Increasing hepatitis A IgG prevalence rate in men who have sex with men attending a sexual health clinic in London: implications for immunization policy.
The aims of this study were to audit an immunization policy to vaccinate men who have sex with men (MSM) attending a large London sexual health clinic, and to undertake an approximate cost analysis of different strategies, using the estimated prevalence rate of anti-hepatitis A virus (HAV) immunoglobulin G (IgG). A retrospective study of the seroprevalence of anti-HAV IgG among MSM was conducted for a 12-month period, involving 395 homosexual or bisexual men attending the genitourinary medicine clinic at St Mary's Hospital, London, for the first time. Overall seroprevalence of anti-HAV IgG in the 2004 population surveyed was 46.6% (140/300); 75.1% (300/395) were offered screening on their first visit and 49.9% (197/395) were offered vaccination. We concluded that anti-HAV IgG screening prior to vaccination of MSM in an area of relatively low prevalence of HAV is still the most cost-effective approach. The audit data also showed that in 2004 the British Association for Sexual Health and HIV targets for hepatitis A screening and vaccination were not reached. If a one-dose policy is seen to establish long-term immunity, then the cost of hepatitis A prevention will be drastically reduced.
O'Riordan
Mary
M
Department of Sexual Health, Jefferiss Wing, St Mary's Hospital, Paddington, London, UK. maryoriordan@doctors.net.uk
Goh
Leslie
L
Lamba
Harpal
H
D001727:Bisexuality; D006291:Health Policy; D006506:Hepatitis A / Q000453:epidemiology* / Q000517:prevention & control; D035922:Hepatitis A Antibodies / Q000097:blood*; D022362:Hepatitis A Vaccines / Q000008:administration & dosage; D006716:Homosexuality; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D008131:London / Q000453:epidemiology; D008297:Male; D012189:Retrospective Studies; D016036:Seroepidemiologic Studies; D014611:Vaccination / Q000191:economics
D035922:Hepatitis A Antibodies; D022362:Hepatitis A Vaccines; D007074:Immunoglobulin G