Bialek Stephanie R, Barry Vaughn, Bell Beth P, Valleroy Linda A, Behel Stephanie, Mackellar Duncan A, Secura Gina, Thiede Hanne, McFarland Willi, Ford Wesley L, Bingham Trista A, Shehan Douglas A, Celentano David D
Division of Viral Diseases, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA 30030, USA.
Sex Health. 2011 Sep;8(3):343-8. doi: 10.1071/SH10162.
Hepatitis A outbreaks are well documented among men who have sex with men (MSM). This analysis examines characteristics associated with hepatitis A virus (HAV) infection among a large group of young adult MSM from five USA cities.
The Young Men's Survey was a cross-sectional prevalence study of HIV infection and related behavioural risk factors among MSM aged 15-29 years during 1994-2000. Serum specimens from HIV-negative participants were retrospectively tested for antibodies to HAV (anti-HAV). Data were stratified by ethnicity and analysed with logistic regression.
Overall anti-HAV prevalence was 18.4% among the 2708 participants, and varied by ethnicity from 6.9 to 45.3% and was highest among Hispanic and Asian men (P < 0.001). Prevalence increased with age across all racial/ethnic groups. Among white men, anti-HAV positivity was associated with having 20 or more lifetime male sex partners for those aged 15-22 years (adjusted odds ratio (AOR)=2.1, 95% confidence interval (CI)=1.0-4.1) and ever having had unprotected anal sex for those aged 23-29 years (AOR=2.4, 95% CI=1.2-4.5).
Factors associated with a history of HAV infection among MSM in non-outbreak settings are probably similar to those among non-MSM. MSM are still at risk for HAV infection as a result of outbreaks occurring in MSM communities. Additional studies of hepatitis A vaccination coverage are needed to determine if strategies to vaccinate MSM are adequate.
甲型肝炎暴发在男男性行为者（MSM）中已有充分记录。本分析研究了来自美国五个城市的一大群年轻成年男男性行为者中与甲型肝炎病毒（HAV）感染相关的特征。
青年男性调查是一项关于1994 - 2000年期间15 - 29岁男男性行为者中HIV感染及相关行为危险因素的横断面患病率研究。对HIV阴性参与者的血清标本进行回顾性检测以检测甲型肝炎抗体（抗-HAV）。数据按种族分层并用逻辑回归分析。
在2708名参与者中，总体抗-HAV患病率为18.4%，因种族而异，从6.9%至45.3%不等，在西班牙裔和亚裔男性中最高（P < 0.001）。所有种族/族裔群体的患病率均随年龄增加。在白人男性中，15 - 22岁有20个或更多终身男性性伴侣者抗-HAV阳性相关（调整优势比（AOR）=2.1，95%置信区间（CI）=1.0 - 4.1），23 - 29岁曾有无保护肛交者抗-HAV阳性相关（AOR = 2.4，95% CI = 1.2 - 4.5）。
在非暴发环境下，男男性行为者中与甲型肝炎病毒感染史相关的因素可能与非男男性行为者中的因素相似。由于男男性行为者社区中发生的暴发，男男性行为者仍有感染甲型肝炎病毒的风险。需要对甲型肝炎疫苗接种覆盖率进行更多研究，以确定针对男男性行为者的疫苗接种策略是否足够。
