Institute of Tropical Medicine, Federal University of Rio Grande do Norte, 300 Cônego Monte Street, Quintas, Natal, RN, 59037-170, Brazil.
Department of Infectious Diseases, Federal University of Rio Grande do Norte, 300 Cônego Monte Street, Quintas, Natal, RN, 59037-170, Brazil.
BMC Infect Dis. 2024 Aug 8;24(1):795. doi: 10.1186/s12879-024-09698-y.
This study aimed to determine the prevalence and factors associated with susceptibility to hepatitis B virus (HBV) among cisgender men who have sex with men (MSM) on HIV pre-exposure prophylaxis (PrEP) in Northeastern Brazil.
This was a cross-sectional, analytical study conducted between September 2021 and June 2023. Participants underwent structured interviews to collect sociodemographic and clinical information, including hepatitis B vaccination history, HIV PrEP use and sexual health history. Blood samples were collected for hepatitis B serologic testing: HBV surface antigen (HBsAg), HBV surface antibody (anti-HBs), total and IgM HBV core antibody (anti-HBc). HBV susceptibility was defined as nonreactive results for all these serological markers.
A total of 287 participants were enrolled into the study. The median age of the individuals was 31 years (interquartile range: 27; 36). HBV susceptibility was found in 58 out 286 individuals (20.3%; 95% CI: 15.9-25.2). Seventy-six percent of the participants reported completing the three-dose hepatitis B vaccine schedule. Susceptibility was significantly associated with a monthly income ≤ 5 minimum wages (PR: 2.02; 95% CI: 1.01-4.05), lack of complete hepatitis B vaccination schedule (PR: 4.52; 95% CI: 2.89-7.06), initiation of HIV PrEP (PR: 2.18; 95% CI: 1.21-3.94), duration of six months of HIV PrEP (PR: 2.16; 95% CI: 1.19-3.91), absence of tattoos (PR: 1.55; 95% CI: 1.00-2.40) and no history of sexually transmitted infections (PR: 1.65; 95% CI: 1.07-2.54).
Our findings highlight the significant burden of HBV susceptibility among MSM on HIV PrEP in Northeastern Brazil. Socioeconomic factors, vaccination status, PrEP use and sexual health behaviors play critical roles in determining susceptibility to HBV. Integrating hepatitis B screening and vaccination into PrEP services is critical for identifying and addressing HBV susceptibility among MSM. Interventions aimed at increasing vaccination coverage and promoting safer sexual practices are essential for mitigating the burden of HBV infection in this population.
本研究旨在确定在巴西东北部接受 HIV 暴露前预防（PrEP）的男男性行为者（MSM）中，乙肝病毒（HBV）易感性的流行情况和相关因素。
这是一项横断面、分析性研究，于 2021 年 9 月至 2023 年 6 月进行。参与者接受了结构化访谈，以收集社会人口统计学和临床信息，包括乙肝疫苗接种史、HIV PrEP 使用和性健康史。采集血液样本进行乙肝血清学检测：HBV 表面抗原（HBsAg）、HBV 表面抗体（抗-HBs）、总和 IgM HBV 核心抗体（抗-HBc）。HBV 易感性定义为所有这些血清学标志物均无反应。
共有 287 名参与者纳入研究。个体的中位年龄为 31 岁（四分位距：27；36）。在 286 名个体中，有 58 人（20.3%；95%CI：15.9-25.2）存在 HBV 易感性。76%的参与者报告完成了三剂乙肝疫苗接种计划。易感性与月收入≤5 最低工资（PR：2.02；95%CI：1.01-4.05）、未完成完整乙肝疫苗接种计划（PR：4.52；95%CI：2.89-7.06）、开始使用 HIV PrEP（PR：2.18；95%CI：1.21-3.94）、HIV PrEP 使用 6 个月（PR：2.16；95%CI：1.19-3.91）、无纹身（PR：1.55；95%CI：1.00-2.40）和无性传播感染史（PR：1.65；95%CI：1.07-2.54）显著相关。
我们的研究结果突出了在巴西东北部接受 HIV PrEP 的 MSM 中 HBV 易感性的显著负担。社会经济因素、疫苗接种状况、PrEP 使用和性行为健康行为在确定 HBV 易感性方面起着关键作用。将乙肝筛查和疫苗接种纳入 PrEP 服务中对于识别和解决 MSM 中的 HBV 易感性至关重要。旨在提高疫苗接种覆盖率和促进安全性行为的干预措施对于减轻该人群的 HBV 感染负担至关重要。
