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


Ceylan M., Tol C., EMECEN A. N., Kaya A., Pullukcu H., Tasbakan M., ...Daha Fazla

MEDITERRANEAN JOURNAL OF INFECTION MICROBES AND ANTIMICROBIALS, cilt.14, 2025 (ESCI) identifier

Özet

Introduction: This study aimed to determine the hepatitis Aseroprevalence 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 anti-hepatitis A virus (HAV) imm & uuml;noglobulin 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.