Molecular epidemiological studies show that hepatitis A virus is endemic among active homosexual men in Europe

Kathrine Stene-Johansen*, Grace Tjon, Eckart Schreier, Viviane Bremer, Sylvia Bruisten, Siew Lin Ngui, Mike King, Rosa M. Pinto, Lluis Aragonès, Anne Mazick, Sylvie Corbet, Lena Sundqvist, Hans Blystad, Helene Norder, Kjell Skaug

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

63 Citations (Scopus)


Large outbreaks of hepatitis A have occurred in Denmark, Germany, the Netherlands, Norway, Spain, Sweden, and the United Kingdom during the period 1997-2005 affecting homosexual men. A collaborative study was undertaken between these countries to determine if the strains involved in these hepatitis A outbreaks were related genetically. The N-terminal region of VP1 and the VP1/P2A region of the strains were sequenced and compared. The majority of the strains found among homosexual men from the different European countries formed a closely related cluster, named MSM1, belonging to genotype IA. Different HAV strains circulated among other risk groups in these countries during the same period, indicating that specific strains were circulating among homosexual men exclusively. Similar strains found among homosexual men from 1997 to 2005 indicate that these HAV strains have been circulating among homosexual men for a long time. The homosexual communities are probably too small within the individual countries to maintain HAV in their population over time, whereas the homosexual communities across Europe are probably sufficiently large to sustain continued circulation of homologous HAV strains for years resulting in an endemic situation among homosexual men.

Original languageEnglish
Pages (from-to)356-365
Number of pages10
JournalJournal of Medical Virology
Issue number4
Publication statusPublished - Apr 2007


  • HAV
  • Homosexual men
  • Molecular epidemiology
  • Outbreaks


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