Hepatitis A virus infection and hepatitis A vaccination in human immunodeficiency virus-positive patients: A review

Table 3 Outbreaks of acute hepatitis A in the injecting drug user population

Ref.	Location	Study period	Total patients	IDU	HIV-positive individuals	Age (yr)	Risk factors1 and comments
	Europe
Widell et al[74]	Malmo, Sweden	1970-1979	323	188	NA	NA
Sundkvist et al[75]	Helsingborg, Sweden	1983-1984	36	32	NA	18-35	The outbreak was associated with intrarectal transportation of illicit drugs
Leino et al[76]	Helsinki, Finland	1994-1995	238	131	NA	31	The outbreak was associated with intrarectal transportation of illicit drugs
Stene-Johansen et al[77]	Oslo, Norway	1995-1996	621	492	NA	NA	The outbreak was associated with needle sharing
O’Donovan et al[78]	United Kingdom	1998-1999	27	14	NA	25
Syed et al[79]	Bristol, United Kingdom	2000	123	69	NA	25	The outbreak was associated with parenteral transmission from contaminated illicit drugs; HAV vaccination of IDUs decreased the reported cases
Roy et al[80]	Aberdeen, Scotland	2000-2002	106	74	NA	NA	Not washing hands after using the toilet, or before preparing food or drugs, sharing needles/syringes, and injecting contact with jaundiced persons
Spada et al[81]	Terni, Italy	2002-2003	47	35	2	34	Contact with jaundiced persons, but not related to injecting practices; HAV vaccination of IDUs decreased the reported cases
	North America
Harkess et al[82]	Oklahoma, United States	1984-1987	79	42	NA	23-27
Jenkerson et al[83]	New York, United States	1986-1987	256	70	NA	NA
Jin et al[84]	Canada	1987-1989	65	59	NA	NA
Hutin et al[85]	Iowa, United States	1996-1997	158	9.7%	NA	NA	Methamphetamine injection, sharing methamphetamine use, using brown methamphetamine, and needle sharing
Vong et al[86]	Florida, United States	2001-2002	403	11%	NA	32	HAV vaccination in jail decreased the reported cases
	Asia-Pacific region
Shaw et al[87]	Queensland, Australia	1997	875	118	NA	NA	Sharing of instruments for smoking marijuana
Manor et al[88]	Tel-Aviv, Israel	2012-2013	75	9	NA	33

¹Risk factors of acquiring HAV infection were identified by case-control studies. HAV: Hepatitis A virus; HIV: Human immunodeficiency virus; IDU: Injecting drug user; NA: Not available.