<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1135-5727</journal-id>
<journal-title><![CDATA[Revista Española de Salud Pública]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. Esp. Salud Publica]]></abbrev-journal-title>
<issn>1135-5727</issn>
<publisher>
<publisher-name><![CDATA[Ministerio de Sanidad]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1135-57272018000100214</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Cambios en el patrón epidemiológico de la Hepatitis A en Andalucía: 2007-2017]]></article-title>
<article-title xml:lang="en"><![CDATA[Changes in Hepatitis A epidemiological pattern in Andalucía: 2007-2017]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Lorenzo Ortega]]></surname>
<given-names><![CDATA[Rocío]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
<xref ref-type="aff" rid="A a"/>
<xref ref-type="aff" rid="A3"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[O'Donnell Cortés]]></surname>
<given-names><![CDATA[Blanca]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ortiz González Serna]]></surname>
<given-names><![CDATA[Rocío]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gallardo García]]></surname>
<given-names><![CDATA[Virtudes]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[López Hernández]]></surname>
<given-names><![CDATA[Begoña]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Virgen de la Victoria Servicio de Medicina Preventiva ]]></institution>
<addr-line><![CDATA[Málaga ]]></addr-line>
<country>España</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Consejería de Salud. Junta de Andalucía Secretaría General de Salud Pública y Consumo Servicio de Vigilancia y Salud Laboral]]></institution>
<addr-line><![CDATA[Sevilla ]]></addr-line>
<country>España</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Universidad de Málaga Facultad de Medicina Departamento de Medicina Preventiva]]></institution>
<addr-line><![CDATA[Málaga ]]></addr-line>
<country>Spain</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Hospital Reina Sofía Servicio de Medicina Preventiva ]]></institution>
<addr-line><![CDATA[Córdoba ]]></addr-line>
<country>España</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2018</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2018</year>
</pub-date>
<volume>92</volume>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_arttext&amp;pid=S1135-57272018000100214&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_abstract&amp;pid=S1135-57272018000100214&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_pdf&amp;pid=S1135-57272018000100214&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Fundamentos: La trasmisión sexual de la hepatitis A (VHA) está documentada, principalmente en conductas de riesgo en hombres que tienen sexo con hombres (HSH). En los últimos años están apareciendo brotes de VHA en HSH en países de la Unión Europea. El objetivo del trabajo fue estudiar la epidemiología del VHA en Andalucía en los últimos 10 años (2007-2017) y la de los brotes ocurridos en HSH en dicho periodo.  Métodos: Estudio descriptivo retrospectivo de los casos de VHA declarados en el Sistema de Vigilancia Epidemiológica de Andalucía (SVEA) entre enero de 2007 y mayo de 2017. Se calculó la tasa de incidencia anual por 100.000 habitantes. Se estudió la distribución de los casos por grupo de edad y sexo. Se usó la razón hombre-mujer, como marcador indirecto de los HSH.  Resultados: La tasa de incidencia media anual en el periodo de estudio fue 4,09 casos por 100.000 habitantes, con una diferencia según sexo: 4,7 por 100.000 hombres y 2,53 por 100.000 mujeres. Aparecieron dos grandes brotes en este periodo: uno en 2008-2009 y otro en 2016-2017. Las características epidemiológicas de estos brotes difirieron del patrón clásico de la enfermedad, afectando a HSH jóvenes, colectivo que se asocia con conductas sexuales de riesgo.  Conclusiones: Los HSH tienen un papel fundamental en los brotes de VHA aparecidos recientemente. Para el control de la enfermedad debemos realizar una estrategia diferente, valorando la introducción de la vacunación sistemática.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Background: 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.  Methods: 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.  Results: 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.  Conclusions: 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.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Hepatitis A]]></kwd>
<kwd lng="es"><![CDATA[Epidemiología]]></kwd>
<kwd lng="es"><![CDATA[Salud Pública]]></kwd>
<kwd lng="es"><![CDATA[Brotes]]></kwd>
<kwd lng="es"><![CDATA[Vacuna]]></kwd>
<kwd lng="en"><![CDATA[Hepatitis A]]></kwd>
<kwd lng="en"><![CDATA[Epidemiology]]></kwd>
<kwd lng="en"><![CDATA[Public health]]></kwd>
<kwd lng="en"><![CDATA[Sexual behavior]]></kwd>
<kwd lng="en"><![CDATA[Outbreaks]]></kwd>
<kwd lng="en"><![CDATA[Hepatitis A vaccine]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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