Evolution of hepatitis A virus seroprevalence among HIV-positive adults in Taiwan

• Published in: PloS one Vol. 12; no. 10; p. e0186338
• Main Authors: Lee, Yu-Lin, Lin, Kuan-Yin, Cheng, Chien-Yu, Li, Chia-Wen, Yang, Chia-Jui, Tsai, Mao-Song, Tang, Hung-Jen, Lin, Te-Yu, Wang, Ning-Chi, Lee, Yi-Chien, Lin, Shih-Ping, Huang, Yu-Shan, Sun, Hsin-Yun, Zhang, Jun-Yu, Ko, Wen-Chien, Cheng, Shu-Hsing, Lee, Yuan-Ti, Liu, Chun-Eng, Hung, Chien-Ching
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 16.10.2017; Public Library of Science (PLoS)
• Subjects: Adolescent; Adult; Adults; Age; Age Factors; Analysis; Anti-HIV Agents - therapeutic use; Antiretroviral agents; Antiretroviral therapy; Biology and life sciences; Children; Confidence intervals; Disease susceptibility; Epidemiology; Evolution; Female; Food contamination & poisoning; Gays & lesbians; Health aspects; Hepatitis; Hepatitis A; Hepatitis A - prevention & control; Hepatitis A Antibodies - blood; Hepatitis A Vaccines - administration & dosage; Hepatitis A virus; Hepatitis A virus - immunology; Hepatitis B; Hepatitis B virus; Hepatovirus; HIV; HIV Infections - blood; HIV Infections - drug therapy; HIV Infections - epidemiology; HIV Infections - immunology; HIV patients; Hospitals; Human immunodeficiency virus; Humans; Independent variables; Infections; Infectious diseases; Internal medicine; Logistic Models; Male; Medicine; Medicine and health sciences; Mens health; Middle Aged; Multivariate Analysis; Patients; People and Places; Public health; Regression models; Retrospective Studies; Risk factors; Seroepidemiologic Studies; Seroepidemiology; Statistical analysis; Taiwan - epidemiology; Vaccination; Vaccines; Viruses; Young Adult; Young adults; Taiwan
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0186338

The study aimed to describe the seroprevalence of hepatitis A virus (HAV) in HIV-positive adult patients in Taiwan between 2012 and 2016 and to examine the evolution of HAV seroprevalence between 2004-2007 and 2012-2016. Clinical information and data of anti-HAV antibody results were collected from 2,860 antiretroviral-naïve HIV-positive Taiwanese aged 18 years or older who initiated combination antiretroviral therapy at 11 hospitals around Taiwan between 2012 and 2016 (2012-2016 cohort). A multivariate logistic regression model was applied to identify independent variables associated with HAV seropositivity. Comparisons of HAV seroprevalences and associated clinical characteristics were made between this 2012-2016 cohort and a previous cohort of 1580 HIV-positive patients in 2004-2007 (2004-2007 cohort). Of the 2,860 HIV-positive patients between 2012 and 2016, the overall HAV seropositivity rate was 21.2% (605/2860), which was independently associated with an older age (adjusted odds ratio [AOR], per 1-year increase, 1.13; 95% confidence interval [95% CI], 1.11-1.15) and co-infection with hepatitis B virus (AOR 1.44; 95% CI, 1.08-1.93). Residence in southern Taiwan (AOR 0.49; 95% CI, 0.34-0.72) was inversely associated with HAV seropositivity. The overall HAV seroprevalence in the 2012-2016 cohort was significantly lower than that in the 2004-2007 cohort (21.2% vs 60.9%, p<0.01). The decreases of HAV seropositivity rate were observed in nearly every age-matched group, which suggested the cohort effect on HAV seroepidemiology. However, among individuals aged 25 years or younger, the HAV seropositivity rate increased from 3.8% (2/52) in the 2004-2007 cohort to 8.5% (50/587) in the 2012-2016 cohort, with 95.4% (560/587) being MSM in this age group of the latter cohort. HAV seroprevalence has decreased with time among HIV-positive adults in Taiwan. The cohort effect has increased the number of young HIV-positive patients that are susceptible to HAV infection in a country without nationwide childhood vaccination program against HAV.