Prevalence of anti-hepatitis B core in men who have sex with men attending a sexual health clinic in Brighton, UK, from 2012 to 2019
Mahmoud Gouda A , Colin Fitzpatrick A , Deborah Williams A and Daniel Richardson
A B *
A Department of Sexual Health and HIV Medicine, University Hospitals Sussex, Brighton, BN2 5BE, UK.
B Brighton and Sussex Medical School, Brighton, UK.
Sexual Health 20(1) 92-95 https://doi.org/10.1071/SH22120
Submitted: 19 July 2022 Accepted: 28 October 2022 Published: 11 November 2022
© 2023 The Author(s) (or their employer(s)). Published by CSIRO Publishing
Abstract
Objective: Hepatitis B is sexually transmitted among men who have sex with men (MSM) and has previously been endemic in some populations of MSM. Presence of anti-hepatitis B core (anti-HBc) determines previous or ongoing infection. We aimed to establish the prevalence and associations of anti-HBc in our clinic population of MSM.
Method: A cross-sectional study of newly attending MSM to determine the prevalence and associations of testing positive for anti-HBc using our clinic database from 2012 to 2019. We used crude odds ratios to identify any associations.
Results: There were 3342/5842 (58%) newly attending MSM who were tested for anti-HBc between 2012 and 2019. Of the 3342 MSM tested for anti-HBc, the median age was 30 years (interquartile range 23–43), 442 (13%) were living with HIV, 10 (0.3%) were HBsAg positive, 62 (1.9%) had past/current hepatitis C, 401 (12%) had a positive syphilis enzyme immunoassay (EIA), 455 (14%) were diagnosed with either gonorrhoea or chlamydia and 1080 (32%) were non-UK born. A total of 331 (10%, 95% confidence interval (CI) = 8.9–11.0) tested positive for anti-HBc and the proportion testing positive reduced significantly throughout the study period (P < 0.004). Testing positive for anti-HBc was associated with age >30 years (OR = 8.2, 95% CI = 5.9–11.4, P < 0.0001), having past/current hepatitis C (odds ratio (OR) = 5.0, 95% CI = 3.0–8.6, P < 0.0001), having a positive syphilis EIA (OR = 5.9, 95% CI = 4.4–7.3, P < 0.0001) and being non-UK born (OR = 1.4, 95% CI = 1.1–1.8, P < 0.006). There were no associations with HIV status or having a diagnosis of gonorrhoea or chlamydia.
Conclusion: Although reducing, the prevalence of anti-HBc remains endemic in MSM locally and further efforts are needed to enhance hepatitis B prevention strategies.
Keywords: anti-HB core antibody, hepatitis B, HIV pre-exposure prophylaxis, men who have sex with men, prevention, sexually transmitted infection, vaccination, viral hepatitis.
References
[1] Busch K, Thimme R. Natural history of chronic hepatitis B virus infection. Med Microbiol Immunol 2015; 204 5–10.| Natural history of chronic hepatitis B virus infection.Crossref | GoogleScholarGoogle Scholar |
[2] Gamagedara N, Weerakoon AP, Zou H, Fehler G, Chen MY, Read TRH, et al. Cross-sectional study of hepatitis B immunity in MSM between 2002 and 2012. Sex Transm Infect 2014; 90 41–5.
| Cross-sectional study of hepatitis B immunity in MSM between 2002 and 2012.Crossref | GoogleScholarGoogle Scholar |
[3] Hahné SJM, Veldhuijzen IK, Wiessing L, Lim T-A, Salminen M, van de Laar M. Infection with hepatitis B and C virus in Europe: a systematic review of prevalence and cost-effectiveness of screening. BMC Infect Dis 2013; 13 181
| Infection with hepatitis B and C virus in Europe: a systematic review of prevalence and cost-effectiveness of screening.Crossref | GoogleScholarGoogle Scholar |
[4] Falla AM, Hofstraat SHI, Duffell E, Hahné SJM, Tavoschi L, Veldhuijzen IK. Hepatitis B/C in the countries of the EU/EEA: a systematic review of the prevalence among at-risk groups. BMC Infect Dis 2018; 18 79
| Hepatitis B/C in the countries of the EU/EEA: a systematic review of the prevalence among at-risk groups.Crossref | GoogleScholarGoogle Scholar |
[5] Urbanus AT, van Houdt R, van de Laar TJW, Coutinho RA. Viral hepatitis among men who have sex with men, epidemiology and public health consequences. Euro Surveill 2009; 14 19421
| Viral hepatitis among men who have sex with men, epidemiology and public health consequences.Crossref | GoogleScholarGoogle Scholar |
[6] Richardson D, Devlin J, Smith H, Parashar K, Fitzpatrick C, Williams D. Sexually transmitted co-infections in men who have sex with men diagnosed with primary or secondary syphilis. J Eur Acad Dermatol Venereol 2022; 36 e474–5.
