It is a well-known fact that around 20 to 25% of new hepatitis B cases occur among men who have sexual intercourse with other men (MSM), whether they identify as gay or not. This excessive burden is related to several situations that require to be urgently addressed. Among the most important:
- The high viral load of HBV in semen among chronic carriers;
- The very poor efforts undertaken by health authorities, institutions and organizations to raise awareness about the existence and severity of the problem among MSM populations and groups (gay, bisexual, or self-identified as heterosexuals with sexual intercourse with other men);
- The possibility of frequent exposure can be associated to greater odds of acquiring HBV and of developing chronic infection and
- The insufficient commitment and resources allocated to facilitate access to HBV vaccination by MSM.
Background: Hepatitis B virus is shed in the semen of chronic surface antigen (HBsAg) carriers as DNA viral particles. Since HBV is a very infectious agent, exposure to this agent may result in an efficient transmission and further spreading of the infection. Although most people who have acquired the infection will clear the virus without any medical intervention, it is estimated that between 5 to 10% will progress to chronic infection. Chronic infection is associated to health conditions that vary in severity from long-term hepatitis to fulminant hepatic failure and/or hepatic cancer. The disproportionate toll of HBV infection MSM echoes the also disproportionate toll of the HIV epidemic among this population that encompasses diverse groups and subpopulations. Given that coinfection with HBV and HIV may result in complex situations with negative public health and clinical outcomes, efforts to promote primary prevention of infection with both agents, reduction of incidence of co-infections, and active detection of the presence of HIV and HBV are of paramount importance. Read more via Med Crave