title: High HIV prevalence in male patients with acute hepatitis A in the Rome metropolitan area, Italy 2002-2008.
abstract: OBJECTIVE
  Several outbreaks of hepatitis A affecting homosexual men have been reported in Europe. However, the prevalence of HIV infection in patients affected by hepatitis A has not been extensively studied and hepatitis A is not considered as an indicator disease for routine HIV testing.
  
  
  METHODS
  We retrospectively analyzed all adult cases of acute hepatitis A, reported by the National Institute of Infectious Disease "L. Spallanzani", Rome-Italy, in 2002-2008. Data on HIV infection were obtained by chart review and cross-linkage with laboratory. Information on exposure to risk factors were collected from the standard questionnaire of the Local Health Unit.
  
  
  RESULTS
  We analyzed a total of 473 cases of hepatitis A, 368 (77.2%) males that accounted for 75% of all reported cases in Rome, aged 25-64 years (same gender distribution). During the study period, we diagnosed a high proportion of cases among male individuals (78%). Among the male patients, HIV serology was available for 203/368 (55.2%). The overall HIV prevalence was 15.2% (56/368); it was significantly associated with same gender sex and was significantly higher than that observed among patients with hepatitis B (4.0%).
  
  
  CONCLUSIONS
  We found a high HIV prevalence, associated with same gender sex, among adult male patients diagnosed with hepatitis A in the period 2002-2008, except for 2006. Our data suggest that in a low incidence area for hepatitis A, with a constant high proportion of cases among male individuals, all individuals with acute hepatitis A should be routinely offered an HIV test.
authors.affiliation: National Institute for Infectious Diseases L. Spallanzani, Rome, Italy. enrico.girardi@inmi.it
authors.forename: Enrico
authors.initials: E
authors.lastname: Girardi
authors.forename: Paola
authors.initials: P
authors.lastname: Scognamiglio
authors.forename: Maria Rosaria
authors.initials: MR
authors.lastname: Sciarrone
authors.forename: Mariarosaria
authors.initials: M
authors.lastname: Loffredo
authors.forename: Claudio
authors.initials: C
authors.lastname: Gnesivo
authors.forename: Pasquale
authors.initials: P
authors.lastname: Noto
authors.forename: Giorgio
authors.initials: G
authors.lastname: Antonucci
authors.forename: Maria Rosaria
authors.initials: MR
authors.lastname: Capobianchi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Ippolito
mesh_terms: D000328:Adult; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology* / Q000635:transmission; D015528:HIV Seroprevalence; D006506:Hepatitis A / Q000150:complications*; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012309:Risk-Taking; D012384:Rome / Q000453:epidemiology