Acute Hepatitis A Outbreak Among Men Who Have Sex With Men in KrakowPoland; February 2017–February 2018

摘要

Since February 2017 in Poland, an increasing number of acute hepatitis A (AHA)cases have been reported; a noteworthy increase to 3,072 cases of AHA in 2017compared to 35 cases in 2016 was reported by the National Institute of PublicHealth (NIPH). The aim of this study was to evaluate the demographic features,clinical manifestations, laboratory results, and sexually transmittedcoinfections. All cases of AHA diagnosed between February 2017 and February 2018at the University Hospital in Krakow were analyzed. A total of 119 cases ofhepatitis A virus (HAV) were reported; 105 (88%) were males and 14 (12%) werefemales, with a mean age 31 years (range 19–62). In 84 patients (71%), the HAVwas transmitted by oral–anal sexual contact between men. Six women were infectedby close house contact with men infected with HAV. The route of transmission wasnot identified for 29 cases, and 88 patients (74%) required hospitalization.Among the cases, the following coinfections were already diagnosed: HIV 36patients (30%), chronic hepatitis C virus (HCV) 4 patients (3%), and chronichepatitis B virus (HBV) 2 patients (1.5%). During AHA diagnosis, some newsexually transmitted infections (STIs) were detected; syphilis eight patients(6.7%), HIV/syphilis seven patients (6%), HIV//HCV/syphilis one patient, andacute retroviral syndrome/ one patient.Overall, AHA outbreak in Poland in 2017 affected primarily men who have sex withmen (MSM) and was connected with oral–anal sexual contacts, and the majority ofpatients did not have HAV vaccination. These results show a clear need forroutinely offering HAV vaccination to at-risk populations and that awarenessamong health-care workers about HAV sexual transmission may help introduceprevention methods.