Viral Hepatitis And Men Who Have Sex with Men

Two men together

Key Facts about Viral Hepatitis in Men Who Have Sex with Men (MSM)

  • Among adults, an estimated 10% of new Hepatitis A cases and 20% of new Hepatitis B cases occur in MSM.
  • MSM are at increased risk for Hepatitis C if they are involved in high-risk behaviors.
  • There is no vaccine for Hepatitis C and testing for Hepatitis C is not recommended for MSM unless they were born from 1945 through 1965, have HIV, or are engaging in risky behaviors. The best way to prevent Hepatitis C is by avoiding behaviors that can spread the disease, especially sharing needles or other equipment to inject drugs.

Hepatitis A and Hepatitis B Vaccine Recommendation for Men Who Have Sex with Men

CDC and the Advisory Committee on Immunization Practices (ACIP) recommend Hepatitis A and Hepatitis B vaccination for MSM.

  • The Hepatitis A and B vaccines can be given separately or as a combination vaccine using a recommended schedule.

Rationale for the Recommendation

Hepatitis A

Since 1996, ACIP has recommended Hepatitis A vaccination of MSM.

  • Hepatitis A outbreaks among MSM have been reported frequently. Cyclic outbreaks have occurred in urban areas in the United States and can occur in the context of an outbreak in the larger community.

Hepatitis B

ACIP and CDC recommend routine Hepatitis B vaccination for MSM.  Because of higher rates of infection among this population, CDC also recommends Hepatitis B Surface Antigen (HbsAg) testing to determine if a person is or has been infected with Hepatitis B and if the vaccine series is needed for protection.

  • The first dose of the vaccine and HbsAg testing should be done during the same medical visit. However, HbsAg testing is not a requirement for vaccination.  In settings where testing is not possible, vaccination of recommended populations should continue.

Scientific Guidelines and Recommendations

MMWR 2015;64(No.3)

Recommendations for Identification and Public Health Management of Persons with Chronic Hepatitis B Virus Infection
MMWR 2008;57(RR-8)

Prevention of Hepatitis A Through Active or Passive Immunization: Recommendations of the Advisory Committee on Immunization Practices (ACIP)
MMWR 2006;55(RR-7)

Hepatitis B Vaccination Recommendations for Adults; Appendix A, B, C
MMWR 2006 ;55(RR-16)

Recommendations for the Identification of Chronic Hepatitis C Virus Infection Among Persons Born During 1945–1965
MMWR 2012; Vol. 61 (RR-4)

Recommendations for Prevention and Control of Hepatitis C Virus (HCV) Infection and HCV-Related Chronic Disease
MMWR 1998;47(RR-19)

Healthcare Provider Resources

Patient Resources