THE NETHERLANDS: Trends in Hepatitis A, B and Shigellosis Compared with Gonorrhea and Syphilis in Men Who Have Sex with Men in Amsterdam, 1992-2006 CDC Daily UpdateImportant note: Information in this article was accurate in 2008. The state of the art may have changed since the publication date.

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THE NETHERLANDS: Trends in Hepatitis A, B and Shigellosis Compared with Gonorrhea and Syphilis in Men Who Have Sex with Men in Amsterdam, 1992-2006

Sexually Transmitted Diseases Vol. 35; No. 11: P. 930-934 (11..08) - Monday, December 15, 2008
Gini G.C. Van Rijckevorsel, MD, MSc; Gerard J.B. Sonder, MD, PhD, MSc; Lian P.M.J. Bovee, MSc; Harold F.J. Thiesbrummel, MD; Ronald B. Geskus, PhD; Anneke Van Den Hoek, MD, PhD


Noting that sexually transmitted infections (STIs) among men who have sex with men (MSM) have increased since the mid-1990s and appear to be related to more risky sexual behavior, the study authors compared trends in hepatitis A, acute hepatitis B, and shigellosis with trends in gonorrhea and infectious syphilis in Amsterdam MSM over a period of 15 years.

Data of all reported hepatitis A, acute hepatitis B, and shigellosis between Jan. 1, 1992, and Dec. 31, 2006, were examined, as were data from all patients newly diagnosed with gonorrhea and infectious syphilis at Amsterdam's Public Health Service STI outpatient department for this period.

Hepatitis A incidence remained unchanged in MSM (mean 0.97 per 1,000 MSM, range 0.04-2.27), who comprised 21 percent of all 1,697 infections. Likewise, hepatitis B remained unchanged in MSM (mean 0.47 per 1,000 MSM, range 0.19-0.77), who had 41 percent of all 448 infections. Shigellosis is mostly travel- related (657/974), and 16 percent of cases occurred in MSM. Its incidence dropped in general, but not in MSM. Both infectious syphilis and gonorrhea in MSM showed steep increases, primarily after 1998.

"Hepatitis A, B, and shigellosis do not follow the rising trends of conventional STI in MSM, which are believed to result from increased risky sexual behavior," the authors concluded. "This disparity in trends implies differences in transmission dynamics. Recent molecular epidemiological studies suggest that clustered transmission in social MSM networks plays a major role."
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