Seroprevalence and associated factors of hepatitis A IgG antibody among HIV-positive people in Tehran, Iran

Abstract

Introduction: Hepatitis A is an acute viral infection involving hepatocytes, and it is transmitted through fecal-oral contacts. There is no difference between symptoms of hepatitis A in HIV-positive and HIV-negative people, but the duration of hepatitis A virus (HAV) viremia and stool shedding may be longer in HIV-positive patients. Also, HIV viral load could increase in co-infection with HAV. Therefore, HAV vaccination is suggested for people who are at higher risk of HIV infection in non-endemic countries. We aim to estimate the seroprevalence of anti-HAV IgG in Iranian HIV-positive population to evaluate the need for vaccination in this group. Material and methods: A cross-sectional study was conducted with 72 HIV-positive people who referred to a voluntary counseling and testing center in a referral hospital during 2019-2020. Participants answered a questionnaire about their demographic data, history of drug use, and HIV risk behaviors. Blood for anti-HAV IgG was tested, and last laboratory results of CD4+ count, HIV viral load, and hepatitis B and C panels from electronic medical records were collected. Results: The seroprevalence of anti-HAV IgG was 82.6%, and independently associated with older age and being married. The participants older than 45 years had significantly higher seropositivity among all age groups (89.7%). Conclusions: Hepatitis A is an endemic viral infection among the Iranian population. Therefore, HAV vaccination does not seem necessary at present. However, we suggest further studies on hepatitis A panel to re-evaluate the need for HAV vaccination in HIV-positive people in the future. We recommend HAV vaccination for travelers from non-endemic countries to Iran.