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Review
. 2017 May 28;23(20):3589-3606.
doi: 10.3748/wjg.v23.i20.3589.

Hepatitis A virus infection and hepatitis A vaccination in human immunodeficiency virus-positive patients: A review

Kuan-Yin Lin  1 , Guan-Jhou Chen  1 , Yu-Lin Lee  1 , Yi-Chia Huang  1 , Aristine Cheng  1 , Hsin-Yun Sun  1 , Sui-Yuan Chang  1 , Chun-Eng Liu  1 , Chien-Ching Hung  1
Affiliations
Review

Hepatitis A virus infection and hepatitis A vaccination in human immunodeficiency virus-positive patients: A review

Kuan-Yin Lin et al. World J Gastroenterol. .

Abstract

Hepatitis A virus (HAV) is one of the most common infectious etiologies of acute hepatitis worldwide. The virus is known to be transmitted fecal-orally, resulting in symptoms ranging from asymptomatic infection to fulminant hepatitis. HAV can also be transmitted through oral-anal sex. Residents from regions of low endemicity for HAV infection often remain susceptible in their adulthood. Therefore, clustered HAV infections or outbreaks of acute hepatitis A among men who have sex with men and injecting drug users have been reported in countries of low endemicity for HAV infection. The duration of HAV viremia and stool shedding of HAV may be longer in human immunodeficiency virus (HIV)-positive individuals compared to HIV-negative individuals with acute hepatitis A. Current guidelines recommend HAV vaccination for individuals with increased risks of exposure to HAV (such as from injecting drug use, oral-anal sex, travel to or residence in endemic areas, frequent clotting factor or blood transfusions) or with increased risks of fulminant disease (such as those with chronic hepatitis). The seroconversion rates following the recommended standard adult dosing schedule (2 doses of HAVRIX 1440 U or VAQTA 50 U administered 6-12 mo apart) are lower among HIV-positive individuals compared to HIV-negative individuals. While the response rates may be augmented by adding a booster dose at week 4 sandwiched between the first dose and the 6-mo dose, the need of booster vaccination remain less clear among HIV-positive individuals who have lost anti-HAV antibodies.

Keywords: Acute hepatitis; Epidemiology; Fecal-oral transmission; Immunization; Immunosuppression; Injecting drug use; Men who have sex with men; Oral-anal sex; Viral hepatitis.

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Conflict of interest statement

Conflict-of-interest statement: Chien-Ching Hung has received research support from Janssen, Abbvie, Bristol-Myers Squibb, Merck, and ViiV and speaker honoraria from Gilead Sciences, and served on the advisory boards for Gilead Sciences, ViiV, Abbvie, and Janssen. Other authors report no potential conflict of interest.

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References

    1. Havelaar AH, Kirk MD, Torgerson PR, Gibb HJ, Hald T, Lake RJ, Praet N, Bellinger DC, de Silva NR, Gargouri N, et al. World Health Organization global estimates and regional comparisons of the burden of foodborne disease in 2010. PLoS Med. 2015;12:e1001923. - PMC - PubMed
    1. Aggarwal R, Goel A. Hepatitis A: epidemiology in resource-poor countries. Curr Opin Infect Dis. 2015;28:488–496. - PubMed
    1. Jacobsen KH, Wiersma ST. Hepatitis A virus seroprevalence by age and world region, 1990 and 2005. Vaccine. 2010;28:6653–6657. - PubMed
    1. Nelson NP, Murphy TV. Hepatitis A: The changing epidemiology of hepatitis A. Clin Liver Dis (Hoboken) 2013;2:227–230. - PMC - PubMed
    1. Mena G, García-Basteiro AL, Bayas JM. Hepatitis B and A vaccination in HIV-infected adults: A review. Hum Vaccin Immunother. 2015;11:2582–2598. - PMC - PubMed

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