International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2026
Dual susceptibility to hepatitis A and B among people newly diagnosed with HIV in Taiwan during the vaccination era: A multicenter study.
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Chiu Po-Wei, Tsai Tsung-Yu, Huang Sung-Hsi, Wu Tzong-Yow, Liu Wang-Da, Chen Andrew Po-Liang, Lin Kuan-Yin, Tsai Chin-Shiang, Hung Chien-Ching
Аннотация
OBJECTIVES: Taiwan's universal infant hepatitis B virus (HBV) vaccination (1984-1986) and sanitation-driven loss of childhood hepatitis A virus (HAV) exposure have reshaped hepatitis immunity. During a 2025-2026 hepatitis A resurgence, joint susceptibility to vaccine-preventable hepatitis among people with HIV (PWH) and HBV serology of those starting tenofovir-sparing antiretroviral therapy (ART) remain undescribed.
METHODS: We categorized 1202 adults newly diagnosed with HIV at six hospitals in Taiwan during 2018-2024 into eight 5-year birth cohorts. Multivariable logistic regression identified predictors of HAV susceptibility and the HBV-susceptible pattern (HBsAg, anti-HBs, anti-HBc all negative). HBV serology of tenofovir (TFV)-sparing ART initiators was characterized.
RESULTS: Among 1055 PWH with complete HAV and HBV serology, immunity to both fell from 60.7% (<1970) to 10.0% (≥2000), while dual susceptibility rose from 4.5% to 41.7% (peak 46.5%, 1995-1999; P < 0.001). HBsAg positivity declined from 17.4% to 1.6% and anti-HAV seropositivity from 74.5% to 11.3% (both P < 0.001). Of 22.8% starting TFV-sparing ART, 43.0% were HBV-susceptible, and one had chronic HBV.
CONCLUSION: A widening immunity gap in younger PWH reflects HBV vaccination and lost childhood HAV exposure. Systematic screening, immune-status-tailored vaccination, and HBV-informed ART selection at HIV diagnosis are warranted irrespective of perceived vaccination status.
METHODS: We categorized 1202 adults newly diagnosed with HIV at six hospitals in Taiwan during 2018-2024 into eight 5-year birth cohorts. Multivariable logistic regression identified predictors of HAV susceptibility and the HBV-susceptible pattern (HBsAg, anti-HBs, anti-HBc all negative). HBV serology of tenofovir (TFV)-sparing ART initiators was characterized.
RESULTS: Among 1055 PWH with complete HAV and HBV serology, immunity to both fell from 60.7% (<1970) to 10.0% (≥2000), while dual susceptibility rose from 4.5% to 41.7% (peak 46.5%, 1995-1999; P < 0.001). HBsAg positivity declined from 17.4% to 1.6% and anti-HAV seropositivity from 74.5% to 11.3% (both P < 0.001). Of 22.8% starting TFV-sparing ART, 43.0% were HBV-susceptible, and one had chronic HBV.
CONCLUSION: A widening immunity gap in younger PWH reflects HBV vaccination and lost childhood HAV exposure. Systematic screening, immune-status-tailored vaccination, and HBV-informed ART selection at HIV diagnosis are warranted irrespective of perceived vaccination status.