Sexually transmitted viral hepatitis have a rising incidence in MSM. During the ANRS IPERGAY PrEP trial (NCT 01473472), vaccination against HAV and HBV was offered free of charge to non-immune participants. We assessed baseline immune status, vaccine acceptability and efficacy in IPERGAY participants.
All subjects included in the IPERGAY blind and/or open phases were studied. HAV and HBV immune status were assessed at baseline and after vaccination. Anti-HAV IgGs and anti-HBs antibodies (Abs) were analyzed on available samples taken 1 to 3 months after each vaccine dose and on the latest available sample. The vaccination scheme was analyzed in subjects with a follow-up >6 months after receiving the 1st vaccine dose. Vaccination was considered incomplete when the last dose was not administered (3rd if HBV, 2nd if HAV). Subjects who started vaccination before trial initiation were excluded from acceptability and efficacy analyses. Sociodemographic factors associated with baseline immune status were explored by univariate analysis.
A total of 429 subjects were analyzed. Two subjects were excluded because of isolated anti-HBc Abs at baseline. The median follow-up was 2.2 years (IQR 1.6-2.9). Absence of anti-HAV IgG at baseline (50%, 215/427) was associated with younger age (p=0.0001) and tobacco use (p=0.02). HBV immunization after infection and vaccination was noted for 12% (50/427) and 67% (287/427) of subjects, respectively. Absence of prior HBV immunization (21%, 90/427) was associated with tobacco use (p=0.05). Among HAV non-immune subjects, 96% (207/215) received ≥1 dose of HAV vaccine and 91% (172/189) received a complete scheme. Among HBV non-immune subjects, 98% (88/90) received ≥1 dose of HBV vaccine and 79% (58/73) received a complete scheme. Among subjects with complete scheme, anti-HAV IgG and anti-HBs Abs were detected on last available sample in 93% (148/159) and 80% (44/55) respectively. Among subjects with incomplete scheme, anti-HAV IgG and anti-HBs Abs were detected on last available sample in 80% (12/15) and 36% (5/14) respectively. After the 1st dose of HBV vaccine 63% (37/59) of subjects developed anti-HBs Abs.
The acceptability and efficacy of HAV and HBV vaccination were high in the IPERGAY population. High receptivity to prevention messages and free of charge vaccination may have favored the acceptability. Physicians must consider HAV and HBV vaccination in subjects receiving PrEP.