Sexual orientation and acquisition of sexually transmitted infections (STIs) are not significantly associated with the occurrence of hepatitis E virus (HEV) infection, according to a study published in Hepatology.1
Both hepatitis A virus (HAV) and HEV are transmitted fecal-orally and can be prevented with improvement in sanitation and personal hygiene and by vaccination.2 While oral-anal sexual contact has been documented as a transmission route of HAV among men who have sex with men (MSM), the possibility of sexual transmission of HEV is still controversial.3 Therefore, researchers investigated the possibility of sexual transmission and related morbidity of HEV infection among patients who are HIV positive during an outbreak of sexually transmitted HAV among MSM in Taiwan between 2015 and 2017.1 They found that the prevalence and incidence of HEV infection were 3.7% (123/3293) and 4.35 per 1000 person-years of follow-up, respectively, which was significantly lower compared with the prevalence and incidence of HAV infection (31.1% [996/3204] and 12.61 per 1000 person-years of follow-up, respectively). Thus, the number of patients with HEV infection did not increase with the hepatitis A epidemic. They did, however, find that the factor associated with prevalent HEV infection was older age, but neither sexual orientation nor acquisition of sexually transmitted infections was related to prevalence or incidence of HEV infection.
“In conclusion, the prevalence and incidence of HEV infection among the HIV-positive population remained low during the acute hepatitis A outbreak that predominately affected HIV-positive MSM in Taiwan. Sexual orientation and acquisition of STIs were not associated with HEV infection,” stated the authors.1
By Virginia Schad
1. Lin KY, Lin PH, Sun HY, et al. Hepatitis E virus infections among HIV-positive individuals during an outbreak of acute hepatitis A in Taiwan [published online May 17, 2019]. Hepatology. doi:10.1002/hep.30771
2. Global hepatitis report, 2017. World Health Organization website. http://apps.who.int/iris/bitstream/handle/10665/255016/9789241565455-eng.pdf?sequence=1. Accessed December 1, 2018.
3. Kamar N, Dalton HR, Abravanel F, Izopet J. Hepatitis E virus infection. Clin Microbiol Rev. 2014;27:116-138.