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Revista Española de Salud Pública

On-line version ISSN 2173-9110Print version ISSN 1135-5727


LORENZO ORTEGA, Rocío et al. Changes in Hepatitis A epidemiological pattern in Andalucía: 2007-2017. Rev. Esp. Salud Publica [online]. 2018, vol.92, e201805016.  Epub May 09, 2018. ISSN 2173-9110.


Sexual transmission of hepatitis A (HAV) is documented, mainly by risk behaviors in men who have sex with men (MSM). There have been HAV outbreaks in MSM in countries of the European Union in the last years. The aim of this work was to study HAV epidemiology in Andalusia in the last 10 years (2007-2017) and the outbreaks among MSM in this period.


Retrospective descriptive study of HAV cases reported in the Andalusia Epidemiological Surveillance System between January 2007 and May 2017. We calculated the annual incidence rate per 100000 habitants. We studied case distribution for gender and age. We used the male-female ratio as an indirect marker for MSM.


The mean annual incidence rate in the study period was 4.09 cases per 100000 habitants, with a difference by sex: 4.7 per 100000 men and 2.53 per 100000 women. Two large outbreaks were detected in this period: one in 2008-2009 and another in 2016-2017. The epidemiological characteristics of these outbreaks differ from the classical pattern of the disease, affecting young MSM with associated sexual risk behaviors.


MSM play a fundamental role in recent outbreaks of HAV. For disease control we must carry out a different strategy, assessing the introduction of systematic vaccination.

Keywords : Hepatitis A; Epidemiology; Public health; Sexual behavior; Outbreaks; Hepatitis A vaccine.

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