Volume 83, Issue 1
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



To assess the epidemiology of hepatitis B virus (HBV) infection among men who have sex with men (MSM) in Peru, we evaluated the prevalence and associated risk factors for HBV serologic markers among participants of a HIV sentinel surveillance conducted in 2002–2003. The standardized prevalences for total antibodies to hepatitis B core antigen (anti-HBc) and hepatitis B surface antigen (HBsAg) were 20.2% and 2.8%, respectively. Individuals with human immunodeficiency virus (HIV-1) infection had significantly higher anti-HBc (44.3% versus 19.3%) and HBsAg (9.5% versus 2.3%) prevalences than uninfected men. Increasing age (adjusted odds ratio [AOR] = 1.06), versatile sexual role (AOR = 1.59), sex in exchange for money/gifts (AOR = 1.58), syphilis (AOR = 1.74), HIV-1 infection (AOR = 1.64), and herpes simplex virus type 2 (HSV-2, AOR = 2.77) infection were independently associated with anti-HBc positivity, whereas only HIV-1 infection (AOR = 3.51) and generalized lymph node enlargement (AOR = 3.72) were associated with HBsAg positivity. Pre-existing HBV infection is very common among Peruvian MSM and was correlated with sexual risk factors. MSM in Peru constitute a target population for further HBV preventive and treatment interventions.


Article metrics loading...

Loading full text...

Full text loading...