| Sexually transmitted co-infections in men who have sex with men diagnosed with primary or secondary syphilis.Crossref | GoogleScholarGoogle Scholar |
[7] Clutterbuck D, Asboe D, Barber T, Emerson C, Field N, Gibson S, et al. 2016 United Kingdom national guideline on the sexual health care of men who have sex with men. Int J STD AIDS 2018; 956462417746897
| 2016 United Kingdom national guideline on the sexual health care of men who have sex with men.Crossref | GoogleScholarGoogle Scholar |
[8] McMillan A. The changing prevalence of hepatitis B virus infection among men who have sex with men who attended a sexually transmitted infections clinic in Edinburgh, Scotland between 1989 and 2003. Int J STD AIDS 2006; 17 539–42.
| The changing prevalence of hepatitis B virus infection among men who have sex with men who attended a sexually transmitted infections clinic in Edinburgh, Scotland between 1989 and 2003.Crossref | GoogleScholarGoogle Scholar |
[9] Jansen K, Thamm M, Bock C-T, Scheufele R, Kücherer C, Muenstermann D, et al. High Prevalence and high incidence of coinfection with hepatitis B, hepatitis C, and syphilis and low rate of effective vaccination against hepatitis B in HIV-positive men who have sex with men with known date of HIV seroconversion in Germany. PLoS ONE 2015; 10 e0142515
| High Prevalence and high incidence of coinfection with hepatitis B, hepatitis C, and syphilis and low rate of effective vaccination against hepatitis B in HIV-positive men who have sex with men with known date of HIV seroconversion in Germany.Crossref | GoogleScholarGoogle Scholar |
[10] Pitasi MA, Bingham TA, Sey EK, Smith AJ, Teshale EH. Hepatitis B virus (HBV) infection, immunity and susceptibility among men who have sex with men (MSM), Los Angeles County, USA. AIDS Behav 2014; 18 248–55.
| Hepatitis B virus (HBV) infection, immunity and susceptibility among men who have sex with men (MSM), Los Angeles County, USA.Crossref | GoogleScholarGoogle Scholar |
[11] Roche R, Simmons R, Logan L, Ledesma J, Sabin C, Ijaz S, et al. Prevalence of hepatitis B immunity and infection in home self-sampling HIV service users. Sex Transm Infect 2022; 98 286–92.
| Prevalence of hepatitis B immunity and infection in home self-sampling HIV service users.Crossref | GoogleScholarGoogle Scholar |
[12] Lama JR, Agurto HS, Guanira JV, Ganoza C, Casapia M, Ojeda N, et al. Hepatitis B infection and association with other sexually transmitted infections among men who have sex with men in Peru. Am J Trop Med Hyg 2010; 83 194–200.
| Hepatitis B infection and association with other sexually transmitted infections among men who have sex with men in Peru.Crossref | GoogleScholarGoogle Scholar |
[13] Oliveira MP, Matos MAD, Silva ÁMC, Lopes CLR, Teles SA, Matos MA, et al. Prevalence, risk behaviors, and virological characteristics of Hepatitis B virus infection in a group of men who have sex with men in Brazil: results from a respondent-driven sampling survey. PLoS ONE 2016; 11 e0160916
| Prevalence, risk behaviors, and virological characteristics of Hepatitis B virus infection in a group of men who have sex with men in Brazil: results from a respondent-driven sampling survey.Crossref | GoogleScholarGoogle Scholar |
[14] Wahome E, Ngetsa C, Mwambi J, Gelderblom HC, Manyonyi GO, Micheni M, et al. Hepatitis B virus incidence and risk factors among human immunodeficiency virus-1 negative men who have sex with men in Kenya. Open Forum Infect Dis 2017; 4 ofw253
| Hepatitis B virus incidence and risk factors among human immunodeficiency virus-1 negative men who have sex with men in Kenya.Crossref | GoogleScholarGoogle Scholar |
