Hepatitis A Screening and Vaccination Among People Living with HIV: When is the Ideal Time?
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RESEARCH ARTICLE
VOLUME: ISSUE:
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Hepatitis A Screening and Vaccination Among People Living with HIV: When is the Ideal Time?

1. Ege University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, İzmir, Turkiye
2. Dokuz Eylul University Faculty of Medicine, Department of Public Health, Epidemiology Subsection, İzmir, Turkiye
3. Ege University HIV/AIDS Research and IPractice Center, İzmir, Turkiye
No information available.
No information available
Received Date: 22.04.2025
Accepted Date: 28.05.2025
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Abstract

Introduction

This study aimed to determine the hepatitis A seroprevalence and vaccination status among [people living with Human Immunodeficiency Virus (HIV) (PLWH)], assess serologic responses to vaccination, and identify age groups for which hepatitis A vaccination is recommended.

Materials and Methods

This research was conducted between January 2019 and 2024, comparing groups with positive and negative antihepatitis A virus (HAV) immunoglobulin G (IgG) antibodies based on age and sex. A receiver operating characteristic (ROC) analysis was performed to identify the optimal age cutoff for predicting anti-HAV IgG positivity. Anti-HAV IgG serology was screened at least 1 month after the second vaccine dose to evaluate antibody formation.

Results

Of the 1,140 participants, 61.5% tested positive for anti-HAV IgG at baseline. Those with positive results exhibited significantly higher mean age (44.6}11.6 years) than those with negative results (33.7}8.6 years; p<0.001). Seropositivity was significantly higher among women (75.0%, n=87/702; p=0.002) and individuals >40 years of age (83.3%, p<0.001). The ROC analysis identified 40 years as the optimal age cutoff, with an area under the curve of 0.78 (95% confidence interval, 0.75 0.81), a sensitivity of 61.6%, and a specificity of 80.1%. Of the seronegative individuals, 86.1% received two vaccine doses; of the 268 with follow-up anti-HAV IgG serology, 86.1% had seroconverted and the results of 109 patients are still awaited.

Conclusion

Examining individuals living with HIV for hepatitis A antibodies at their initial hospital admission is critical so that those with seronegativity can be vaccinated with two doses of hepatitis A. Vaccination can be administered to those <40 years of age without prior serological testing. These findings provide valuable insights for developing hepatitis A vaccination policies and monitoring strategies for PLWH.

Keywords:
HIV, HAV, vaccination, prophylaxis