Federal University of Mato Grosso do Sul, Campo Grande, Brazil.
Federal University of Mato Grosso, Rondonópolis, Brazil.
PLoS One. 2021 Sep 16;16(9):e0256818. doi: 10.1371/journal.pone.0256818. eCollection 2021.
Hepatitis A is a fecal-oral infection caused by hepatitis A virus (HAV). Men who have sex with men (MSM) and transgender women (TW) have been reported as target groups for HAV infection. This study aimed to determine the seroprevalence, risk factors, and circulating strains associated with HAV infection among MSM and TW in Central Brazil.
A cross-sectional study was conducted from November 2011 to September 2013. Serum samples were collected from 425 individuals for anti-HAV antibody testing and HAV molecular characterization. Of them, 149 (35.1%) participants were self-identified as transgender women. Statistical analysis was performed to evaluate the risk factors of HAV seropositivity.
The seroprevalence of HAV exposure was 69.7% (95% Confidence Interval: 65.3-74.0%). Serological evidence of HAV was significantly higher in participants who self-identified as transgender women (83.2%) than MSM (62.3%). Increasing age, non-white race, and lower monthly household income were independently associated with HAV exposure among MSM. Only lower monthly household income was independently associated with HAV exposure among TW. One anti-HAV IgM positive sample, from a transgender woman (0.2%), was detected and classified as subgenotype IA.
High HAV prevalence was observed, markedly among TW. Considering the risky sexual behaviors this population is exposed to, HAV vaccination and prevention programs targeting this population should be considered to prevent outbreaks and the burden of the disease.
甲型肝炎是一种由甲型肝炎病毒（HAV）引起的粪-口感染。男男性行为者（MSM）和跨性别女性（TW）已被报告为 HAV 感染的目标人群。本研究旨在确定巴西中部 MSM 和 TW 中与 HAV 感染相关的血清流行率、危险因素和循环株。
本研究为一项横断面研究，于 2011 年 11 月至 2013 年 9 月进行。采集 425 名个体的血清样本，用于抗-HAV 抗体检测和 HAV 分子特征分析。其中，149 名（35.1%）参与者自我认同为跨性别女性。统计分析用于评估 HAV 血清阳性的危险因素。
HAV 暴露的血清流行率为 69.7%（95%置信区间：65.3-74.0%）。自我认同为跨性别女性的参与者（83.2%）的 HAV 血清学证据明显高于 MSM（62.3%）。在 MSM 中，年龄增长、非白色人种和较低的月家庭收入与 HAV 暴露独立相关。在 TW 中，仅较低的月家庭收入与 HAV 暴露独立相关。从一名跨性别女性（0.2%）中检测到并分类为亚基因型 IA 的 1 份抗-HAV IgM 阳性样本。
观察到 HAV 高流行率，在 TW 中尤为明显。考虑到该人群面临的危险性行为，应考虑针对该人群的 HAV 疫苗接种和预防计划，以预防疫情和疾病负担。
