Viral Hepatitis Among Men Who Have Sex with Men

Key points

  • Men who have sex with men (MSM) have a high prevalence of hepatitis B.
  • Despite the availability of a safe and effective vaccine, hepatitis A outbreaks among MSM have been reported frequently.
  • MSM who are 18 and older should be vaccinated against hepatitis A, tested for and vaccinated against hepatitis B, and tested for hepatitis C.
Two men hugging that are vaccinated against hepatitis A and hepatitis B

Risks

Hepatitis A virus (HAV), hepatitis B virus (HBV), and hepatitis C virus (HCV) can be spread through sexual activity. Viral hepatitis infection left untreated can damage the liver.

Infections are high among MSM, which puts this population at an increased risk to transmit the virus or become infected.

MSM and hepatitis A

HAV can be found in the blood or stool of a person who is infected. Transmission can happen when someone ingests even small amounts of the virus through close personal contact, sex with a person who is infected, or eating or drinking contaminated food or drink.

Person-to-person transmissions of hepatitis A have occurred across the United States and many are affecting gay and bisexual men. Hepatitis A outbreaks among MSM have been reported frequently despite the availability of a safe and effective vaccine.

MSM and hepatitis B

HBV can be found in blood, semen, and other bodily fluids. Transmission can happen when someone who does not have the virus is exposed to the bodily fluids of someone who is infected with the virus. This can occur while sharing needles or syringes to inject drugs or by having sex.

MSM and hepatitis C

HCV can be found in blood and semen. Transmission can happen when someone who does not have the virus is exposed to the bodily fluids of someone who is infected with the virus. This can occur while sharing needles or syringes to inject drugs or by having sex.

Preventing viral hepatitis

Due to the high prevalence of viral hepatitis in MSM and the ongoing risk for infection, MSM should be tested for hepatitis B and hepatitis C and vaccinated against hepatitis A and hepatitis B.

Hepatitis A

Since 1996, the Advisory Committee on Immunization Practices (ACIP) has recommended hepatitis A vaccination of MSM. Despite this longstanding recommendation, hepatitis A vaccination coverage among this population remains low, with vaccination coverage estimated at 25%–45% overall.

Keep Reading: Hepatitis A Vaccine Administration

Hepatitis B

CDC recommends hepatitis B screening for all adults. The screening tests include: hepatitis B surface antigen (HBsAg), antibody to hepatitis B surface antigen (anti-HBs), and antibody to hepatitis B core antigen (anti-HBc). Susceptible persons, regardless of age, with ongoing risk should be tested periodically while risk persists. MSM have an increased risk for acquiring HBV infection.

However, hepatitis B testing is not a requirement for vaccination, and in settings where testing is not feasible, vaccination should continue without testing. Serologic testing should not be a barrier to vaccination of susceptible persons, especially in populations where it is difficult to access screening or testing services.

Hepatitis B vaccination is the most effective means of preventing transmission among people at risk for infection. ACIP recommends hepatitis B vaccination among all adults aged 19–59 and adults 60 and older with risk factors. Adults aged 60 years and older without risk factors but seeking protection may be vaccinated. The first dose of hepatitis B vaccine should be administered during the same medical visit immediately after blood is collected for serologic testing.

Hepatitis A and hepatitis B vaccines can be given separately or as a combination vaccine using a recommended schedule.

Keep Reading: Hepatitis B Vaccine Information for Health Care Providers

Hepatitis C

There is no vaccine for hepatitis C, but curative treatment is available. CDC recommends one-time hepatitis C testing of all adults 18 and older and regular testing for people with risk factors. People with hepatitis C should immediately be treated with curative antiviral medications.

Resources for clinicians

These resources from CDC provide further guidance and information on hepatitis viruses and human immunodeficiency virus (HIV).

Scientific guidelines and recommendations

Health care provider resources

Resources for gay and bisexual men

Webpage

Posters

Download these posters and customize with information on hepatitis A and hepatitis B vaccination services offered by your organization.

Campaign One: Hepatitis A and Hepatitis B Vaccination, Younger Men

Campaign Two: Hepatitis A and Hepatitis B Vaccination, Mature Men

Digital tools

Download and share via websites, email signatures, social media, dating apps, and other forms of digital advertising.

Campaign One: Hepatitis A and Hepatitis B Vaccination, Younger Men

Campaign Two: Hepatitis A and Hepatitis B Vaccination, Mature Men

Hepatitis A outbreak resources

Fact Sheet for Gay and Bisexual Men on Risk Factors, Symptoms, and Prevention Against Hepatitis A

Posters for MSM Encouraging Hepatitis A Vaccination

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Content Source:
Division of Viral Hepatitis