Rapid communication Open Access
Like 0


Since 2016, an increase in the number of hepatitis A cases affecting mainly men who have sex with men (MSM) has been reported in low endemic countries in Europe. We calculated the attack rate in Lyon, France, in populations considered at high-risk: HIV-infected MSM and HIV-negative MSM receiving HIV pre-exposure prophylaxis (PrEP). In these populations, high level of immunity did not prevent the outbreak, indicating that vaccination should be reinforced, particularly in younger individuals.


Article metrics loading...

Loading full text...

Full text loading...



  1. World Health Organization (WHO). Hepatitis A outbreaks mostly affecting men who have sex with men – European Region and the Americas. Geneva: WHO; 7 Jun 2017. Available from: http://www.who.int/csr/don/07-june-2017-hepatitis-a/en/
  2. Werber D, Michaelis K, Hausner M, Sissolak D, Wenzel J, Bitzegeio J, et al. Ongoing outbreaks of hepatitis A among men who have sex with men (MSM), Berlin, November 2016 to January 2017 - linked to other German cities and European countries. Euro Surveill. 2017;22(5):30457.  https://doi.org/10.2807/1560-7917.ES.2017.22.5.30457  PMID: 28183391 
  3. Beebeejaun K, Degala S, Balogun K, Simms I, Woodhall SC, Heinsbroek E, et al. Outbreak of hepatitis A associated with men who have sex with men (MSM), England, July 2016 to January 2017. Euro Surveill. 2017;22(5):30454.  https://doi.org/10.2807/1560-7917.ES.2017.22.5.30454  PMID: 28183392 
  4. Freidl GS, Sonder GJ, Bovée LP, Friesema IH, van Rijckevorsel GG, Ruijs WL, et al. Hepatitis A outbreak among men who have sex with men (MSM) predominantly linked with the EuroPride, the Netherlands, July 2016 to February 2017. Euro Surveill. 2017;22(8):30468.  https://doi.org/10.2807/1560-7917.ES.2017.22.8.30468  PMID: 28251892 
  5. Sante publique France. Epidémie d'hépatite A en France et en Europe - Point de situation au 11 septembre 2017. [Hepatitis A outbreak in France and in Europe – Situation as at 11 September 2017]. Paris: Sante publique France. [Accessed 27 Sep 2017]. French. Available from: http://invs.santepubliquefrance.fr/Dossiers-thematiques/Maladies-infectieuses/Hepatites-virales/Hepatite-A/Points-d-actualite/Epidemie-d-hepatite-A-en-France-et-en-Europe-Point-de-situation-au-11-septembre-2017
  6. Schwarz NG, Revillion M, Roque-Afonso AM, Dussaix E, Giraud M, Liberpre C, et al. A food-borne outbreak of hepatitis A virus (HAV) infection in a secondary school in Upper Normandy, France, in November 2006. Euro Surveill. 2008;13(22):18885. PMID: 18761959 
  7. Carrillo-Santisteve P, Tavoschi L, Severi E, Bonfigli S, Edelstein M, Byström E, et al. ECDC HAV Expert Panel. Seroprevalence and susceptibility to hepatitis A in the European Union and European Economic Area: a systematic review. Lancet Infect Dis. 2017;17(10):e306-19.  https://doi.org/10.1016/S1473-3099(17)30392-4  PMID: 28645862 
  8. Spada E, Genovese D, Tosti ME, Mariano A, Cuccuini M, Proietti L, et al. An outbreak of hepatitis A virus infection with a high case-fatality rate among injecting drug users. J Hepatol. 2005;43(6):958-64.  https://doi.org/10.1016/j.jhep.2005.06.012  PMID: 16143420 
  9. Morlat P, editor. Prise en charge médicale des personnes vivants avec le VIH. Recommandations du groupe d’experts. Actualisation 2017. [Medical management of people living with HIV. Recommendations from the group of experts. 2017 update]. Paris: la Documentation Française; 2017. [Accessed 24 Nov 2017]. French. Available from: https://cns.sante.fr//wp-content/uploads/2017/07/experts-vih co-infections.pdf
  10. Lepoutre A, Antona D, Fonteneau L, Halftermeyer-Zhou F, Baudon C, Dorléans F, et al. Séroprévalence des maladies à prévention vaccinale et de cinq autres maladies infectieuses en France. Résultats de deux enquêtes nationales 2008-2010. [Seroprevalence of vaccine-preventable diseases and five other infectious diseases in France. Results of two national surveys 2008-2010]. Bull Epidemiol Hebd (Paris). 2013; (41-42):526-34. French.
  11. Molina J-M, Capitant C, Spire B, Pialoux G, Cotte L, Charreau I, et al. ANRS IPERGAY Study Group. On-Demand Preexposure Prophylaxis in Men at High Risk for HIV-1 Infection. N Engl J Med. 2015;373(23):2237-46.  https://doi.org/10.1056/NEJMoa1506273  PMID: 26624850 
  12. Velter A, Sauvage C, Saboni L, Sommen C, Alexandre A, Lydié N, et al. Estimation de la prévalence du VIH chez les hommes ayant des relations sexuelles avec des hommes fréquentant les lieux de convivialité gay de cinq villes françaises – PREVAGAY 2015. [HIV prevalence estimate among men who have sex with men attending gay venues in five French cities – PREVAGAY 2015]. Bull Epidemiol Hebd (Paris). 2017; (18):347-54. French. Available from: http://invs.santepubliquefrance.fr/beh/2017/18/2017_18_1.html
  13. Phung B-C, Launay O. Vaccination against viral hepatitis of HIV-1 infected patients. Hum Vaccin Immunother. 2012;8(5):554-9.  https://doi.org/10.4161/hv.19105  PMID: 22634451 
  14. Ali H, Regan DG, Guy RJ, Robertson P, Watchirs-Smith L, McNulty AM, et al. Increasing hepatitis A immunity in men who have sex with men in Sydney, 1996-2012. Vaccine. 2015;33(38):4745-7.  https://doi.org/10.1016/j.vaccine.2015.01.090  PMID: 25720793 

Data & Media loading...

Submit comment
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error