Hepatitis A Screening and Vaccination Among People Living with HIV: When is the Ideal Time?

Introduction:This study aimed to determine the hepatitis A seroprevalence and vaccination status among [people living with Human Immunodeficiency Virus (HIV) (PLWH)], assess serologic responses to vaccination, and identify age groups for which hepatitis A vaccination is recommended.Materials and Methods: This research was conducted between January 2019 and 2024, comparing groups with positive and negative antihepatitis A virus (HAV) immnoglobulin G (IgG) antibodies based on age and sex.A receiver operating characteristic (ROC) analysis was performed to identify the optimal age cutoff for predicting anti-HAV IgG positivity.Anti-HAV IgG serology was screened at least 1 month after the second vaccine dose to evaluate antibody formation.Results: Of the 1,140 participants, 61.5% tested positive for anti-HAV IgG at baseline.Those with positive results exhibited significantly higher mean age (44.611.6 years) than those with negative results (33.78.6 years; p<0.001).Seropositivity was significantly higher among women (75.0%, n=87/702; p=0.002) and individuals >40 years of age (83.3%, p<0.001).The ROC analysis identified 40 years as the optimal age cutoff, with an area under the curve of 0.78 (95% confidence interval, 0.75-0.81),a sensitivity of 61.6%, and a specificity of 80.1%.Of the seronegative individuals, 86.1% received two vaccine doses; of the 268 with follow-up anti-HAV IgG serology, 86.1% had seroconverted and the results of 109 patients are still awaited. Conclusion:Examining individuals living with HIV for hepatitis A antibodies at their initial hospital admission is critical so that those with seronegativity can be vaccinated with two doses of hepatitis A. Vaccination can be administered to those <40 years of age without prior serological testing.These findings provide valuable insights for developing hepatitis A vaccination policies and monitoring strategies for PLWH.