  1. Shepard CW, Simard EP, Finelli L, Fiore AE, Bell PB, , 2006. Hepatitis B virus infection: epidemiology and vaccination. Epidemiol Rev 28: 112125.[Crossref]
  2. World Health Organization, 2002. Hepatitis B. Geneva: World Health Organization.
  3. Echevarria JM, Leon P, , 2003. Epidemiology of viruses causing chronic hepatitis among populations from the Amazon Basin and related ecosystems. Cad Saude Publica 19: 15831591.[Crossref]
  4. Casey JL, Niro GA, Engle RE, Vega A, Gomez H, McCarthy M, Watts DM, Hyams KC, Gerin JL, , 1996. Hepatitis B virus (HBV)/hepatitis D virus (HDV) coinfection in outbreaks of acute hepatitis in the Peruvian Amazon basin: the roles of HDV genotype III and HBV genotype F. J Infect Dis 174: 920926.[Crossref]
  5. Cabezas C, Gotuzzo E, Escamilla J, Phillips I, , 1994. Prevalence of serological markers of viral hepatitis A, B and delta in apparently healthy schoolchildren of Huanta, Peru. Rev Gastroenterol Peru 14: 123134.
  6. Farfan G, Cabezas C, , 2002. Mortality due to digestive and hepatobiliary diseases in Peru, 1995–2000. Rev Gastroenterol Peru 22: 310323.
  7. Ruiz E, Almonte MM, Pizarro R, Celis J, Montalbelti JA, Urbano R, , 1998. Hepatitis B and C virus infection as risk factors for hepatocarcinoma in Peru: case and control study. Rev Gastroenterol Peru 18: 199212.
  8. Indacochea S, Bueno R, De La Fuente J, Ferrufino JC, , 1997. Liver cancer in hyperendemic area of B and deltahepatitis: report of 19 cases. Rev Gastroenterol Peru 17: 5659.
  9. Barham WB, Figueroa R, Phillips IA, Hyams KC, , 1994. Chronic liver disease in Peru: role of viral hepatitis. J Med Virol 42: 129132.[Crossref]
  10. Indocochea S, Gotuzzo E, , 1993. Mortality due to viral hepatitis B in Abancay. Rev Gastroenterol Peru 13: 173177.
  11. Alter MJ, Margolis HS, , 1990. The emergence of hepatitis B as a sexually transmitted disease. Med Clin North Am 74: 15291541.[Crossref]
  12. Atkins M, Nolan M, , 2005. Sexual transmission of hepatitis B. Curr Opin Infect Dis 18: 6772.[Crossref]
  13. Heathcote J, Gateau P, Sherlock S, , 1974. Role of hepatitis-B antigen carriers in non-parenteral transmission of the hepatitis-B virus. Lancet 17: 370371.[Crossref]
  14. Lama JR, Lucchetti A, Suarez L, Laguna-Torres VA, Guanira JV, Pun M, Montano SM, Celum CL, Carr JK, Sanchez J, Bautista CT, Sanchez JL, , 2006. Association of herpes simplex virus type 2 infection and syphilis with human immunodeficiency virus infection among men who have sex with men in Peru. J Infect Dis 194: 14591466.[Crossref]
  15. Cabezas C, , 2007. Viral hepatitis B and delta in Peru: epidemiology and basis for control. Rev Peru Med Exp Salud Publica 2007: 378397.
  16. Jin F, Prestage GP, Zablotska I, Rawstorne P, Kippax SC, Donovan B, Cunningham PH, Templeton DJ, Kaldor JM, Grulich AE, , 2007. High rates of sexually transmitted infections in HIV positive homosexual men: data from two community based cohorts. Sex Transm Infect 83: 397399.[Crossref]
  17. Koike K, Kikuchi Y, Kato M, Takamatsu J, Shintani Y, Tsutsumi T, Fujie H, Miyoshi H, Moriya K, Yotsuyanagi H, , 2007. Prevalence of hepatitis B virus infection in Japanese patients with HIV. Hepatol Res 38: 310314.[Crossref]
  18. Seage GR, Mayer KH, Lenderking WR, Wold C, Gross M, Goldstein R, Cai B, Heeren T, Hingson R, Holmberg S, , 1997. HIV and hepatitis B infection and risk behavior in young gay and bisexual men. Public Health Rep 112: 158167.
  19. Stroffolini T, Corona R, Giglio A, Gentili G, Caprilli F, Prignano G, Tosti ME, Pasquini P, Mele A, , 1997. Risk factors for hepatitis B virus infection among homosexual men attending a sexually transmitted diseases clinic in Italy. New Microbiol 20: 333338.
  20. Osella AR, Massa MA, Joekes S, Blanch N, Yacci MR, Centonze S, Sileoni S, , 1998. Hepatitis B and C virus sexual transmission among homosexual men. Am J Gastroenterol 93: 4952.[Crossref]
  21. Christiansen MA, Lowhagen GB, , 2000. Sexually transmitted diseases and sexual behavior in men attending an outpatients' clinic for gay men in Gothenburg, Sweden. Acta Derm Venereol 80: 136139.
  22. Diamond C, Thiede H, Perdue T, Secura GM, Valleroy L, Mackellar D, Corey L, , 2003. Viral hepatitis among young men who have sex with men: prevalence of infection, risk behaviors, and vaccination. Sex Transm Dis 30: 425432.[Crossref]
  23. Marino R, Minichiello V, Disogra C, , 2003. Male sex workers in Cordoba, Argentina: sociodemographic characteristics and sex work experiences. Rev Panam Salud Publica 13: 311319.[Crossref]
  24. Choi KH, McFarland W, Neilands TB, Nguyen S, Secura G, Behel S, Mackellar D, Valleroy L, , 2005. High level of hepatitis B infection and ongoing risk among Asian/Pacific Islander men who have sex with men, San Francisco, 2000–2001. Sex Transm Dis 32: 4448.[Crossref]
  25. Pando MA, Bautista CT, Maulen S, Duranti R, Marone R, Rey J, Vignoles M, Eirin ME, Biglione MM, Griemberg G, Montano SM, Carr JK, Sanchez JL, Avila MM, , 2006. Epidemiology of human immunodeficiency virus, viral hepatitis (B and C), Treponema pallidum, and human T-cell lymphotropic I/II virus among men who have sex with men in Buenos Aires, Argentina. Sex Transm Dis 33: 307313.[Crossref]
  26. Gilson RJ, Hawkins AE, Beecham MR, Ross E, Waite J, Briggs M, McNally T, Kelly GE, Tedder RS, Weller IV, , 1997. Interactions between HIV and hepatitis B virus in homosexual men: effects on the natural history of infection. AIDS 11: 597606.[Crossref]
  27. Sulkowski MS, , 2008. Viral hepatitis and HIV coinfection. J Hepatol 48: 353367.[Crossref]
  28. McMahon BJ, , 2005. Epidemiology and natural history of hepatitis B. Semin Liver Dis 25: S3S8.[Crossref]
  29. Hijar J, Suarez M, Padilla C, Cabezas C, , 2007. Genotyping of hepatitis B virus in patients of endemic areas from Peru. Rev Peru Med Exp Salud Publica 24: 427430.
  30. Graham D, McClean H, , 2007. Yorkshire regional audit of hepatitis B vaccination. Int J STD AIDS 18: 212214.[Crossref]
  31. Warwick Z, Dean G, Carter P, , 2007. B safe, B sorted: results of a hepatitis B vaccination outreach programme. Int J STD AIDS 18: 335337.[Crossref]
  32. Sethi G, Holden BM, Greene L, Gaffney J, Ward H, , 2006. Hepatitis B vaccination for male sex workers: the experience of a specialist GUM service. Sex Transm Infect 82: 8485.[Crossref]
  33. Collier AC, Corey L, Murphy VL, Handsfield HH, , 1998. Antibody to human immunodeficiency virus (HIV) and suboptimal response to hepatitis B vaccination. Ann Intern Med 109: 101105.[Crossref]
  34. Keet IP, van Doornum G, Safary A, Coutinho RA, , 1992. Insufficient response to hepatitis B vaccination in HIV-positive homosexual men. AIDS 6: 509510.[Crossref]
  35. Yee LJ, Rhodes SD, , 2002. Understanding correlates of hepatitis B virus vaccination in men who have sex with men: what have we learned? Sex Transm Infect 78: 374377.[Crossref]
  36. Rudy ET, Detels R, Douglas W, Greenland S, , 2003. Factors affecting hepatitis vaccination refusal at a sexually transmitted disease clinic among men who have sex with men. Sex Transm Dis 30: 411418.[Crossref]
  37. McMillan A, , 2005. Hepatitis B vaccination of men who have sex with men: experience with an accelerated course of vaccination in a genitourinary medicine clinic. Int J STD AIDS 6: 633635.[Crossref]
  38. Gunn RA, Lee MA, Murray PJ, Gilchick RA, Margolis HS, , 2007. Hepatitis B vaccination of men who have sex with men attending an urban STD clinic: impact of an ongoing vaccination program, 1998–2003. Sex Transm Dis 34: 663668.[Crossref]

Data & Media loading...

  • Received : 02 Jan 2010
  • Accepted : 16 Mar 2010

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error