By Liz Highleyman

In the U.S., the 2007 incidence of acute HBV and HCV infection were the lowest ever recorded (1.5 and 0.3 per 100,000 persons, respectively). But trends have not been so favorable for gay and bisexual men.

Men who have sex with men have long been included in the list of groups considered to be at elevated risk for hepatitis B -- and therefore a high priority for HBV vaccination efforts. The risk of hepatitis C in this population has been recognized more recently, as outbreaks of apparently sexually transmitted acute HCV infection have been reported among mostly HIV positive gay and bisexual men in several cities in Europe, Australia, and the U.S. starting around 2002.

Investigators with the Centers for Disease Control and Prevention (CDC) reported on cases of acute hepatitis B and C reported voluntarily to the CDC by state health departments for 2006-2007. Cases of acute HBV and HCV infection must meet clinical and laboratory diagnostic criteria to be included in the count of confirmed cases.

Results

	Of the 5660 cases of acute hepatitis B among men aged 15 or older reported in 2006-2007, 85% had no information about sexual orientation or practices.
	Of the 826 cases in which this information was available, 20% were MSM.
	A majority of cases (65%) among MSM and about half of cases (54%) among non-MSM were white men.
	Reported risk factors for acute HBV infection included:
	Injection drug use (8% of MSM and 18% of non-MSM); Multiple sex partners (63% and 39%, respectively); Sexual contact with an individual known to have HBV (10% vs 8%).
	Most men had at least 1 of these risk factors (65% of MSM and 47% or non-MSM).
	Of the 861 cases of acute hepatitis C among men aged 15 or older reported during the same period, 93% had no information on sexual sexual orientation or practices.
	Of the 62 cases where this information was available, 16% were MSM.
	For hepatitis C, larger majorities of cases among MSM (80%) and non-MSM (67%) were white men.
	Reported risk factors for acute HCV infection were:
	Injection drug use (63% of MSM and 39% of non-MSM); Multiple sex partners (75% and 43%; respectively); Sexual contact with an individual known to have HBV (0% vs 5%).
	Most men had at least 1 of these risk factors (90% of MSM and 60% of non-MSM).

"National surveillance for acute HBV and HCV infections in MSM is important to monitor trends in demographics and risk factors," the investigators stated. "Most MSM and non-MSM had at least one injection drug use or sexual risk factor indicating that screening and prevention interventions should be offered in health-care settings providing services to MSM or persons who inject drugs."

9/22/09

Reference
D Daniels, M Klevens, N Harris, and R Jiles. Acute Hepatitis B Virus (HBV) and C Virus (HCV) Among Men Who Have Sex with Men: Data from Population-Based Surveillance, 2006-2007 . 49th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC 2009). San Francisco. September 12-15, 2009. Abstract H-225.