International Journal of STD & AIDS > Volume 18, Number 10 > Pp. 707-710

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Audit reports

Increasing hepatitis A IgG prevalence rate in men who have sex with men attending a sexual health clinic in London: implications for immunization policy

Mary O'Riordan, Leslie Goh and Harpal Lamba

Department of Sexual Health, Jefferiss Wing, St Mary's Hospital, Praed Street, Paddington, London W2 1NY, UK; Department of Sexual Health, Jefferiss Wing, St Mary's Hospital, Praed Street, Paddington, London W2 1NY, UK; Department of Sexual Health, Jefferiss Wing, St Mary's Hospital, Praed Street, Paddington, London W2 1NY, UK

The aims of this study were to audit an immunization policy to vaccinate men who have sex with men (MSM) attending a large London sexual health clinic, and to undertake an approximate cost analysis of different strategies, using the estimated prevalence rate of anti-hepatitis A virus (HAV) immunoglobulin G (IgG). A retrospective study of the seroprevalence of anti-HAV IgG among MSM was conducted for a 12-month period, involving 395 homosexual or bisexual men attending the genitourinary medicine clinic at St Mary's Hospital, London, for the first time. Overall seroprevalence of anti-HAV IgG in the 2004 population surveyed was 46.6% (140/300); 75.1% (300/395) were offered screening on their first visit and 49.9% (197/395) were offered vaccination. We concluded that anti-HAV IgG screening prior to vaccination of MSM in an area of relatively low prevalence of HAV is still the most cost-effective approach. The audit data also showed that in 2004 the British Association for Sexual Health and HIV targets for hepatitis A screening and vaccination were not reached. If a one-dose policy is seen to establish long-term immunity, then the cost of hepatitis A prevention will be drastically reduced.

Key Words: HEPATITIS A • VACCINATION POLICY • MEN WHO HAVE SEX WITH MEN • PREVALENCE • COST ANALYSIS

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