Vaccine-preventable viral hepatitis in men living with HIV/AIDS - immunity and associated factors

People living with HIV/AIDS (PLWHA) have a higher risk of morbidity and mortality from acquiring infectious diseases, including those preventable by vaccination, such as hepatitis A and B. This study aimed to analyze the immunity of men living with HIV to hepatitis A and B, with emphasis on those in the MSM category, to identify the factors associated with this immunity.

This is a retrospective, analytical, observational study of cases of men living with HIV, as reported in the Notifiable Diseases Information System of the municipality of Ribeirão Preto, São Paulo, Brazil, between 2015 and 2020. Data were collected from different information systems in 2021 and 2022 using a REDCap platform form. Sociodemographic, clinical and vaccine-related data were collected. Descriptive analysis, assessment of associations, and logistic regression were performed.

The sample consisted of 538 men living with HIV, 55% of whom were immune to hepatitis B, with the highest proportion of reactive anti-HBs in the first collection of this test in the 20-29 age group (67.8%). Men living with HIV/AIDS with adequate vaccination status were 5.6 times more likely to have reactive anti-HBs (aOR: 5.65, 95% CI: 3.04-10.51; p = 0.000). In the assessment of immunity to hepatitis A, the highest proportions of individuals with non-reactive anti-HAV IgG were in the 13-19 year age group (20; 76.9%; p = < 0.001). In the multivariate analysis, men living with HIV/AIDS aged 40 and over were 19.6 times more likely (aOR: 19.68, 95% CI: 4.61-83.94; p = 0.000) to be immune to hepatitis A compared to men living with HIV/AIDS aged 13-19.

Our findings reinforce the importance of serological screening and ensuring the completion of vaccination schedules in all PLWHA, especially among those who are not immune.