Hepatitis B infection and vaccination coverage in men who have sex with men consulting a Danish venereal disease clinic

Infect Dis (Lond). 2015 Aug;47(8):517-22. doi: 10.3109/23744235.2015.1026932. Epub 2015 Apr 1.

Abstract

Background: Vaccination guidelines from the Danish Health and Medicines Authority recommend vaccination of all men who have sex with men (MSM) against hepatitis B virus (HBV). The only existing data on HBV infection in Danish MSM stem from 1984: 58% of MSM attending venereal clinics in Copenhagen had a prior and 4% had a chronic HBV infection. The aim of this study was to provide up-to-date data on the prevalence of HBV infection and vaccination coverage among Danish MSM.

Methods: At the venereal clinic at Aarhus University Hospital, 1525 consecutive patients received a questionnaire covering risk group and vaccination status; moreover, HBV serology was performed. Prevalence proportions of serological signs of vaccination, infection, etc. were stratified according to self-reported risk group and vaccination status.

Results: In total, 141 patients were MSM. Among these, 14% (CI = 9-21%) were vaccinated, 7% (CI = 3-13%) had a prior infection and 1.4% (CI = 0.2-5%) were HBsAg positive. In patients recalling three doses of vaccination, 18% (CI = 11-26%) were anti-HBs negative and 0.8% (CI = 0.02-5%) were HBsAg positive. Similar data for other risk groups and the total clientele are presented.

Conclusions: This study presents the first Scandinavian data on the prevalence of HBV infection and vaccination among MSM since the introduction of the vaccine. Danish health authorities should evaluate whether a carrier frequency of 1.4% and a vaccination coverage of 14% in MSM is acceptable or warrants intensified focus on vaccination. Prospective vaccination campaigns should consider prevaccination testing, since 18% of patients recalling three doses of vaccination were anti-HBs negative.

Keywords: Hepatitis B; homosexuals; immunization; prevalence; risk.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Ambulatory Care / statistics & numerical data*
  • Denmark / epidemiology
  • Hepatitis B / epidemiology*
  • Hepatitis B / prevention & control
  • Hepatitis B Antibodies / blood
  • Hepatitis B Antibodies / immunology
  • Hepatitis B Vaccines*
  • Homeodomain Proteins
  • Homosexuality, Male*
  • Humans
  • Male
  • Middle Aged
  • Prevalence
  • Prospective Studies
  • Risk Factors
  • Serologic Tests
  • Sexually Transmitted Diseases / prevention & control
  • Surveys and Questionnaires
  • Vaccination / statistics & numerical data*
  • Young Adult

Substances

  • Hepatitis B Antibodies
  • Hepatitis B Vaccines
  • Homeodomain Proteins
  • RAG-1 protein