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An outbreak of acute hepatitis A among young adult men: clinical features and HIV coinfection rate from a large teaching hospital in Rome, Italy
Author(s) -
Ciccullo A,
Gagliardini R,
Baldin G,
Borghetti A,
Moschese D,
Emiliozzi A,
Lombardi F,
Ricci R,
Speziale D,
Pallavicini F,
Di Giambenedetto S
Publication year - 2018
Publication title -
hiv medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.53
H-Index - 79
eISSN - 1468-1293
pISSN - 1464-2662
DOI - 10.1111/hiv.12597
Subject(s) - medicine , incidence (geometry) , coinfection , serology , outbreak , hepatitis , gastroenterology , pediatrics , human immunodeficiency virus (hiv) , immunology , virology , antibody , physics , optics
Objectives Italy is a low‐incidence region for hepatitis A; however, during the last 2 years an increase in the incidence of hepatitis A virus ( HAV ) infection was reported in Europe. The aim of this study was to describe this recent outbreak. Methods We retrospectively analysed all cases of acute hepatitis A diagnosed at our laboratory between January 2010 and June 2017. We evaluated the following variables at the time of diagnosis: sex, age, nationality, glutamic oxaloacetic transaminase (GOT/AST), glutamic pyruvic transaminase (GPT/ALT), bilirubin concentration, international normalized ratio ( INR ) and the presence or absence of anti‐ HIV ‐1/2 antibodies. Hospitalization was also considered. We analysed these parameters using the χ 2 test and Mann–Whitney U ‐test. Results A total of 225 cases were analysed; 82.7% were in male patients, 94.2% were in Italians and the median age of the patients was 36.4 years. At diagnosis, the median GOT value was 306 U/L, the median GPT was 1389 U/L, and the median total bilirubin value was 5.88 mg/dL. Hospitalization was required for 142 patients, with a median duration of hospital stay of 8.5 days. In 2016‐2017 we registered 141 cases, with a higher prevalence of male patients, higher GPT values and a higher prevalence of patients aged 20‐39 years compared with older (2010‐2015) cases. Homosexual intercourse was reported as the HAV risk factor in 70.2% of patients. HIV serology was available for 120 patients: 24 were HIV ‐positive, four of whom represented new diagnoses. HIV ‐positive patients showed lower bilirubin and GPT values and fewer hospitalizations than HIV ‐negative patients. Conclusions In 2016–2017, we saw a rise in the number of hepatitis A cases, with a higher prevalence of adult male patients. No significant differences regarding the prevalence of HIV coinfection emerged.