Hepatitis B infection and vaccination coverage in men who have sex with men consulting a Danish venereal disease clinic

Abstract

Background: Vaccination guidelines from the Danish Health and Medicines Authority recommend vaccination of all men who have sex with men (MSM) against hepatitis B virus (HBV). The only existing data on HBV infection in Danish MSM stem from 1984: 58% of MSM attending venereal clinics in Copenhagen had a prior and 4% had a chronic HBV infection. The aim of this study was to provide up-to-date data on the prevalence of HBV infection and vaccination coverage among Danish MSM. Methods: At the venereal clinic at Aarhus University Hospital, 1525 consecutive patients received a questionnaire covering risk group and vaccination status; moreover, HBV serology was performed. Prevalence proportions of serological signs of vaccination, infection, etc. were stratified according to self-reported risk group and vaccination status. Results: In total, 141 patients were MSM. Among these, 14% (CI = 9–21%) were vaccinated, 7% (CI = 3–13%) had a prior infection and 1.4% (CI = 0.2–5%) were HBsAg positive. In patients recalling three doses of vaccination, 18% (CI = 11–26%) were anti-HBs negative and 0.8% (CI = 0.02–5%) were HBsAg positive. Similar data for other risk groups and the total clientele are presented. Conclusions: This study presents the first Scandinavian data on the prevalence of HBV infection and vaccination among MSM since the introduction of the vaccine. Danish health authorities should evaluate whether a carrier frequency of 1.4% and a vaccination coverage of 14% in MSM is acceptable or warrants intensified focus on vaccination. Prospective vaccination campaigns should consider prevaccination testing, since 18% of patients recalling three doses of vaccination were anti-HBs negative.

Keywords::

• Hepatitis B
• immunization
• prevalence
• homosexuals
• risk

Acknowledgments

The study was carried out in a collaboration between the following departments at Aarhus University Hospital: the venereal disease clinic at the Department of Dermatology, Department of Infectious Diseases and Department of Clinical Immunology. There was no external funding or other financial involvement. We wish to thank the management of all three departments for allocating time and resources to make this study possible.

Declaration of interest: Carsten Schade Larsen has received standard fees for lectures from Glaxo-Smith-Kline, SBL-Crucell Vaccines and Sanofi Pasteur MSD. The authors alone are responsible for the content and writing of the paper.