Men Who Have Sex with Men and Viral Hepatitis
Men who have sex with men should be tested for hepatitis B and vaccinated against hepatitis A and hepatitis B.
Because men who have sex with men (MSM) have a high prevalence of hepatitis B, CDC recommends hepatitis B testing for MSM. However, hepatitis B testing is not a requirement for vaccination.
CDC and the Advisory Committee on Immunization Practices (ACIP) recommend hepatitis A and hepatitis B vaccination for men who have sex with men (MSM). The hepatitis A and hepatitis B vaccines can be given separately or as a combination vaccine using a recommended schedule. Adult vaccination rates are low and many men remain at risk for hepatitis A and hepatitis B.
CDC also recommends one-time hepatitis C testing of all adults (18 years and older) and regular testing for people with risk factors.
MSM and Hepatitis A
Despite the availability of a safe and effective vaccine, Hepatitis A outbreaks among MSM have been reported frequently. Widespread outbreaks of hepatitis A are occurring across the U.S. and many are affecting gay and bisexual men. Since 1996, ACIP has recommended hepatitis A vaccination of MSM. Despite this longstanding recommendation, hepatitis A vaccination coverage among this population remains low, with vaccination coverage estimated at 25%–45% overall.
MSM and Hepatitis B
The hepatitis B vaccine is safe and effective, and both ACIP and CDC recommend routine hepatitis B vaccination for MSM. CDC also recommends hepatitis B testing for MSM because of the high prevalence of hepatitis B in this population and the population’s ongoing risk for infection. Hepatitis B testing for MSM is recommended as a component of prevaccination testing for these adults and consists of testing for HBsAg, anti-HBs, and anti-HBc. However, serologic testing should not be a barrier to vaccination of susceptible persons, especially in populations that are difficult to access. The first dose of hepatitis B vaccine should be administered during the same medical visit immediately after blood is collected for serologic testing. Hepatitis B testing of MSM is not a requirement for vaccination, and in settings where testing is not feasible, vaccination should continue without testing.
Scientific Guidelines and Recommendations
Prevention of Hepatitis A Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices, 2020
CDC Recommendations for Hepatitis C Screening Among Adults — United States, 2020
MMWR 2020; 69(2);1–17
Prevention of Hepatitis B Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices
MMWR 2018;67(No. RR-1):1–31
Recommendations for Identification and Public Health Management of Persons with Chronic Hepatitis B Virus Infection
Health care Provider Resources
- Hepatitis A Tools and Resources
- MMWR: Notes from the Field: Increase in Reported Hepatitis A Infections Among Men Who Have Sex with Men — New York City, January–August 2017
- Hepatitis A Outbreak Resources
- Hepatitis B Tools and Resources
- Hepatitis C Tools and Resources
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Hepatitis A Outbreak Resources