]	London, United Kingdom	1980	24	NA	23	NA	NA	HAV infection was associated with homosexual activity
Kani et al[46]	London, United Kingdom	1989-1990	7000	NA	41	NA	NA	Oral-anal sexual contact
Atkins et al[47]	London, United Kingdom	1989-1992	206	121	65	NA	NA	Oral-anal sexual contact and sexual promiscuity
Leentvaar-Kuijpers et al[48]	Amsterdam, the Netherlands	1992-1993	293	NA	39	NA	NA	Visiting saunas and darkrooms
Walsh et al[49]	Thames region, United Kingdom	1995	481	NA	58	NA	NA	Oral-anal and digital-rectal intercourse
Stene-Johansen et al[50]	Oslo, Norway	1995-1998	26	26	26	NA	NA
Bell et al[51]	London and East Sussex, United Kingdom	1997	48	NA	41	NA	NA	Eating shellfish and sex in gay saunas
Manfredi et al[52]	Bologna, Italy	1999-2004	122	104	81	11	28	Unprotected sexual contact
Mazick et al[53]	Copenhagen, Denmark	2004	18	18	18	NA	NA	Casual sex and sex in gay saunas
Girardi et al[54]	Rome, Italy	2002-2008	473	368	115	57	25-64	Same gender sex
								Routine HIV test in HAV-infected patients should be considered
Bordi et al[55]	Rome, Italy	2008-2010	162	143	34	14	36	Monophyletic HAV strain sustained the outbreak
Tortajada et al[56]	Barcelona, Spain	2002	48	47	NA	28%	31
		2003-2004	60	60	NA	24%	32
		2008-2009	189	185	NA	21%	33
Dabrowska et al[57]	Warsaw, Poland	2007-2008	860	NA	50	6	28	No difference in disease severity between HIV-positive and HIV-negative individuals
Tortajada et al[58]	Barcelona, Spain	2008-2009	150	126	87	NA	33
Sfetcu et al[59]	Northern Ireland, United Kingdom	2008-2009	38	36	26	NA	29	The outbreak strain was indistinguishable from that in Czech Republic
Taffon et al[60]	Tuscany, Italy	2008	240	NA	32%	NA	NA	A unique circulating HAV strain
	North America
Kosatsky et al[61]	Anchorage, Alaska	1982-1983	17	17	17	NA	19-31
Desenclos et al[62]	Florida, United States	1988-1989	311	69	26	NA	NA
Henning et al[63]	New York, United States	1991	180	180	62	NA	20-49	Anonymous sex partner, group sex, oral-anal and digital-rectal intercourse
Allard et al[64]	Montréal, Canada	1996-1997	376	376	376	NA	33	Vaccination campaign achieving 20%-41% coverage in MSM decreased incidence rapidly
Finton et al[65]	Atlanta, United States	1996	222	NA	75%	NA	NA	Vaccination campaign in MSM decreased reported cases
Cotter et al[66]	Ohio, United States	1998-1999	136	118	47	NA	33	Contact with hepatitis A cases
	Asia-Pacific region
Stewart et al[67]	Melbourne, Australia	1991	495	407	210	NA	NA	Sexual and social contact
Stokes et al[68]	Sydney, Australia	1991-1992	570	515	330	NA	31	Sexual contact was the most reported contact type
Ferson et al[69]	Sydney, Australia	1991-1996	1138	991	587	NA	30	Household or sexual contact
Delpech et al[70]	Sydney, Australia	1997-1999	354	265	139	NA	32
Chen et al[71]	Taiwan	2015-2016	> 1000	NA	> 70%	> 60%	NA	A total of 1296 cases reported as of February, 2017

¹Risk factors of acquiring HAV infection were identified by case-control studies. HAV: Hepatitis A virus; MSM: Men who have sex with men; NA: Not available.