engleski

Hepatitis A virus epidemics among men who have sex with men in Zagreb region, Croatia, 2017

Background: In the period between 1 June 2016 and 27 September 2017, 20 EU/EEA countries reported 2’873 outbreak-confirmed cases of hepatitis A (HAV) to the ECDC. The majority of infected persons were males, particularly men who have sex with men (MSM) infected with three outbreak strains (VRD_521_2016, RIVM-HAV16-090 and V16- 25801). The aim of this study was to describe the ongoing hepatitis A outbreak in Croatian capital Zagreb including the patient's clinical and laboratory characteristics as well as HAV typing results. Materials/methods: In 2017, 25 acute HAV cases were reported in Croatia, among whom 14 received clinical care at the University Hospital for Infectious Diseases (UHID), Zagreb, and these were included in the present study. Demographic, clinical and laboratory data were extracted from the UHID clinical database. HAV typing was performed by sequencing VP1-2a region, according to the HAVNET protocol. Results: Patients were predominantly male (10/14) with a mean age of 40.6±9.9 years. A total of 10 patients were hospitalized for a mean of 13.6±9.6 days. Nine patients self-reported to be MSM and 5 of them have been previously diagnosed with HIV infection (4/5 were receiving antiretroviral therapy at the time of HAV diagnosis). Episodes of sexually- transmitted infections have been registered in 4 MSM (4 cases of syphilis, 2 acute hepatitis B, 1 human papillomavirus infection and 1 genital herpes). One patient had concomitant syphilis during acute HAV. Six of 14 patients had been vaccinated previously against hepatitis B but none against HAV. Two patients traveled abroad recently (<2 months), one to UK, and another to Barcelona, Spain. One patient presented with severe hepatitis but subsequently all patients recovered. HAV RNA was detected in blood of 9/14 patients. HAV typing was successful in 7/9 viremic patients and the presence of VRD_521_2016 outbreak strain (London, associated with travelling to Spain) was detected in all 7 patients. Conclusions: Recent outbreak of HAV in Croatia mainly affected MSM. Major identified strain was VRD_521_2016, one of three HAV strains which caused recent epidemics among MSMs in several EU/EEA countries. Our results suggest the need for an urgent HAV vaccination campaign among MSM in Croatia.

Hepatitis A ; epidemic ; MSM

nije evidentirano