An outbreak of acute hepatitis A among young adult men: clinical features and HIV coinfection rate from a large teaching hospital in Rome, Italy. Issue 6 (29th January 2018)

• Record Type: Journal Article
• Authors: Ciccullo, A; Gagliardini, R; Baldin, G; Borghetti, A; Moschese, D; Emiliozzi, A; Lombardi, F; Ricci, R; Speziale, D; Pallavicini, F; Di Giambenedetto, S
• Is Part Of: HIV medicine. Volume 19:Issue 6(2018)
• Page Start: 369
• Page End: 375
• Publication Date: 2018-01-29
• Subjects: hepatitis A -- HIV -- men who have sex with men -- outbreak; HIV infections -- Treatment -- Periodicals; HIV-positive persons -- Periodicals; HIV infections -- Treatment -- Decision making -- Periodicals; 616.9792
• DOI: 10.1111/hiv.12597
• Languages: English
• ISSNs: 1464-2662

Abstract

Abstract : Objectives: Italy is a low‐incidence region for hepatitis A; however, during the last 2 years an increase in the incidence of hepatitis A virus (HAV) infection was reported in Europe. The aim of this study was to describe this recent outbreak. Methods: We retrospectively analysed all cases of acute hepatitis A diagnosed at our laboratory between January 2010 and June 2017. We evaluated the following variables at the time of diagnosis: sex, age, nationality, glutamic oxaloacetic transaminase (GOT/AST), glutamic pyruvic transaminase (GPT/ALT), bilirubin concentration, international normalized ratio (INR) and the presence or absence of anti‐HIV‐1/2 antibodies. Hospitalization was also considered. We analysed these parameters using the χ 2 test and Mann–Whitney U ‐test. Results: A total of 225 cases were analysed; 82.7% were in male patients, 94.2% were in Italians and the median age of the patients was 36.4 years. At diagnosis, the median GOT value was 306 U/L, the median GPT was 1389 U/L, and the median total bilirubin value was 5.88 mg/dL. Hospitalization was required for 142 patients, with a median duration of hospital stay of 8.5 days. In 2016‐2017 we registered 141 cases, with a higher prevalence of male patients, higher GPT values and a higher prevalence of patients aged 20‐39 years compared with older (2010‐2015) cases. Homosexual intercourse was reported as the HAV risk factor in 70.2% of patients. HIV serology was available for 120 patients: 24 were HIV‐positive, four of whom represented new diagnoses. HIV‐positive patients showed lower bilirubin and GPT values and fewer hospitalizations than HIV‐negative patients. Conclusions: In 2016–2017, we saw a rise in the number of hepatitis A cases, with a higher prevalence of adult male patients. No significant differences regarding the prevalence of HIV coinfection emerged.